DOWNED BY DRUGS

Bryan Baldwin had been through the methadone program at the Eastern
Indiana Treatment Center. The Latonia man managed to stay clean for
nearly three months. His mother says he was trying to rebuild his life.

When he slipped -- just once, by all indications. In some ways, he
survived; he lived through an intentional overdose of the opiate that
was supposed to keep him from abusing other opiates like OxyContin.

But in other ways yet to be measured, the 33-year-old Baldwin lost his
life.

He spends his days in a bed in the rehab ward at Lakeside Nursing Home
in Highland Heights. Two months ago, he was a lean, 181-pound
six-footer. His weight as of a week ago was 127 pounds.

His neurologist says the extent of the damage to Baldwin's brain won't
be clear for several months.

"Typically in cases like this, there may be some improvement for six
months," said Dr. Scott Becker.

"You'll see memory loss, changes in behavior and personality,
staggering, an inability to do simple tasks like bathing oneself,
brushing one's teeth, feeding oneself.

"A year from now, if that's where a patient is, he's usually stuck
that way the rest of his life."

Methadone is a growing problem. The federal Drug Awareness Warning
Network reports that 11,709 emergency-room visits were attributed to
methadone overdoses in 2002, the most recent year for which figures
are available.

That's double from what it was in 1999, says Nick Reuter, senior
public health analyst for the Substance Abuse and Mental Health
Services Administration in Rockville, Md.

The increase seems due primarily to prescriptions written by
physicians and dispensed through pharmacies for methadone in tablet
form. In those cases, Reuter says, methadone is mainly in tablet form
and prescribed for pain relief through so-called pain clinics.

Distribution of methadone through those channels has more than doubled
since 1999, Reuter says -- from 50 grams to 140 grams per day for
every 100,000 Americans.

Meanwhile, he says, the use of methadone in liquid form -- of the sort
dispensed through methadone clinics like the EITC, where the drug is
geared to weaning addicts off opiates -- over the same period is
relatively flat.

Baldwin's mother, Marie Forand of Latonia, isn't sure when the
youngest of her eight children got mixed up with OxyContin, the
morphine-based painkiller that conservative radio talk host Rush
Limbaugh admitted an addiction to earlier this month. She remembers
maybe five years ago people telling her Bryan had a problem, her not
believing them.

As his drug use escalated, Baldwin's marriage began to unravel. He
entered the methadone program at Eastern Indiana Treatment Center,
just across the Ohio River in Greenville, Ind., and the closest clinic
for Northern Kentuckians to receive methadone treatment.

He was an EITC customer for three years. His mother said he lowered
his daily doses of methadone more quickly than his EITC counselor
recommended.

"He was trying to get free," Mrs. Forand said.

"He always said he wanted to go home to his wife and his little girl.
His last trip to that clinic was June 3."

On the evening of Aug. 20, Baldwin told his mother he was going to
visit two friends, Dennis Schadler and Larry Barnes, at their E. 39th
Street apartment in Latonia. Early the next evening, Baldwin went with
Schadler to a house in Bellevue and bought a dose of methadone.

Schadler would later tell Covington police and members of Baldwin's
family that Baldwin took a 150-milligram liquid dose of methadone. If
it's true that Baldwin had not taken methadone since leaving EITC,
health care professionals experienced in methadone treatment agree,
150 milligrams could easily be a fatal dose.

Said Dr. Andrea Barthwell, deputy director for Demand Reduction in the
White House Drug Policy Office, "Often in these instances, when one
returns to the drug after having been away for a time, they
over-estimate their tolerance. If (Baldwin) had weaned himself off
methadone and had not taken any for three months, he would not have
the tolerance to support a 150-milligram dose."

Repeated efforts to contact Schadler were unsuccessful. But Barnes
gave this account, starting with his return to his apartment Aug. 21:

"I didn't get in from work until 10:30 or 11 that night, and (Bryan)
was passed out. I asked Dennis what we should do, and he said to leave
him, he was sleeping it off.

"I went to work the next day, got off early, and when I got there,
(Bryan) was still lying there. I said, 'He ain't sleeping it off.'
That's when I called his mom."

Mrs. Forand said Barnes called around 4:30 p.m. on Aug. 22, to tell
her something was wrong with her son, that he'd been passed out on the
floor since 11 p.m. the previous night.

