GIULIANI ORDERS 5 CITY HOSPITALS TO WEAN ADDICTS OFF METHADONE

NEW YORK -- Following through on his promise to overhaul drug treatment in
New York City, Mayor Rudolph Giuliani has decided that heroin addicts
treated at city hospitals will generally be allowed to get methadone for no
more than three months, city health officials Friday. The policy change,
which will take place in about 60 days, will affect 2,000 addicts who take
methadone, a synthetic drug that has been widely prescribed to blunt heroin
cravings for the last 30 years. Under the new plan, addicts enrolled in
programs at five city hospitals will be weaned from methadone within three
months, instead of taking it indefinitely as they do now. The programs will
continue to offer intensive counseling and other services after that time.

The mayor has argued that methadone maintenance programs simply substitute
one dependency for another, and that abstinence from drugs is a more moral
and decent approach to curing addiction.

In preparation for the shift, city officials suspended admissions this week
to the methadone programs at Bellevue, Harlem Hospital, Metropolitan
Hospital, Elmhurst and Kings County. The hospitals, which each typically
receive about four new patients weekly, began referring those clients to
other private and state-run clinics, city officials said. The decision
immediately created a furor in the drug-treatment community, where
methadone treatment has been embraced by the National Institutes of Health;
Gen. Barry McCaffrey, the White House drug policy chief, and state drug
rehabilitation officials.

While city officials control less than 10 percent of the 36,000 methadone
treatment slots in New York City, state health officials said the policy
shift could create a shortage of desperately needed slots. The city's
methadone treatment system is already operating at more than 90 percent of
capacity, officials said.

State officials, who provide some of the financing for the city programs,
said they also feared for the health and well-being of the heroin addicts
forced to make the new transition. About 1,000 methadone-to-abstinence
slots already exist in New York City, but "historically, it has not worked
for everybody," said Wendy Gibson, the spokesperson for the State Office of
Alcoholism and Substance Abuse.

State officials said they wanted to review the city's plan, but Dr. Luis
Marcos, president of the city's Health and Hospitals Corp., said the city
had the authority to make the decision on its own.

Marcos said the new policy will liberate heroin addicts from their
dependency on methadone, moving them to abstinence, very much like
alcoholics. "We would like to be able to free many of these men and women
who are life-dependent on this drug, which is a synthetic painkiller very
similar to heroin," Marcos said in an interview.

"The expectation for the alcoholic is to be abstinent and the expectation
for the heroin addict should have the same goal. I believe that society has
been rather lax in terms of dealing with heroin addicts. It's very easy and
inexpensive to give a pill of methadone for life to people. But the time
has come to liberate these addicts from that kind of expectation." Marcos
said heroin addicts receiving treatment at city hospitals would also be
required to work as part of their recovery program, which is a plan widely
supported by most drug treatment experts. Hospital officials have already
begun to evaluate the 2,000 methadone maintenance patients to assess their
needs.

City officials said they were also re-evaluating methadone treatment for
the 4,300 inmates at city jails. And Marcos said he expected some
consternation among drug treatment officials as the city moves to dismantle
a treatment regimen that has been widely considered the best hope for
heroin addicts. "I know change is not easy, and their reaction is the
normal expected reaction of people who are being challenged to do things
differently," Marcos said. "No matter what the change is, people react with
fear and concern. But it is time to re-evaluate. We're going to do it."

Checked-by: Mike Gogulski