PART 2: THE CONTROVERSY

Is methadone good medicine or just another opiate for
addicts?

Even though he takes methadone every day, J.J. says he's been clean
for more than two years.

And most treatment programs would agree with that assertion.

But even the people who prescribe and distribute methadone know it's
not a panacea.

Methadone became part of addictions treatment in this province earlier
this decade in response to a widespread abuse of OxyContin and other
opiates and the crime wave that followed in its wake.

J.J. has been a drug addict since he started sniffing gas behind St.
Theresa's school in St. John's as a teenager.

His parents were "potheads," J.J. says. But even though he didn't want
to be like them, it didn't take him long to become smitten with drugs
after he tried them - first marijuana, then Valium at age 15, then
cocaine.

Eventually, in prison in British Columbia, he started smoking opium
and shooting heroin.

"I tried (heroin) once and that was it. ...," he says. "Some people
thinks that junkies are gross ... the worst people on the face of the
planet. ... Looking at it now, it's just another way of doing drugs.
But I'm sure I thought the same thing - I'm not a junkie sticking
needles in (my) arms. I'll never do that."

Now, as he looks for work and is trying to wean himself off methadone
- - he's down to 39 milligrams a day from more than 100 mg in the first
few weeks of treatment - J.J. says he's keeping clean for his son.

"I'll tell him the truth," he says when asked what he'll tell the
little boy playing with dinkies in the next room. "Drugs ruined my
life."

But some people question whether a person can really be clean when
they're still taking opiates.

And some of those people don't want addicts in their
backyard.

This summer, when a methadone program opened in Windsor, Ont., the
community rallied against it. More than 100 neighbours turned out to
protest the clinic and pharmacy, even though the police said they'd
received next to no extra calls from the neighbourhood since it opened.

The controversy surrounding the use of methadone was perhaps best
characterized in 1998, when then New York mayor Rudy Giuliani spoke
out against the long-term use of the drug.

Giuliani accused methadone providers of "enslaving" addicts instead of
pushing them toward abstinence, according to a New York Times article
on his plan to get 2,000 addicts off heroin.

The former mayor was sharply criticized by drug treatment experts,
including scientists at the National Institutes of Health and White
House drug policy officials.

Yet in Europe, a methadone treatment program is often used as an
example of the problems that can arise when the drug is provided in a
free-for-all-style program.

In the U.K., there were plenty of glitches when a methadone program
was rolled out in the late '80s and early 1990s, including hundreds of
overdoses after addicts were allowed to get dozens of doses of
methadone to go from pharmacies.

An article in The Independent in July 2000 asked whether methadone was
a "Cure or Con."

The in-depth report examined the use of the drug in Glasgow - then the
heroin capital of the U.K., with more than 8,500 addicts on the streets.

"One, (methadone), is legally prescribed by doctors. The other,
(heroin), is illegally procured from dealers. What, they're asking in
Britain's drugs capital, is the good of that?" the article asked.

Critics argued that methadone was simply a "method of social control,
introduced to contain HIV infection," by getting needles off the streets.

Advocates, however, took one look at Glasgow and pointed out that a "3
million pound methadone programme looks (like) good value when set
against the 194 million pounds of goods that Glasgow addicts steal
annually to fund their habits."

Dr. Laurence Gruer, director of public health science in Scotland and
one of the experts who created the Glasgow methadone treatment
program, acknowledged years later that the drug and the program was an
"easy option."

In 2007, he told a conference of justice officials in Scotland that
more money should have been put into rehab services to help prevent
addicts from going back to drugs after getting clean.

At the time, an estimated 20,000 people in Scotland were on
methadone.

Methadone providers in this province say that they've learned from
others' mistakes.

Barry Hewitt, who runs the local program, says it's relatively
well-funded and staffed as compared to some other programs across the
country and even internationally.

At the opiod treatment clinic in Pleasantville, there are two drugs
counsellors, an addictions nurse, a licenced practical nurse, a
pharmacist, security team, and one and a half support staff.

There are also two fee-for-service doctors who prescribe
methadone.

And the centre has one thing that many community-based methadone
options don't - counselling.

Dr. Jeff White, who prescribes the drug from his Paradise medical
practice, says rehab facilities are sorely lacking.

He says he's seen patients with short addiction histories looking for
help and only finding methadone.

"This is not the way that methadone is supposed to be used. ... So
it's either all or nothing," White says of patients addicted to
morphine or OxyContin for only a few months to a year.

But the contradiction of prescribing a drug for long-term use after a
short addiction is one White has to live with because of the lack of
options for rehab after detoxing.

After all, White says some of his patients really clean up their lives
and get out of the day-to-day rut of using drugs thanks to their a
daily "drink."

"To me that sounds better than where (they were) before. It's a
tradeoff - harm-reduction is what we call it."