DRUG CZAR CRITICIZES GOV. DEAN

MONTPELIER - The nation's top drug official criticized Gov. Howard B. Dean
Wednesday for threatening to veto a bill that would make methadone
treatment available to heroin addicts in Vermont.

During remarks made at a national conference on methadone treatment in San
Francisco, Barry McCaffrey found fault with the governor's arguments
against using methadone maintenance treatment to combat heroin addiction.

"I find that ... so set up nicely - like central casting stepped forward to
articulate a line of argument that doesn't make any sense," McCaffrey said,
responding to one of Dean's concerns that a methadone clinic would attract
heroin addicts to Vermont. "... Does this mean we're going to outlaw Prozac
so that depressed, schizophrenic patients won't move to Vermont?"

McCaffrey, director of the Office of National Drug Control, compared Dean
to New York City Mayor Rudolph Giuliani, who mounted an unsuccessful effort
two years ago to rid the city of methadone clinics. McCaffrey was similarly
critical of Giuliani's attempts in 1998.

"This should be an interesting test case," he said. "If Giuliani was the
test case for New York City, Gov. Dean may be the test case for his state."

McCaffrey's comments came in response to a question from Mark Beresky, a
Vermonter who attended the American Methadone Treatment Association
Conference in San Francisco. Beresky, of Dummerston, is an advocate of
bringing methadone to Vermont and has testified before both Vermont Senate
and House committees in support of a bill that would open up the treatment
in the state. A former heroin addict, Beresky receives methadone treatment
from a clinic in Greenfield, Mass.

Dean has been vocal about his opposition to the use of methadone, a
synthetic narcotic that has been used for decades to blunt withdrawal
symptoms of heroin addicts.

In a letter to McCaffrey Thursday, Dean fired back.

"I would recommend that the next time you comment on Vermont's approach to
drug treatment that you learn something about Vermont first," he wrote. "My
opposition to methadone is based on the destruction that methadone clinics
often create in communities because of the once-a-day dosing schedule."

Dean went on to challenge the effectiveness of McCaffrey's approach to the
nation's heroin problem.

"Since your efforts to curb heroin use in the rest of the country have met
with such obvious failure, we prefer to find a Vermont solution to this
very difficult problem," he wrote.

Dean said his opposition is based on his personal experience as a physician
and as a politician. He cites former heroin users who have contacted him
detailing the addictive effects of methadone when misused and concerns from
law enforcement officials who say clinics are magnets for dealers and addicts.

The bill is now under review by the House Health and Welfare Committee. It
directs the Department of Health, in consultation with an appointed
advisory panel, to draft guidelines for a system of care that combines
counseling and pharmacological treatments.

The proposal cites three drug treatments that have been approved by the
Federal Drug Administration, including methadone.

The measure was passed in the Senate last month with enough votes to
override Dean's veto.

According to House lawmakers who support the bill, it is unclear if there
are enough House votes to withstand a veto.

Supporters are continuing to work on the proposal, with some expressing
hope a compromise could be reached.

"We have a (heroin) problem we have to do something about," said Rep. Ann
Pugh, D-South Burlington, vice chairwoman of the committee, after a meeting
with the governor Wednesday. "Right now, we're doing something that isn't
going to pass. Is there something acceptable? We're talking."

Rep. Karen Kitzmiller, D-Montpelier, told fellow committee members that she
had met with the governor and was encouraged that a middle ground could be
found. Kitzmiller noted particularly a proposal she pitched that would
establish the clinics in certain hospitals that were best equipped to deal
with methadone. The hospital scenario decreases the likelihood of clinics
becoming drug dealer outposts because of security and the difficulty in
separating the methadone patients from other patients, she said.

Dean acknowledged Kitzmiller's proposal as a good one Wednesday, saying he
is working with the committee to come up with an alternative.

Dean did support one proposal on the bill offered by Rep. Paul Poirier,
D-Barre city, though it is doesn't appear to have the necessary support to
move out of committee. Poirier's amendment would require the Legislature to
revisit the matter next year before any system is put in place.