S.F. LIKES U.S. PLAN FOR USING METHADONE ; DRUG CZAR MCCAFFREY URGES
SUPPORTIVE TREATMENT

A White House initiative to expand methadone treatment for heroin addiction
is getting a warm response from San Francisco health officials, who say it
is precisely in line with their own goals.

In February, the Board of Supervisors passed a resolution asking the
federal government for a waiver so that doctors with training could
prescribe the synthetic narcotic designed to lessen heroin cravings.
Currently, strict regulations prevent anyone but specially licensed clinics
from dispensing it.

White House drug policy chief Gen. Barry McCaffrey said Tuesday there are
plans to begin training programs for physicians to become accredited to
prescribe methadone.

"This is an area where there are too many regulations," said Barbara A.
Garcia, director of community substance abuse services for the Department
of Public Health. "This puts us in a very, very opportune situation in
terms of our ability, on a local level, to push this issue."

Currently, about 1,800 people are being served at five methadone clinics in
The City, each governed by a complex web of state and federal regulations.
Another 415 are on a waiting list for treatment.

Garcia said she hopes more people will choose methadone if they know they
can get it confidentially through their doctor. It could also lead to
better medical care for conditions that often crop up in injection drug
users, she said.

Still, Garcia said it will likely be at least a year and maybe longer
before regulations can be rewritten on both a state and federal level to
make methadone access easier.

Last year, the National Institutes of Health issued a sharply worded report
saying the nation's heroin addiction policies are outdated and that plenty
of evidence exists that methadone works well.

The treatment remains controversial, however. New York City Mayor Rudolph
Giuliani has said it only swaps one addiction for another and announced a
plan in that city to get users to quit. A few states have no methadone
clinics.

The cost for treatment is usually about $ 3,400 a year per person and
involves frequent visits to the clinics. Medi-Cal, the state's health
insurance for the poor, pays for its members to receive methadone, but some
people pay for it themselves, Garcia said. She said they are able to do
that because methadone stabilizes addicts and allows them to hold down jobs.

Eventually, The City hopes to provide treatment, including methadone, on
demand for all addicts. That goal remains years away, Garcia said.

Copyright 1998 The Hearst Corporation

Checked-by: Richard Lake