TREATING HEROIN USERS EFFECTIVE

Decline in addicts seeking agency help attributed to methadone clinic
opening.

WILKES-BARRE - Quietly in 2004 the shift began.

Back then the number of people seeking treatment from the
Luzerne-Wyoming Counties Drug and Alcohol Program claimed heroin was
their drug of choice.

In its latest data for the fiscal year 2007-08 heroin dropped down a
notch and program administrator Mike Donahue zeroed in on the reason
- - the opening of the methadone treatment clinic in April 2004.

"It reduced the number of heroin addicts who were going in for
multiple treatments," he said.

Under the program's accounting method, every time a person seeks
treatment is counted as an admission. But those repeat admissions for
heroin are down, freeing up more spots for other treatment services.

The highpoint for heroin use occurred in 2003-04, according to
program data, when 898 people sought treatment. They accounted for 39
percent of the clients. When the other 101 clients using opiates,
including synthetic prescription drugs, were added, the total reached
43 percent of the 2,295 admissions.

By comparison, there were 597 people who listed heroin as their drug
of choice in 2007-08, according to the program data. They accounted
for 30 percent of all admissions for treatment. Adding in the other
94 opiate users, the total increased to 35 percent of all 1,979 admissions.

The introduction of medication - assisted treatments that include
methadone and suboxone, a prescription drug whose primary active
ingredient buprenorphine blocks the craving for opiates - has enabled
some to stop illegal drug use and stabilize their lives, Donahue
said.

They've been able to get jobs, take care of their families and in
turn no longer rely on social and human service agencies for help.

The treatments are not for everyone, Donahue added, and some people
and treatment centers prefer to go the drug-free route.

Getting users into treatment is an effective way of eliminating the
market for illegal drugs such as heroin, said Ernest Drucker, Ph. D.
of the Montefiore Medical Center, Bronx, N.Y.

Drucker has some familiarity with the county, having researched fatal
drug overdoses here between 1998 and 2002.

If addicts' drug use is in under control, "they're taken out of the
market as buyers and sellers," Drucker said.

However, there are not enough treatment slots for addicts, he said.
Nationally, there are approximately 200,000 slots for methadone
treatment, but an estimated 1 million heroin addicts. Given those
percentages, the vast majority of addicts go untreated.

It does not have to be that way, nor does one treatment method apply
to all.

Methadone is inexpensive and has proven to be effective for heroin
and opiate addicts. Buprenorphine, another more expensive medication,
also works, Drucker said.

What also works are different settings for the treatments. Instead of
clinics that dispense medication to hundreds of people daily,
doctor's offices and even pharmacies can be used.

Drucker conducted a case study of a doctor and a pharmacy in
Lancaster that ran a pilot program between 2003 and 2005 dispensing
methadone to people who had previously received it a clinic.

He concluded the office-based opiate treatment program delivered
clinical results that were just as good or even better than the
clinic and at a lower cost with greater patient satisfaction.

The patients appreciated the social interaction with the pharmacy
staff, the doctor and his staff and welcomed the freedom of the
program that gave them back their dignity.

The office-based opiate treatment is commonly used in other countries
with success.

The mass dispensing clinics with their regimented routines have
soured patients on the treatment and methadone, Drucker added.

"It's been so maligned that the addicts themselves come to hate it,"
he said.