DRUGS, SCIENCE AND SENSE

The nation's drug czar offers a sound plan for treating heroin
addicts.

Add the reasoned voice of Barry McCaffrey to the all-too-often
strident debate over how to treat heroin addiction.

Mr. McCaffrey, a former Army general who now serves as the White House
drug policy czar, has come forth with a sound plan to make methadone
more available to heroin addicts. He wants to allow some doctors to be
able to prescribe methadone, which prevails on brain receptors to
block the craving for heroin, directly to their patients. He also
wants to improve the quality of the clinics that now dispense
methadone to about 115,000 addicts nationwide, including 42,000 in New
York.

What's most refreshing about Mr. McCaffrey's initiative is that it
regards methadone as medicine and drug addiction as a medical
disorder, not unlike heart disease, hypertension or diabetes.
Methadone, by his reasoning, should be as available as insulin and
heart and blood pressure medication. On that point in particular, Mr.
McCaffrey is supported by a vast group of doctors and addiction
specialists alike. Among them is David C. Mactas, president of the
Hazelden drug treatment programs in the New York City area. "That
methadone is effective is not a matter of opinion,'' Mr. Mactas says.
"It is a matter of fact.''

The opposition comes, predictably, from political quarters. New York
City Mayor Rudolph Giuliani in particular has become a vicious critic
of methadone treatment. The mayor moralizes that the country should be
drug free and notes that it is possible to become physically dependent
on methadone, too. He goes so far as to suggest that such a dependency
is even worse than heroin addiction -- an assertion unsettling to the
point of being breathtaking.

It's one thing for Mr. Giuliani to lean on taxi drivers and hot-dog
vendors. But it would be best if he'd stay out of a public health
discussion that he shows little evidence of understanding.

The data offered by Mr. McCaffrey is compelling. When methadone is
properly administered to addicts, he says, their heroin use declines
by 70 percent. The crimes they commit drop by 57 percent. Gainful
employment among addicts, meanwhile, increases by 24 percent. How can
Mr.Giuliani responsibly object to any of that?

Others, however, may raise responsible objections to Mr. McCaffrey's
plan on the grounds that it doesn't provide enough funding to ensure
success. Mr. McCaffrey promises only that federal spending on drug
treatment will increase by 38 percent during the next five years.
Methadone programs, though, will need money immediately. No less an
authority than Dr. Jerome Jaffe, who was an early proponent of
methadone treatment during his days as drug policy director for the
Nixon administration, points out what should be obvious: Most people
who need such help can't afford to pay for it.

We've had reason to criticize Mr. McCaffrey before. Earlier this year,
he refused to pay for needle-distribution programs, despite convincing
evidence that clean needles save addicts' lives. Proper funding for
the expanded methadone treatment effort he's proposing, though, would
allow him to claim the high road in the drug policy debate.

Checked-by: Rich O'Grady