MAN, MYTH AND METHADONE

The Age Of Addiction: In The Final Part Of Our Series Gayle Killilea And
Aine O'Connor Tackle The Questions Surrounding Heroin Treatment

"NOT nearly enough is being done to counter our heroin problem. Having a
heroin addiction is just like having an addiction to drink, gambling or
anything else. Methadone treats the physical addiction to heroin but it does
not treat the psychological addiction. Methadone is like a life jacket, it
keeps you afloat. It stabilises you and enables you to think straight so
that you can start rehabilitating yourself."

These are the words of Aslan's Christy Dignam, talking about heroin
addiction. Christy can speak with authority on this ugly subject. His
short-lived heroin addiction in 1988 caused such turmoil in his professional
and personal life that he split from the successful band. They reformed in
1993 and made a successful comeback; their new album is No 2 in the Irish
charts.

When Christy decided to kick his habit and attend the Rutland Centre for
treatment and counselling, he was put on a methadone programme that
ultimately led to his complete rehabilitation.

"People have died from methadone, but more people have died from drink. If
you added up the amount of people who have died from heroin and methadone
abuse it would come nowhere near the amount of drink-related deaths," he
says. "Methadone is a strong narcotic; there are bound to be mistakes when
you use it. People take overdoses of Anadin and paracetamol and no one talks
about banning them. Methadone is definitely the lesser of two evils."

International research recognises that methadone is the most effective form
of treatment for heroin addiction. However, an analysis of last year's
Dublin City Coroners Court records has shown that methadone was involved in
37 drug and alcohol-related deaths, while heroin was implicated in 36
deaths. These figures have brought the methadone controversy to light once
again.

Dr Joe Barry, public health specialist with the Eastern Health Board, says
that before the new methadone prescribing regulations were introduced many
of those who died with methadone in their bodies had obtained it illicitly.
Since the Misuse of Drugs Act was introduced last year, illegal street
dealing in methadone has been reduced. Under the new protocol, methadone can
only be prescribed for clients on a central treatment list held by the EHB
who have been issued with photographic ID cards listing the name of the
doctor who prescribes them methadone and the name of the pharmacist who
dispenses it.

The Irish heroin epidemic remains most virulent in the Dublin area. EHB
figures show that approximately 4,000 people from Dublin, Kildare and
Wicklow are receiving drug treatment through the EHB clinics or from their GPs.

Nationwide statistics up to July this year show that 4,040 people nationwide
are receiving treatment. The heroin problem outside the east of the country
appears to be relatively non-existent.

Christy Dignam says that although there is an argument for legalising heroin
rather than replacing it with a substitute such as methadone, he does not
agree with making heroin freely available.

"I would not advocate legalising heroin, although there is an argument that
it is the only way we are ever going to manage to control it.

"There was a study done in Manchester where they showed addicts how to
inject properly and gave out free needles and heroin.

"Crime and prostitution and other problems associated with heroin dropped
dramatically. But I think that we in Ireland are not ready as a nation for
legalising heroin. If it is freely available, more people will try it.

"There is no better alternative than methadone; people talk about how it
shouldn't be used but I don't hear anyone coming up with a better alternative.

"It is very tightly controlled in this country. Methadone is available and
is clean. The heroin you buy on the street is often contaminated."

Hugh Greeves, coordinator of the Ballymun Drugs Task Force, agrees with
this. "The answer to the question of why young people use drugs is because
they are there," he says.

"Methadone is part of a response but is not the only response. It gives
addicts the stability to take a clear look at their lives, and think about
child-care and job prospects.

"It is only the first step, though; a whole rehabilitation programme is
needed. But we need to clear the current bottle-neck. There are people who
are entering methadone programmes and not coming off them they are
continuing to take methadone for long periods of time."

Another big problem facing addicts is the long waiting list for methadone
treatment, estimated to be 500-strong.

To qualify for treatment, users have to prove they are addicted to heroin by
giving urine samples over a few days. Even then they can be waiting a long
time to be approved.

This problem is of particular concern to Hugh Greeves. "There is a new
culture developing whereby more and more people are developing an aspiration
to get on a methadone programme.

"Many of them may not be heavily using heroin, but they have to prove they
are addicts to qualify for a programme so this encourages them to use more
heavily.

"Their aspirations in life should not be gaining a place on a methadone
programme. People just starting on heroin don't need methadone. They need
more job training, encouragement and options. It's no coincidence that the
big heroin areas are in unemployment blackspots. This needs to be recognised."

EHB chief executive Pat McLoughlin has appealed for people living in
drug-use areas to support the establishment of treatment services in their
communities.

The EHB has set up more than 50 treatment locations so far with 22 opened in
the past 18 months and wants to complete a region-wide infrastructure, but
they still face the "Not In My Back Yard" syndrome.

However, Hugh Greeves says Ballymun always gives a considerate response to
new addiction centres, mainly because they know it is the only way to combat
the problem.

The general consensus among experts is that while methadone is not the only
solution to the heroin problem, it is the first step towards rehabilitation.

The main issue facing Irish heroin addicts is not methadone itself, but the
shortage of rehabilitation and methadone facilities.

The answer to combatting our heroin problem is not leaving our addicts in a
haze of methadone-induced hell.

The real solution is simpler, and far more humane more post-care treatment,
support and encouragement.