FREER METHADONE SEEN AS KEY TO CURING HEROIN ADDICTION

A federal panel's report calls for more physician control in distributing
and dosing the synthetic narcotics used to wean addicts

By Paul Recer, The Associated Press

BETHESDA, Md. Heroin addiction is a medical problem that can be cured if
doctors are freed from the heavyhanded restrictions on the use of
methadone, a federal scientific panel concluded Wednesday.

The report by a committee at the National Institutes of Health supports an
earlier White House call for more physician control of dosing and
distribution of methadone, a synthetic narcotic used to wean addicts from
heroin.

Physicians are reluctant to treat heroin addiction because of mountains of
paperwork and "onerous" regulations imposed on the use of methadone by
federal agencies and state governments, said the chairman, Dr. Lewis L.
Judd of the University of California, San Diego.

"We know of no other area of medicine where the federal government intrudes
so deeply and coercively into the practice of medicine," Judd said. "If
extra levels of regulation were eliminated, many more physicians and
pharmacies could prescribe and dispense methadone," and make the treatment
more readily available.

Methadone is a pill that has some of the same physiological effects on the
brain as heroin, which helps blunt the effects of heroin withdrawal.
Methadone does not produce the "high" that most addicts crave, and it takes
several hours for its biological effects to occur.

For these reasons, methadone is not considered a drug that is attractive to
abusers and should be available for prescription, Judd said.

Dosing of methadone is controlled by the Food and Drug Administration.
Distribution of the heroin substitute also comes under regulations of the
Drug Enforcement Administration and the Department of Health and Human
Services.

In addition, almost every state has laws that closely control how, when and
where methadone is to be used, Judd said.

"Laws to control methadone were passed to limit distribution of methadone
because of apprehension it could be sold on the black market to heroin
addicts, he said.

The report, drafted by 12 independent experts commissioned by the NIH, is
consistent with a proposal made in September by Barry McCaffrey, director
of the White House Office of National Drug Control Policy.

McCaffrey said then that methadone should be "prescribed by doctors and not
by policy" and that trained and monitored physicians should be allowed to
dispense methadone.

Bob Weiner, a spokesman for McCaffrey, said the presidential adviser would
not comment directly on the new report, but he continues to support changes
in federal methadone policy proposed earlier.

Doctors who attempt to treat addicts with methadone face frequent state and
federal inspections and are required to submit paperwork proving the drug
is used within the limits of various laws.

In the meantime, authorized methadone treatment centers have monthslong
waiting lists, and at least seven states do not even have such centers, he
said.

Judd said there are an estimated 600,000 heroin addicts in the United
States. Only about 115,000 are enrolled in methadone maintenance programs.