SCOTT MAY HAVE DODGED METHADONE BULLET

Thanks to Virginia Delegate Terry Kilgore and unanimous votes by both
chambers of the Virginia General Assembly, the prospect of a methadone
clinic locating in Scott County looks increasingly unlikely, and that
accrues to the good of the community. Feeding the habit of drug
addicts does not end their addiction.

Kilgore's bill effectively establishes a moratorium on new methadone
clinics' ability to locate in rural areas that lack zoning
regulations. It also directs the Mental Health, Mental Retardation and
Substance Abuse Services Board to establish standards to evaluate the
need and appropriateness for the issuance of new methadone clinic licenses.

The standards will include common-sense criteria relating to the
number of persons needing such treatment in the service area, the
proposed site of the clinic, the existing access to such treatment,
the geographic and demographic parameters of the service area, and the
proposed clinic's security and accountability measures.

The moratorium and a new set of ground rules for methadone clinics are
certainly steps in the right direction. But it is the increasingly
questionable rationale for these clinics that fundamentally needs to
be addressed.

Designed to wean addicts off heroin, methadone and the clinics that
dispense it have sparked a great deal of concern. In Tennessee and
Virginia the regulation of methadone clinics is a state
responsibility, effectively leaving local governments with no voice in
the matter. That's plainly wrong. If a locality can decide whether it
wants liquor-by-the-drink, it ought to be able to determine whether it
wants to allow a for-profit business to dispense drugs.

But lack of local control over such clinics is only part of the
problem.

There are literally thousands of addicts in Virginia and Tennessee
receiving methadone "treatment.'' But methadone is a highly addictive
Schedule II drug, which places it in the same category as morphine and
other potent painkillers and opiates. Methadone doesn't cure or
rehabilitate a drug addict in the clinical sense, but merely steers
the individual from being addicted from one drug to another. Even
those who operate methadone clinics admit that only a fraction of
their clientele ultimately kick their methadone habit and go
completely drug-free. There's a good reason for that: money.

Since methadone treatment moved out of carefully monitored, intensive
hospital settings into for-profit clinics, there is a powerful
economic disincentive to terminate "treatment.'' That means most
methadone patients simply continue their medication indefinitely. If
these individuals were diabetics needing insulin, such lifelong
medication would be understandable, but a diabetic's need for insulin
and a drug addict's artificially induced desire for opiates are not
the same thing.

Methadone was originally introduced as a means to an end, a way to
wean hard-core heroin addicts away from their addiction and eventually
to reintroduce them into society as useful, working, crime-free
citizens. Instead, it has become an alternate addiction not only for
its patients but the clinics that have come to depend on the profits
derived from it.

If the location of methadone clinics is going to be regulated by the
state rather than by localities, then state lawmakers need to
radically reconsider the rules under which this drug is
distributed.

A good start would be to bring methadone treatment back into a
hospital setting where only physicians could dispense the drug.
Frequent, unannounced drug screenings would catch those using other
drugs, and they would lose their chance to continue in the program.
Most important, physicians would be required by the state to
eventually wean a patient from methadone at a date certain.

Drug addiction is a terrible thing. But we do no kindness to addicts
by allowing for-profit clinics to prey upon them in the name of
compassion. Methadone's use, which is sadly all too common, should be
as regulated as it is rare.