DESPITE SUCCESSES, MANY WARY OF METHADONE

Drug Blocks Heroin Cravings but Is Rarely Used Under Prop. 36.

For more than three decades, Eddie Vela "chased the bag," desperately
seeking heroin to feed his addiction.

He started shooting up at age 13 after his alcoholic father kicked him
out of the house, and he spent most of his adult life on the streets
or in prison.

That all changed last year when he became eligible for treatment under
Proposition 36, the voter-approved initiative requiring treatment
instead of prison for nonviolent drug offenders.

Vela kicked his heroin habit by entering a methadone program at the
Bi-Valley Medical Clinic in Sacramento.

"I don't crave for drugs anymore," the 48-year-old former addict said.
"Every day I wake up, and I don't have to think anymore that I have to
go make some money (for heroin) and get well."

Methadone, a medication that blocks the craving for heroin for about
24 hours, is the most successful treatment for heroin and other opiate
addictions, according to the National Institute on Drug Abuse.

But it is the most controversial, least used and arguably most
problematic treatment offered under Proposition 36.

Almost 10 percent of Proposition 36 participants are heroin users, but
only 1 percent of those sentenced to treatment under the initiative
get methadone.

A University of California, Los Angeles, study of Proposition 36 found
lower success rates for heroin users than other drug offenders in the
program and suggested more could kick their habits with methadone.

"You would quickly get 2 to 3 percent higher completion rates with
potentially many hundreds fewer people going to jail," said Dave
Fratello, one of Proposition 36's authors. "There is just an inherent
bias against it (from people who believe) you need to stop all drugs."

Kathryn Jett, director of the state Department of Alcohol and Drug
Treatment Programs, said most of the opposition to methadone stems
from a misunderstanding of the treatment regimen.

"They think it's just a dispensing office when, in fact, a
well-managed methadone clinic would not only dispense but provide
regular routine counseling and medical oversight," she said.

Methadone is not an intoxicating drug when it's used properly. But it
can be intoxicating and deadly if it's mishandled, too much is
ingested or it is combined with other drugs.

In a tragic case in Berkeley, for instance, a 3-year-old took his
aunt's methadone and died.

Its use is tightly monitored because the medication can be sold on the
street to other drug users seeking a high or relief from addiction.
But street sales still happen.

In Los Angeles, for instance, the Martin Luther King Jr. methadone
treatment program was shut down for several problems, including a
nurse who stole the drug and sold it on the street.

Proposition 36 also poses an additional hurdle for methadone
treatment. It pays for just 18 months of treatment, and most former
addicts will take methadone for longer than that. They must find
another way to pay for their doses or wean themselves off methadone.

Jett said state officials are trying to increase the use of methadone
under Proposition 36 by educating county officials about its
effectiveness and the use of counseling with the medication.

For Vela, who is receiving methadone in Sacramento, the counseling
helped him succeed.

For the first time, he said he's forging relationships with his six
children and 10 grandchildren. He's stayed out of prison for more than
a year, and he's free of the constant search for heroin.

"This program works," Vela said. "It works really well."