STATE PROBES DOCTOR'S HOTEL DETOX OF WEALTHY

Medicine: Possible Violations Include Use Of Unlicensed Facility And
Prescription Of Opiates To Treat Addicts. Physician Declines To Comment.

The enforcement arm of the California Medical Board is investigating
whether a doctor violated any laws by detoxing heroin addicts at the
Peninsula Hotel in Beverly Hills, sources said.

The probe follows an article published last month in The Times
focusing on so-called hotel detoxes at the Peninsula and other
Westside luxury hotels--a lucrative practice for a small group of
physicians who cater to the entertainment industry's rich and
celebrated. In the article, Dr. David A. Kipper said he had detoxed
about 20 heroin addicts at the Peninsula and conceded that his detox
program--which included the use of a synthetic opiate,
buprenorphine--might not be "completely legal."

A series of Westside physicians over the past 18 years have used some of
Los Angeles' most
luxurious hotels to wean wealthy addicts off drugs while protecting
their anonymity. Experts contend that hotel detoxes are unsafe and
often fail because they allow addicts to set the terms of their own
treatment, often to their own disadvantage.

State authorities say that conducting drug detoxification in an
unlicensed facility such as a hotel violates the state and health
safety codes.

State regulations also prohibit the use of any opiate--including
buprenorphine--to detoxify narcotic addicts.

"The major problem that this doctor seems to face is with the
regulations that govern the treatment of opiate addicts with an opiate
in a nonlicensed facility," said Dr. Michael Miller, chairman of the
quality improvement committee of the American Society of Addiction
Medicine.

Investigators for the state medical board declined to comment
Thursday. Board investigations, which often take more than a year, can
result in criminal prosecutions. More commonly, when a doctor is
determined to have violated state medical standards, the board deals
with the case administratively or seeks license revocation.

Kipper, a Beverly Hills internist whose Lasky Drive office faces the
Peninsula's rear entrance, declined to comment Thursday.

Last month, Kipper told The Times that he had kept the Peninsula
management apprised of his activities at the hotel. But the hotel's
management and owners said Kipper never told them he was conducting
medical procedures on the property.

Ali V. Kasikci, the general manager of the Peninsula, said Thursday
that the hotel had not been contacted by state investigators.

"The Peninsula has been an innocent bystander in all of this," Kasikci
said. "These detoxes were being done covertly without our knowledge.
The instant it was brought to our attention, we stopped doing business
with Dr. Kipper." Earlier this year, one rock star detoxed by Kipper
was seen ordering a whiskey at the Peninsula bar during the course of
his treatment. The rock star, who spoke with The Times on condition
that he not be named, said he had no trouble gaining access to the
opiates used for his treatment, even though they were supposed to be
locked in a safe in the hotel room.

Kipper said that case was unique, describing the entertainer as "the
most recalcitrant patient we've ever treated." The rock star underwent
Kipper's treatment three times in two months but failed to stay off
drugs.

Kipper said his program is safe and has a 70% success rate, which he
defined as having patients admitted and maintained in a treatment
facility for one month after leaving his supervision--a dubious
standard, according to experts. Kipper charges $10,000 to $19,000 per
week for detoxification (not including the hotel rate of up to $800 a
night per room)--about four times the rate charged by several
nationally recognized treatment clinics.

Despite its cost, Kipper said his treatment method is so popular that
during one week this year he was detoxing four addicts in separate
rooms around the Peninsula.

This week, another Beverly Hills physician, Dr. Stephen Scappa, told The
Times that he too has detoxed wealthy addicts at the Peninsula. On
Thursday, the hotel's management said it had no
knowledge that Scappa had conducted detoxes on the premises.

In an interview, Scappa said he and his partner, drug counselor John
Citro, have detoxed more than 150 drug addicts and alcoholics on an
outpatient basis around Los Angeles over the past 16 years. Scappa,
who is a certified addiction psychiatrist, said less than a quarter of
his detoxification treatments were for heroin.

Scappa said he has conducted the bulk of his detoxes at patients'
homes, but has detoxed a number of addicts at the Peninsula--which is
located about a block from his Wilshire Boulevard office. Scappa said
he typically charges about $10,000 for a weeklong detox, but has
charged as much as $8,000 a day under "extraordinary circumstances."
"I work with a population that is wealthy, and my approach is very
unique and very successful," Scappa said.

"I take a different tack than most of the guys doing outpatient detoxes.
They are internists.
As a psychiatrist, my emphasis is on a comprehensive treatment that
includes psychotherapy, psycho-pharmacology and environmental
management." Scappa said that although he starts with a detox in a
hotel or home, his program concentrates primarily on long-term
psychiatric treatment of patients with substance abuse problems.
Scappa, who typically charges $240 per hour, says his detox patients
generally consult with him three times a week for more than a
year--sometimes as often as twice a day in the early stages of treatment.

Scappa said his methods complied with state laws. He said addicts in
his program are admitted as patients in a local methadone clinic,
through which they are legally prescribed methadone on an outpatient
basis.

"I'm not doing anything illegal--to the best of my knowledge." "I did
my first detox in a hotel way back in 1982," Scappa said. "I have a
wealth of experience in how to detox and treat substance abuse
problems. I know what I'm doing."

Checked-by: Patrick Henry