Mrs. Forand immediately called one of her daughters, Valerie Yaden, an
R.N. at St. Elizabeth Medical Center North, and asked her to meet her
at the friends' house. Mrs. Yaden described the scene when they arrived:

"I said, 'Oh, my God, Mom, Bryan's in trouble.' There was vomit all
over. He'd been lying on his right side for 15 or 16 hours, and the
blood had pooled to the right side of his body.

"His kidneys had shut down, and his heart was barely beating. His
entire body had gone stiff, with his hands curled in and his eyes wide
open. The lack of oxygen had caused his body to go rigid.

"His skin had broken open in several places from lying in one position
for so long. They're called 'pressure sores,' like bedsores. He was
making groaning sounds.

"When we got him to St. E, the nursing supervisor said it was the
worst overdose she'd ever seen. No one expected him to last through
the night."

But he did. Thirteen days later, with only limited use of the right
side of his body, he was released from the hospital.

His condition suddenly took on new dimensions Sept.
24.

"He started talking real crazy, mean-like," Mrs. Forand
said.

"It was a complete change."

She checked him into the St. Elizabeth Medical Center South Behavioral
Health Center. Initially, she said, hospital staffers thought he'd
taken another drug -- but tests showed he was clean.

Dr. Becker diagnosed him as suffering from delayed post-anoxic
demylineation:

"It occurs when a person has had a period of loss of oxygen to the
brain. They seem to recover then, two or three weeks later, the white
matter of the brain, the insulation around the wiring, deteriorates.
It's not fixable."

Again, Baldwin was not expected to live. Mrs. Forand said she was told
that, at the rate he was declining, he probably would not live more
than a few weeks longer. But again, his condition stabilized.

Late last week, Mrs. Forand was advised to find a nursing home where
her son could spend some time in rehabilitation. Depending on his
progress, she could eventually take him home to live with her. He will
not be able to live on his own.

Finding a nursing home that would accept him turned out to be a
difficult task, Mrs. Forand said, because his records from the
Behavioral Health Center indicated he was homicidal.

"Can you believe that?" she said. A few feet away, her son lay
motionless in his bed, staring at a TV that was tuned to a soap opera.

On some days, Baldwin is able to eat on his own. On others, one of his
sisters spoon-feeds him. One day last week, a social worker stopped by
his room at Lakeside to ask him a few questions.

Does he like to play cards? Does he like to watch TV? Does he like
arts and crafts?

He answered only occasionally and then only with a nod or a
glance.

Mrs. Forand blames Schadler for letting her son lie there for so many
hours. She blames the people in Bellevue who sold him the methadone,
and the people who were their source for the methadone. Too, she
blames her son for taking it.

One Cincinnati health care professional who asked that his name not be
used said he has been working in the methadone treatment field for 25
years.

"And I never saw a single case of methadone overdose in this part of
the country until maybe five years ago," he says.

"Now it's becoming increasingly prevalent. It's because there are more
take-home doses on the streets than there previously were."

The EITC, a for-profit clinic with an estimated 1,800 clients, allows
its customers to take-home supplies of liquid methadone of up to 31
days' dosages. The clinic has come under attack, both from its
non-profit counterparts and law enforcement officials in Dearborn
County, who argue that EITC's for-profit nature provides little
incentive for the clinic to wean its clients from their $12-a-day
methadone doses. They also say EITC's lax procedures and take-home
policies are to blame for widespread abuse of the drug.

The EITC had no comment. But in the past, in response to allegations
that the clinic has been too free in dispending the drug, an EITC
spokesman acknowledged that methadone is abused. He added:

"But we believe -- and also believe that any doctor, pharmacist or law
enforcement official will agree -- that diversion and sale of other
drugs, such as pain medication, is much more common.

"Methadone can save lives, but it only works if those taking it
sincerely want to restore their lives. Like any drug, its abuse tends
to make bad situations worse."

Mrs. Forand hopes that, once she gets her son back home again, his
memory will return in bits and pieces. It will be slow, she said.

He always was her baby, she said -- eight years younger than her next
youngest. Maybe she shouldn't have babied him as much as she did, she
said.

She has reconciled herself to the very real likelihood he'll forever
remain the baby of the family. At least, she said, he's alive.