TREATMENT GOES UNFUNDED

State Spurns Requests For Methadone Funding, Despite Epidemic Of Heroin Deaths.

ORLANDO -- Lin Lindsay greets about 20 heroin addicts outside her office
building just after dawn.

They've come to the Center for Drug-Free Living, where Lindsay is director
of medical services, for methadone. Methadone is a viscous red liquid that
looks and tastes like cherry cough syrup -- and suppresses an addict's
craving for heroin.

With methadone, the center's 125 heroin-addicted clients hold jobs and
maintain families. Some are in the entertainment industry. One is a pilot
for a major airline. Some have been in the program for as long as 18 years.

But three years ago, the state eliminated its methadone funding for the
Center for Drug-Free Living, which up until then offered the area's only
state-supported methadone program.

Since then, deaths from heroin addiction in the Central Florida area have
almost tripled. The number of Central Floridians admitting they use heroin
has increased 433 percent. And the number of addicts seeking methadone
treatment is sharply up.

Now, in an apparent about-face, the state has announced it wants to
establish a new methadone program in Central Florida. But once again,
Tallahassee is balking at providing funding for such a program.

In fact, while Florida in general -- and Orlando in particular -- are
hotbeds of heroin use, state-funded methadone programs are virtually
nonexistent, just as addicts seek help in record numbers.

"All the local methadone programs are swamped -- packed to the limits far
beyond anything they've ever experienced in their histories," says Bill
Sheridan, vice president of Orlando-based Colonial Management Group, which
runs the Orlando Methadone Treatment Center. And, he says, "Nowhere in the
state is it as pronounced as in Orlando."

Drugs and death

Orlando has earned the dubious distinction of having the highest number of
heroin deaths per capita statewide, according to a report just released by
the Florida Department of Law Enforcement.

But even those grim figures may underestimate the problem.

The number of heroin-related arrests in the area, 231, is now the second
highest in the state. More than half of all juvenile heroin addicts in the
state reside in Orlando. Moreover, while last year 36 heroin-related deaths
were reported in Orlando, once numbers from nearby Sanford, Daytona Beach
and Melbourne are added in, heroin-related deaths rise to 56.

It's a set of numbers that has spooked heroin users into seeking treatment
in record numbers.

"I've seen a huge increase in the number of heroin addicts coming in in the
last six months," says Lindsay. "They used to be 10 percent of our
admissions, but now make up one-third or more." Further, she says, for every
one seeking treatment, there likely are another 10 heroin addicts in the
community who have not sought treatment. Thus, "I think the numbers will
continue to rise."

That increase in heroin use is why the state now says there is a need for
another Central Florida methadone program. The new program most likely will
go in Osceola County -- where, like Central Florida's other three methadone
programs, it also will receive no state funding.

A sane solution? There is little doubt that methadone helps. "Methadone
takes the urge for heroin away and gets you to go to work," says one local
two-year methadone client.

In fact, addicts receiving methadone treatment at the Center for Drug-Free
Living hold jobs. "You'd be surprised at the wide range of people who are
stable and successful on methadone," says Lindsay.

Adds Harry Moffett, an operations and management consultant in the state's
Department of Children & Families Substance Abuse Program, "I've seen
attorneys, doctors and entrepreneurs able to function and be productive on
methadone.

"There is no sin to it. It is absolutely a viable heroin treatment
alternative. And a certain percentage of people will need to be on it for
their entire lives, just like a diabetic needs to take insulin."

Adds Kimberly Bliss-Cohen, another consultant with the Department of
Children & Families, "Heroin is so bad that other medication such as
methadone has to be involved for long-term users."

The treatment also has won applause from insurance companies.

John Garlick, regional behavioral health manager for Aetna US Healthcare's
Southeast region, points out that the number of opiate-related emergency
room visits nationwide dropped by more than half between 1991 and 1995 as a
result of more methadone treatment programs. The number of deaths nationwide
during that time also plummeted, from 4,000 to 2,300.

"The overall death rate of those on methadone is one-third the death rate of
heroin addicts not on methadone," he says. "Methadone treatment is highly
effective" -- one reason why an estimated 1,700 people in Central Florida
currently are in methadone treatment programs.

Hurdles to help But even while death rates skyrocket, and demand
intensifies, the state has been reluctant to fund methadone treatment.

