METHADONE CLINIC OPENS DOORS TODAY

Heroin Reportedly The Drug Of Choice In County

Udi Barkai doesn't sugarcoat it.

The Israeli-born president and chief executive officer of Aegis
Medical Systems, Inc., says methadone clinics are often seedy and run
by bottom-line scoundrels.

Poorly trained clinic workers have traded take-home privileges for
sexual favors and patients using methadone purchased on the street
have overdosed and died.

"There are a lot of bad elements that come into this field,
especially ex-addicts," said Barkai, who visited Aegis clinics in the
Central Valley last week.

At 5 a.m. today, Aegis will begin dispensing doses of methadone at
1343 W. Main St., ending a three-year battle to open a clinic in Merced.

The clinic will operate between 5 a.m. and 2 p.m. on weekdays and 5
a.m. to 11 a.m. on weekends.

The Agoura Hills-based company owns 24 methadone clinics in
California, including locations in Fresno and Modesto.

Methadone is a synthetic opiate used to reduce cravings for heroin,
morphine or other opium derivatives. It prevents pain and sickness
accompanied with narcotic withdrawal and blocks heroin's euphoric
rush. It is most commonly taken orally in a liquid form.

Rather than a "juice bar" where recovering heroin addicts come for a
quick dose to stave off the jitters, Barkai said Aegis attacks
addiction using a holistic approach.

That includes a 12-step program, counseling, nutritional education
and group therapy.

Patients are required to enroll in at least one program beyond
medical methadone treatment.

The combination increases the odds of people shedding their heroin
addictions, he said.

The Merced clinic is the first the private company has built from the
ground up.

It is supported in part through a 16-month, $230,000 contract with
Merced County for outpatient narcotic treatment services. That
funding comes from the state Drug Medi-Cal program.

Because of the high street value of methadone, security is tight.

Employees must check in using a biometric time clock which scans
their fingerprints and the methadone is guarded by a security system
controlled by the Drug Enforcement Administration.

Aside from the extra security, the clinic is set up like a regular
doctor's office. It has two examination rooms, a laboratory and a
waiting room. It is staffed by a physician, a medical assistant, two
nurses and a manager.

John Morton, the clinic manager, said the facility will impose
stricter standards than state law requires. In addition to mandatory
monthly urinalysis tests for illicit drugs, patients also will be
subject to random testing.

The Merced clinic will take in about a dozen patients initially and
grow to about 50 by its third month, said Morton. It is licensed by
California Department of Alcohol and Drug Programs to treat 150 people.

Morton has talked with neighboring businesses in Westgate Plaza and
said he wants to stay ahead of any problems.

Protests from parents, teachers and Merced County officials blocked a
previous attempt to open a clinic on D Street, near an elementary
school, a preschool and a children's health center.

Opposition from a few public officials about the appropriateness of
the Main Street site has surfaced, but their protest has remained
relatively muted.

Health officials say 40 to 50 people from the county currently drive
to clinics in Fresno and Modesto for treatment every day.

Many will be the first patients at the Merced clinic. But fear of
having their methadone treatment become known could keep some from
seeking services here.

Aegis officials say the clinic will not take in patients from out of the area.

Clients pay between $250 and $300 a month for treatment. Drug
Medi-Cal covers roughly half of the patients and the other half pay
cash, Morton said. A heroin addiction can easily match that figure in a day.

Methadone treatment isn't for everyone. Like heroin, it is addictive,
and kicking it is not easy.

Rather than tapering off of methadone, some recovering addicts quit
heroin "cold turkey."

Last year, 69 people, or 4 percent, of those going through
nonmethadone substance abuse programs in the county identified heroin
as their drug of choice, according to Troy Fox, director of the
county mental health department.

Methadone treatment has its share of critics.

"Methadonia," an HBO documentary that premiered last week,
highlighted how methadone can be combined with prescription
anti-anxiety medication to produce an intense heroin-like rush.

Additionally, some drug recovery programs discourage methadone
treatment because it is seen as replacing one addiction for another.

While people can remain on methadone for decades, Morton said it is
better used as a bridge between addiction and a sober life.

"It's not meant to be a lifelong treatment," he said.