DOCTOR CHALLENGED OVER DETOX METHOD

MERCHANTVILLE, N.J. (AP) -- 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 Gooberman's
procedure was not the cause of any patient's death.

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

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
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 and magazine programs praising the
method. The procedure also has been depicted on TV medical dramas.

At least a dozen 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 initiating methadone maintenance
therapy both 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.

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.

"There is no evidence of a cause-and-effect relationship between the
procedure and any of the deaths in question," Smith wrote in a report for
Gooberman's defense.

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

One four-year heroin addict said she was well enough to tour the Grand
Canyon three days after the procedure. Danielle, 19, says Gooberman gave
her and her parents extensive information about the procedure's risks and
aftermath.

"My parents and I pretty much think we owe my life to that procedure
because I had tried rehab eight different times," says Danielle, who says
she has been drug-free for 19 months.

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 for-profit centers.

"It cannot be an assembly line," says Oppenheim, whose company offers the
procedure at a northern New Jersey hospital.

The chief medical officer of Oppenheim's company, Dr. Clifford Gevirtz of
Mount Sinai School of Medicine in New York, is expected to testify against
Gooberman. Gevirtz says he expects the procedure eventually will gain wide
acceptance.

"If it's done properly, it brings people a humane, safe approach to detox,"
Gevirtz says.

The experts do agree on one thing: More research is needed. Under a grant
from the National Institute on Drug Abuse, the first national trial
comparing rapid detox with two forms of slow detoxification began in
September and is to last three years.