PROPOSAL WOULD ALTER DRUG REHAB

Doctors Would Have More Autonomy In
Dispensing Methadone, Used To Treat Heroin Addicts.

In a change in approach that tips government policy toward the idea that
drug addiction is a disease, federal officials announced yesterday a plan
to give doctors greater autonomy in running methadone-maintenance programs
- - treatment designed to keep addicts away from heroin.

"We're talking about sensible drug treatment for 810,000 Americans," said
Barry McCaffrey, chief of the White House Office of National Drug Policy.
He made the announcement at the Veterans Administration Medical Center in
West Philadelphia.

According to the proposal published in the Federal Register, the Food and
Drug Administration, which currently stringently monitors the supply of
methadone to treatment clinics, would hand over control to the Center for
Substance Abuse Treatment, a wing of the Department of Health and Human
Services.

The center would not prescribe specific rules. Instead, it would outline
standards of care, measure results, and accredit centers that measure up.
Doctors at the clinics would be allowed to choose from a range of
drug-control treatments.

"Drug treatment saves money, saves lives," said Wesley Clark, director of
the Center for Substance Abuse Treatment.

"Nowhere else in medicine would treatment be held to standards of 30 years
ago," he said. "The new program is designed to put patients first."

Flexibility

Currently addicts in methadone-maintenance programs receive treatment
according to rigid, one-size-fits-all federal policies.

Eventually, Clark said, the government might allow addicts to be treated at
doctors' offices and get prescriptions written for methadone. The thinking
is that the change would bring more addicts in for treatment, reduce the
stigma of drug addiction, and rehabilitate them.

As many as 170,000 people are in methadone-maintenance plans nationwide.
John Carroll, CEO at Parkside Recovery, one of 10 Philadelphia centers,
estimated that there were 3,500 patients in Philadelphia alone. Methadone
helps control the craving that drives recovering addicts to relapse.

McCaffrey said that methadone-maintenance programs reduce addiction,
decrease crime, and move addicts into the "tax-paying" workforce.

Encouraging Companies

Researchers have been working for years to develop medicines that wean
addicts from drugs or make drug-taking unpleasant. Methadone falls under
the first category. Others are being developed for cocaine, nicotine and
alcohol addictions.

The federal officials also hope that medicalizing addiction will encourage
pharmaceutical companies to find medicines that fight drug addictions. They
further hope to encourage insurance companies to treat drug treatment as a
routine medical procedure.

The medicalization of the war against drugs has been controversial. Doctors
have long campaigned that drug addictions were medical problems. But many
groups have argued against a "treatment" approach toward people who they
say voluntarily made "bad choices."

Drug policy chief McCaffrey said yesterday that he continued to oppose
"harm-reduction" proposals.

He has staunchly opposed programs that distribute free needles to addicts
in order to reduce the risk of transmitting AIDS. He has also fought any
attempts to legalize marijuana or have it approved for treatment of any
medical conditions.