PART 3: LOOKING BACK, AND AHEAD

Is Methadone The Only Option For Addicts?

In Newfoundland and Labrador, there are two main ways to come off
opiod drugs if you're hooked - taking methadone or going cold turkey.

Barry Hewitt, program manager of the Recovery Center, Opioid Treatment
Clinic and Terrace Clinic, says the cold turkey method is probably the
hardest way to come off drugs like OxyContin, heroin and other narcotics.

"It's not deadly. You won't die," he says. "You start (feeling
symptoms after) about 24 hours. It gets worse around Day 3: a lot of
sweats, dancing leg, aches and pains ... not many people stay (at the
recovery centre until they completely detox)."

Still, there are some people who simply don't want to take methadone,
Hewitt says.

And while people who work in addictions will tell you methadone is not
a magic elixir for OxyContin addicts, it's here and it works.

"We're still new to methadone ... we're still learning. Are we close
to (getting it right)? Yeah. Do I think we have a good program? Yeah,"
Hewitt says.

There are other options out there.

Other options aren't practical

A quick search of the Internet turns up hundreds of responses on how
to detox from OxyContin - methods that can be costly and, in some
cases, radical.

One of them is ultra-rapid detox - which sees the addict put under
anesthesia and quickly detoxed through the use of other drugs.

But recent studies say ultra-rapid detox may not be the safest option,
nor is it cheap.

There's also plenty of advice on the Internet about cold-turkey
detoxing, some of which includes the use of other drugs to fight the
symptoms of withdrawal, also known as medical detoxing.

The Calton Athletic Recovery Group, an athletic-based recovery centre
in Glasgow, Scotland, bans all alcohol and drugs, instead promoting
endorphins from exercise as a cure to heroin addiction.

"At Calton Athletic we realize this stance can seem harsh to some
people. They believe that not everyone is capable of giving up drugs.
We accept that. But we also believe that most drug addicts want to
give up, but feel that they can't," reads the group's website.

Another controversial weaning option was offered recently to a test
group of addicts in Vancouver and Montreal.

The experiment saw the addicts provided their drug of choice - heroin
- - in measured doses.

The 251 participants hadn't benefited from standard addiction
treatments.

The results of the North American Opiate Medication Initiative showed
that the overall health of the addicts improved, illicit drug use
dropped by nearly 70 per cent and the illegal activity and the amount
of money spent on drugs dropped dramatically in the first 12 months,
something the parallel-running methadone maintenance program couldn't
accomplish.

There are other also other pharmacological options for people not
willing or unable to take methadone, including methadone replacement
Bupernorphine, and Levo-Alpha Acetyl Methadol, the long-acting but
rarely-prescribed version of methadone known as LAAM. But they don't
all work the same, nor are they a guarantee or cure.

Risky business

Gerry Young, the pharmacist for this province's opiod treatment
program, says there are problems introducing new drug treatments -
specifically for pharmacists.

Pharmacists already take risks when they have to judge just how sober
their methadone patients are when they watch them drink the
methadone-laced cup of orange Tang.

A patient who is already high could overdose on opiates, or if they're
drunk they could stop breathing, as methadone decreases respiration
and alcohol can add to that effect.

Handing out similar drugs in pill form would add another potential
liability in that pharmacists would have to make sure the patients
swallowed the pills, Young explains.

Another problem with these alternative drugs - none of which are
available in this province - is that success rates are quite low.

Abstinence programs have an even higher rate of failure, some experts
say.

Dr. Jeff White, one of few doctors in the St. John's area prescribing
methadone, says just stopping taking opiates doesn't work.

"They've already tried it. Every person who comes in to me has already
tried some form of detox whether it's home, detox centre, jail," he
says.

The best treatment White knows of is the combination of methadone and
counselling.

But sometimes that treatment is hard to come by.

"In my estimation, methadone is better than nothing," he says. "The
counselling opportunities are dismal in St. John's. In fact, they're
so bad right now I'm not even referring anyone because they never hear
back."

The opioid treatment centre offers counselling as part of the
methadone treatment, White says, but the waiting list for the centre
is longer than that of a doctor's office.

"At least (at my office) they're getting methadone (even if they
aren't getting counselling). ... What else am I going to do? If they
don't get it now, I don't want to see these people two years down the
road, who are gone from taking six Percocets today to taking six
OxyContin 80 milligram tablets a day."

Methadone isn't the panacea, he says, but it does work and it's the
best tool available right now.

"You're not going to fix everyone ... but you have to try," White
says. "And I'll give them a chance."

Third in a three-part series examining the effectiveness of the
province's methadone treatment program for drug addictions