GIULIANI'S WAR ON METHADONE

Mayor Giuliani ignited a minor storm this week when he launched into an
attack on methadone, the synthetic analgesic widely used to dull the
effects of heroin withdrawal. The mayor blasted a treatment method that, he
said, focuses more on maintaining people on methadone than on encouraging
them to stop using drugs altogether.

No longer will participants in drug treatment programs be excluded from
workfare, the mayor said. And he wants to end the distribution of methadone
in New York City altogether within a few years.

The mayor was immediately blasted by the drug-treatment community, which
has been handing out methadone for more than three decades and made it a
public-policy sacred cow. There's no reason it should be beyond debate and
discussion.

Methadone is at the heart of a $50-million business in New York. Of the
115,000 authorized methadone "slots" nationwide, 43,000 are in New York
state (the overwhelming majority in the city). There's good reason for
this; it's one of the few treatment programs withany record of success. The
problem is that the record isn't a very good one studies show it varies
between 20 and 30 percent.

People invoke the term "drug treatment" as though it were a cure-all
solution to the drug problem. In truth, drug addiction has so far defeated
rational efforts at treatment, even a simple substitution system like
methadone.

Some drug-treatment experts think the methadone system needs an outright
overhaul in any case. Mark Kleiman of UCLA says one reason methadone
remains popular, despite the availability of substitutes thought to be
superior (such as LAAM), is because it is easily traded on the black market
for other drugs.

Whether methadone should be gotten rid of or not, the mayor is right about
requiring those in treatment to work. Many methadone patients lead
middle-class lives indistinguishable from those of their non-drug-using
neighbors. Treating heroin addicts as though they are the same as people
with severe physical disabilities is an act of moral condescension. The
mayor has done a service in bringing this critical issue to the public's
attention.

Checked-by: (Joel W. Johnson)