S.F. LIKES FEDERAL METHADONE PLAN

U.S. proposes to train doctors to give heroin addicts synthetic
substitute

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report saying the nation's heroin addiction policies are outdated and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.

Checked-by: Patrick Henry