There are about 25 methadone treatment centers in Florida, with the highest
concentration in Miami (four) and Orlando (three).

Yet only nine of those 25 centers receive any state money -- $1.4 million.
And the centers in Orlando and Miami, which rank first and second in the
number of overall heroin-related deaths in the state, receive none at all.

Two years ago, local state officials said they eliminated funding to the
Center for Drug-Free Living's methadone program because the district's own
budget was cut.

Glen Casel, district program director for the Department of Children &
Families, says over the past six to seven years, the substance abuse budget
has been gradually whittled away, prompting the local agency to cut funding
to programs such as methadone.

But, he says, "We looked closely at methadone programs and determined that
they could survive without us. That's why the decision to not give any
funding was made."

It's true that even without state funding, some heroin addicts have been
able to begin or continue their treatment. For example, the Center for
Drug-Free Living, which lost state funding in 1996, has been subsidizing the
methadone program with private donations and the $70 a week paid by addicts
seeking treatment.

However, that has limited the center to helping those addicts who have
somehow been able to hold down a job, or those whose habit hasn't yet burned
through their financial resources. And, as the number of addicts has grown,
the center is struggling -- sometimes unsuccessfully -- to keep up.

"There is a huge demand for methadone," Lindsay says. But, she adds, "It
always boils down to money."

Further, alternatives to outpatient methadone treatment are few and far
between. Most area residential drug treatment programs are full, with long
waiting lists. Others cost as much as $1,000 per day.

Capt. Ernie Scott, who is with the Orange County Sheriff's Office narcotics
section, cites the case of one local judge who got nowhere when his own
19-year-old daughter needed residential treatment. Says Scott, "They're a
politically connected, financially stable family, and they can't get crap done."

Deadly alternatives

That lack of treatment options leaves untreated addicts vulnerable to their
heroin cravings -- and in Central Florida, such cravings are unusually deadly.

"We suspect it is because we have better heroin here, which is very
unfortunate," says Scott. "Orlando has the highest heroin purity in the
state, if not the nation." He points out that the purity of heroin in
Orlando currently is about 95 percent, up from 60 percent pure in 1997.

That dubious distinction attracts heroin addicts from other areas to
Orlando. For example, several heroin deaths in Palm Bay have resulted from
heroin that has been tracked as coming from south Orlando, even though
heroin is readily available in Palm Bay.

And because longtime heroin addicts from out of state don't realize how
powerful the drug is here, they end up overdosing.

"For the novice user or visitor, there is an excellent chance of accidental
overdose," says Lindsay.

Taxing issues To be sure, not everyone thinks state-supported methadone
treatment is the answer.

The sheriff department's Scott, for example, says many heroin addicts see
methadone treatment centers as just a place "to line up sources -- to meet
people who can direct them to the real drugs."

However, even Scott admits he has met some former heroin addicts "who got
their start in recovery in methadone programs." And, he says, the state does
need to start pouring money into treatment.

"Your chances for success improve dramatically if you have residential
treatment and consistent monitoring and support," he says. "But people don't
want their tax dollars spent to rehabilitate drug addicts. They'd rather see
them in jail -- but it is cheaper and more effective to treat them."

Putting money into heroin detox is a wise investment, agrees one local
methadone client. "Methadone takes you off the streets and stops the robbing
and stealing," he says, adding that he once committed crimes to finance his
$100-a-day heroin habit.

That's why Lindsay expects to be knocking on the state's door again this
year, seeking funding, as well as a grant that would enable the center to
treat 45 more addicts with methadone.

Sitting in her tiny West Columbia Street office, surrounded by positive
messages -- a plaque on the wall that says "You are Not Alone," an angel
calendar, a photo frame that says "Love," a framed beach scene and an area
rug that says "To Thine Ownself Be True" -- the veteran drug counselor and
recovering alcoholic admits, "It can
get discouraging, and there are so few resources here in Orlando for our
detox clients." But, she intends to keep fighting for state funding. "We do
help a lot of people," she says, pointing at a small empty glass vase she
keeps as a reminder of the day a former addict stopped by with flowers. That
former addict now runs a small business.

Unfortunately, says Scott, the clock is ticking for those addicts still
looking for a way out. Notes the law enforcement officer, "1999 looks like
it's going to be a banner year for heroin deaths in Orlando."

Susan Lundine can be reached via e-mail at slundine@amcity.com.