METHADONE TREATMENT DOES NOT CURE ADDICTS

It is one of those interesting ironies of medical history that
methadone would probably not exist if Nazi Germany had possessed an
adequate supply of morphine to treat its war casualties.

Allied forces discovered the formula for the synthetic opiate at the
end of World War II in the secret German war archives, and it was
subsequently examined by U.S. medical researchers who saw it as a
nonaddictive cure for morphine and heroin dependency.

But today, nearly 60 years after its development as a wartime
necessity, methadone's cachet as a Cinderella drug has dimmed
considerably. Uncritically celebrated in the beginning, it is now
universally recognized as a highly addictive Schedule II drug. For all
the hope and hype initially surrounding it, it's now abundantly clear
that methadone doesn't rehabilitate drug addicts, but merely steers
them from being addicted from one drug to being addicted to another.

It's little wonder that the prospect of a methadone clinic in Scott
County, Va., has residents up in arms. What community anywhere would
welcome a business that depends on drug addicts?

In neighboring Tazewell County, Sheriff, H.S. Caudill, has seen an
increase in crime since a methadone clinic located there approximately
three years ago. He warns that a new clinic in Scott would likely
attract what are now familiar problems with shoplifting and associated
crimes in his jurisdiction.

Methadone clinic advocates, which consist almost entirely of the
for-profit clinics and their clients, strive mightily to accentuate
the positive. They stress the rigor of the supervised drug treatment
program they say makes methadone abuse a virtual impossibility. They
also point out that many of their patients hold steady, responsible
jobs and have been otherwise drug-free for years.

There's no doubt methadone treatment has been a godsend to many drug
addicts. But they are still addicts.

They are still one dose and one day away from their previous drugs of
choice.

This isn't rehabilitation, but maintenance - often for life. In
Tazewell County, Dr. Maria Encarnacion, medical director of the Life
Center, readily admits that a mere two in 10 of the center's patients
ever reach what is called full recovery, meaning that they wean
themselves from all drugs including methadone. The fact is methadone
is a treatment in search of a patient - and his money.

Here's something else to consider. When it comes to drug
rehabilitation, methadone is no longer the only game in town, as it
were. In a head-to-head comparison of treatments for heroin addiction,
medical researchers have recently found that a new, easier-to-take
medicine called Buprenorphine works every bit as well. Better yet,
unlike methadone which has to be taken daily, Buprenorphine is longer
acting and can be taken as little as three times a week.

Often referred to as "bup B" or by the popular prescription name,
Subutex, Buprenorphine has also been found useful in helping patients
withdraw from - a drum roll, please - methadone. Since Buprenorphine
is a milder narcotic, researchers report patients have an easier time
weaning themselves from it.

Drug addiction is a terrible thing, but a lifetime of methadone
treatment isn't much of an alternative. No expert in the field would
claim that drug rehabilitation proceeds in a perfectly straight line.
But the seemingly endless circle of methadone clinic treatment isn't a
reasonable, or even rational, description of true recovery.

Local addicts don't need a more convenient clinic. They need a cure.