2 DOCTORS MAY LOSE LICENSES OVER FAST-DETOX METHOD

Medicine: Treatment For Drug Addicts May Have Contributed To Seven
Patients' Deaths, New Jersey Health Regulators Say.

MERCHANTVILLE, N.J.--Dr. Lance L. Gooberman has devoted his medical
practice to perfecting "rapid opiate detoxification," designed to
reduce the agony of drug withdrawal and get more addicts into recovery.

Himself a recovering addict long drug-free, Gooberman says his
practice--which, unlike similar rapid-detox programs, doesn't require
a hospital stay--has successfully detoxified about 2,350 patients over
seven years and guided them into long-term recovery programs.

But over four years, seven of his patients died within days of the
procedure. Gooberman says they had undetected heart problems or took
cocaine, triggering a heart attack.

In a civil trial beginning Wednesday, state regulators will try to
strip the medical licenses of Gooberman and his former employee, Dr.
David Bradway.

"We just want to make sure these 'cutting-edge treatments' aren't
cutting off life," says Mark Herr, director of New Jersey's Division
of Consumer Affairs, which oversees the state board regulating physicians.

Gooberman and his attorney, John Sitzler, have lined up medical
experts to testify that accepted medical standards were followed and
that Gooberman's procedure was not the cause of any patient's death.

Sitzler says their patients' death rate was just 0.3%, lower than for
many surgical procedures, and that outpatient procedures involving
anesthesia are commonly performed in physicians' offices.

Procedure May Cause Severe Physical Stress

Gooberman's program, U.S. Detox Inc., uses medications to rapidly
flush the opiate drugs--heroin, morphine, methadone and prescription
painkillers--out of addicts' bodies to ease withdrawal symptoms such
as diarrhea and tremors. The patients are anesthetized during the
approximately four-hour procedure in his office.

He then implants a pellet of medicine in the abdomen that prevents
patients from "getting high" if they take opiate drugs during the
crucial first two months of recovery. "I'm just trying to come up with
a better way to do detox," Gooberman says.

Gooberman, 49, for years was addicted to the stimulant
methamphetamine, but he says he has been drug-free for 14 years after
a six-week stay in a hospital psychiatric unit triggered by a drug
binge.

Rapid opiate detoxification was first performed in the late 1980s in
Europe. Gooberman and other doctors who pioneered it in this country
have appeared on television talk shows praising the method. The
procedure also has been depicted on TV medical dramas.

At least 12 other U.S. physicians perform variations on rapid detox,
but in a hospital and with an overnight stay required.

Some have published articles in medical journals indicating many more
patients were drug-free after six months than with traditional
detoxification programs. And a handful of insurance plans have begun
paying for the procedure.

But even doctors who perform rapid detoxification say it severely
stresses addicts' ravaged bodies, and at least a dozen of the
thousands of American and European patients who underwent the
procedure in a hospital also died. The slower, traditional
detoxification and the use of methadone maintenance therapy have been
documented to kill some patients as well.

New Jersey's lawyers are expected to stress that Gooberman and Bradway
are the only doctors known to perform detoxification as an outpatient
procedure.

The state alleges, among other things, that the doctors did not have
sufficiently trained support staff and adequate emergency equipment,
warn patients enough about the method's risks or properly instruct the
caregiver taking the patient home. The doctors deny all of that.

Experts Say More Research Is Needed

Rapid opiate detoxification has been approved by the professional
organization for doctors in their specialty, the American Society for
Addiction Medicine, as long as it's "performed by adequately trained
staff with access to appropriate medical equipment," according to the
society's executive vice president, James F. Callahan.

Former society president Dr. David E. Smith, a San Francisco addiction
specialist, says he regards Gooberman's program as the best in the
country.

Patients treated by Gooberman and Bradway have promised to testify on
the doctors' behalf.

Bennett Oppenheim, a psychologist who once oversaw treatment at
several U.S. rapid detox centers run by a for-profit company, says he
now believes the procedure should be done in hospitals, not in
for-profit centers.

Experts agree that more research is needed. Under a grant from the
National Institute on Drug Abuse, a three-year national trial
comparing rapid detox with two forms of slow detoxification began in
September.