PANEL: DEREGULATE HEROIN TREATMENT

Bethesda, Md. (AP) Heroin addiction is a medical problem that can be
cured if doctors are freed from 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.

Committee chairman Dr. Lewis L. Judd of the University of California, San
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.

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 a ``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.

``Laws to control methadone diversion are no longer necessary,'' Judd said.
The laws were passed, he said, to limit distribution of methadone because
of apprehension it could be sold on the black market to heroin addicts.

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 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 that were proposed earlier.

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.

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.

``It should be dealt with as a medical illness, just as are any other
medical disorders,'' Judd said. ``It is a nofault illness.''

The committee found that heroin addicts who are on methadone maintenance
for at least a year have a good chance of conquering the addiction,
although many patients may have to take methadone for life.

Successfully weaning addicts from heroin also requires psychological and
social therapy, the committee said.

Judd said patients on methadone maintenance are able to work and avoid
criminal activity. In contrast, heroin addicts usually spend most of their
time finding ways to support the habit. This usually means stealing.

Additionally, methadone patients are much less likely to contract
infections that are common from illegal injected drugs. About 75 percent of
all new HIV infections, for instance, are among intravenous drug users,
Judd said.

Health care costs associated with heroin addiction was estimated at $1.2
billion a year, the committee found.