METHADONE REGULATIONS

Heroin substitute needs to be more widely available

Methadone maintenance is the best available treatment for this
nation's 600,000 heroin addicts.

If that's as good as treatment gets, researchers have work to do. A
lifelong dependence on methadone is a grim future for a 19-year-old
addict. There must be a better treatment waiting to be discovered.

But until new treatments appear, methadone needs to be easily
available. Drug czar Barry McCaffrey is right to suggest removing
bureaucratic barriers to methadone use.

At a meeting of the American Methadone Treatment Association in
Manhattan last month, former Gen. McCaffrey recommended that private
physicians be allowed to dispense methadone in their offices. His
recommendations are based on suggestions from several expert panels.

Right now, methadone, which most addicts need daily, is tightly
controlled. It usually is dispensed only at special clinics, which can
disrupt heroin addicts' attempts to work and lead more normal lives.
About 115,000 Americans participate in methadone maintenance programs.

Methadone is a synthetic, non-intoxicating substitute for heroin. It
can eliminate heroin withdrawal symptoms, lessen craving for heroin
and block its "high" - but methadone also creates a physical
dependence as severe as that of heroin. Despite that drawback - and
it's significant - researchers say addicts on methadone are less
likely to compulsively seek drugs, which leads to crime and prevents
them from holding jobs.

Methadone doesn't work for everyone. Many long-term addicts have
difficult, entrenched psycho-social problems that methadone alone
can't cure. They also may be using other drugs. They require
additional behavioral therapy and treatment.

New York Mayor Rudolph Giuliani's dismissal of methadone treatment -
he argues it simply substitutes one addiction for another - ignores
the nuances of the debate. Research shows opiate addiction causes
physical changes in the brain. Cold-turkey withdrawal and lifetime
abstinence may truly be impossible for some addicts.

Methadone maintenance is far from perfect. Treating it as a cure for
addiction is like pretending kidney dialysis is a cure for diabetes.
But until something better comes along, it's the best thing we have.

Checked-by: Rich O'Grady