HEROIN ADDICTS TREATABLE, DOCTORS SAY

Report Seeks Fewer Methadone Curbs

Bethesda, Md. Overwhelming evidence now exists that heroin addiction is a
medical disorder that can be treated effectively, a government panel has
concluded.

A report from a committee at the National Institutes of Health also sharply
criticized existing treatment programs and said doctors should be freed
from heavyhanded restrictions on the use of methadone.

The report 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.

Committee chairman Dr. Lewis L. Judd of UCSan Diego said 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.

"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.

U.S. Drug Czar Agrees

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

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.

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

Doctors who attempt to treat addicts with methadone face frequent state and
federal inspections and are required to submit paperwork proving that the
drug is used within the limits of various laws. The aggravation discourages
most doctors from treating addicts, Judd said. In the meantime, authorized
methadone treatment centers have monthslong waiting lists, he said, and at
least seven states don't even have such centers.

Few Addicts Get Methadone

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

The committee said the widespread and deeply ingrained belief that heroin
addiction is a selfimposed condition leads many to feel it should be
treated as a moral and legal problem.

But the experts said research clearly shows that heroin addiction is a
medical problem, a disorder linked to a genetic predisposition and to
social conditions, the committee found.