OFFER METHADONE THERAPY YESTERDAY

Handwringing was understandable as a first response to learning this week
that nearly one in three high school seniors in Seattle and King County
regularly smokes marijuana and that cocaine use is resurging after years of
decline.

Handwringing is not an understandable, or acceptable, reaction to learning
that King County is right on track this year to equal 1998's tally of deaths
from heroin overdoses.

Through May of this year, heroin fatalities numbered 43, according to the
medical examiner's office. That's precisely the number recorded through May
1998. The count soared to 144 by year's end, making Seattle and King County
the country's heroin capital.

What's worse than the weight of that distinction is the appalling lack of
cooperation from state legislators who wield the power to help the county
begin reversing the trend. Despite the urgency of the problem, legislators
adjourned without sending Gov. Gary Locke the bill that would have reformed
the antiquated system of providing methadone treatment.

Like too many pieces of worthy legislation, SB5019 passed the Senate --
unanimously -- but fell prey in the House to the gamesmanship endemic to the
49-49 split between the political parties.

Now, while marching toward another record toll, Seattle and King County will
be prevented from providing enough of the treatment that has been medically
proven for years. It's not only a matter of redeeming individuals lost to
heroin; discontinuing intravenous drug use also reduces the risk of
hepatitis, AIDS and other blood-borne infectious diseases.

The demand for help is profound. The county's injection drug users number
between 12,000 and 18,000, yet the treatment capacity is 2,100. What
exacerbates the problem in King County is the influx of heroin addicts from
nearby counties; only four Washington counties have clinics that dispense
methadone. The disparity is so laughable that addicts don't bother to sign
up on waiting lists.

"We need a system that puts people into treatment immediately, not one that
puts them on an extended waiting list," Greg Nickels, chairman of the King
County Board of Health, rightly said in a letter last month to the state
Division of Alcoholism and Substance Abuse. Nickels, a King County
Councilman, also noted that more than half the county clients pay for their
own treatment.

Olympia knows what Seattle and King County need. As early as the first day
of the 2000 session, the Legislature should agree to:

- - Rescind the cap of 350 clients for each methadone clinic, and transfer
authority for siting the clinics from the counties to the state. Since the
state already licenses all treatment clinics for alcoholism and drugs other
than heroin, it can handle methadone clinics as well. If these clinics are
responsibly run -- and there's nothing on the record to show they aren't --
they should not fall prey to NIMBY attacks.

- - Encourage a shift of the treatment burden from King, Pierce, Spokane and
Yakima counties.

- - Explore allowing physicians in private practice to dispense methadone to
addicts who have already completed the initial round of treatment at the
licensed clinics. These patients, stable enough to need only the daily dose
of methadone with periodic checkups, would then create space for those on
the waiting list to begin recovery.

In an admirable step -- admirable because Connecticut has yet to distinguish
itself as a heroin capital -- legislators there have already authorized a
pilot project to determine the pluses and minuses of methadone being
dispensed away from clinics. Study results, due next spring, could provide a
model for Washington state.

It shouldn't take a crisis -- defined here as the needless deaths of 187
King County residents in 17 months -- to motivate the state to help some of
its most desperate citizens. Like free birth control for women who've
already given birth to drug-addicted babies, methadone treatment ought to be
available on demand.