METHADONE: MEDICINE OR MENACE?

Clinics Are Popping Up All Over W.Va. for Addicts Wanting to Quit Opiates

Twenty-eight months ago, West Virginia had no methadone clinics.
Today, it has seven.

The clinics are for-profit facilities. They make money by selling
methadone, a legal opiate drug, mostly to people who have abused
OxyContin, another legal opiate drug. The methadone - which costs
about $12 a day, much cheaper than an OxyContin habit - is supposed to
block the craving for street drugs and stop the terrible withdrawal
symptoms.

Methadone treatment has been praised by much of the medical community
for 40 years. It allows heroin and other opiate abusers to get off
illegal drugs, stop stealing to support their habits, repair their
broken relationships, avoid AIDS from dirty needles.

But the for-profit methadone clinics do have their critics. Ohio has
banned them.

Methadone clinics in Ohio must be either government-run or nonprofit.
The idea is that for-profit clinics have less incentive to ever wean
addicts off methadone.

"We want to make sure we're promoting [addicts'] recovery," said
Stacey Frohnapfel Hasson, communications director for the Ohio
Department of Alcohol and Drug Addiction Services.

"Do you want to spend a lifetime as a addict? It doesn't have to be
that way. We have lots of state programs that provide detox and then
treatment, and do not use methadone."

Weirton, Lewisburg Are Next

In 1997, Southern West Virginians were just beginning to discover that
the OxyContin their doctors had prescribed for pain was getting them
really hooked, really fast.

They started trickling in to a methadone clinic in southern Indiana,
hoping that methadone treatment would ease the harsh withdrawal from
OxyContin. That clinic - and five others in Indiana, which account for
75 percent of Indiana's methadone customers - is owned by National
Specialty Clinics Inc.

The corporation decided to start selling methadone in Charleston. It
opened West Virginia's first methadone clinic in January 2001, just
outside the city limits, on Greenbrier Street.

"That program was an overwhelming success," said Reeve Sams, regional
director for NSC. "We experienced more of a response than we thought
we'd get there."

NSC spread out across the state. It now sells methadone at clinics in
Clarksburg, Parkersburg, Beckley and Huntington. A clinic is set to
open in Williamson on Tuesday.

By the end of summer, NSC plans to open a clinic in Weirton. A
Lewisburg clinic will follow shortly thereafter, making nine methadone
clinics in West Virginia. (The ninth clinic, in Martinsburg, is run by
a different corporation.)

"It is highly controversial," Sams said. "A lot of people aren't
educated in it, and try to bash it."

Nine months ago, The Cincinnati Post did a special report on an NSC
methadone clinic across the Indiana border from Cincinnati. The clinic
draws many patients from Ohio, where methadone laws are much stricter.

A director at a government-run methadone clinic in Cincinnati told the
Post that, when NSC opened the East Indiana Treatment Center, "he
began hearing complaints from some clients that the methadone doses at
[his government clinic] were too low, that they could get higher doses
at EITC.

"'One day, I realized that they [EITC] were actually recruiting my
clients,'" he said. "'Leaflets were turning up on the windshields of
cars in our parking lot that basically said, 'New treatment program in
Indiana, adequate doses, call this number.' The leaflets stopped just
short of saying, 'Hey, come get all the methadone you want.'"

Are higher methadone doses necessarily a bad thing? Not according to a
three-year study published in 1999 in the Journal of the American
Medical Association.

The study looked at two groups of people in methadone treatment: One
group took moderate doses of methadone (40 to 50 milligrams per day),
and the other took high doses (80 to 100 milligrams per day). Both
groups were equally likely to stay in treatment, but the high-dose
group was much less likely to return to illegal drugs. The high-dosers
also were 13 percent more likely to eventually get off methadone.

'Addiction As a Treatment'

Eleven months ago, another NSC clinic in Indiana was visited by an
undercover TV reporter with a camera. The reporter told the counselor
and physician at Eastern Indiana Treatment Center that she was taking
OxyContin. She was not.

The reporter submitted a urine sample, as required by federal law. But
before the clinic could get the results of the urine test, which would
have shown that the reporter was lying about the OxyContin, she was
given her first dose of methadone.

The reporter asked the counselor if methadone is addictive. The
counselor said no. In fact, methadone is extremely addictive.

Denny Ailes, NSC's regulatory affairs director, declined to comment on
the report.

Because of public uproar, the Indiana Legislature is tightening
regulations on methadone clinics, said John Viernes of the state's
Division of Mental Health and Addiction.

"We will be required by law now to write some rules - a methadone
treatment protocol - which they should have done in the past, but have
not done until we had some real public outcry," Viernes said. "It's
the result of more public scrutiny of addiction-as-a-treatment modality."

Indiana already has more methadone regulations than West Virginia.
There, methadone clinics must report all kinds of information to the
state: how much they charge, how many patients they have, how long
they keep those patients on methadone, how many patients successfully
complete treatment and get off methadone. All of the information is
posted on the Internet so the public can see.

West Virginia does not regulate its methadone clinics. It does not
collect any of that information, either.

"We do not have state regulations," said Merrit Moore of the West
Virginia Division for Alcoholism and Drug Abuse. "Some states do."

Moore said the state's opinion is that federal regulations, coupled
"It's very hard to get off of some of these drugs. [People] are just
scared to death."

Randy Gilman, a disabled coal miner from Delbarton, welcomes anything
that will help people get off OxyContin - "if they know what they're
doing," he added.

He's distrustful of some of the doctors in the area, who he said are
too free with the painkillers in the first place.

"People need to learn to live with a little bit of pain," Gilman said.
"Everyone's had pain in their life. A pill isn't necessarily what you
need."