METHADONE: CODE BLUE

Opiate addiction inevitably entails terrible personal and social
consequences. Up to 5 percent of the populace abuses such drugs, which
range from heroin to prescription pain medications like Oxycontin. So, it's
not surprising that methadone has become such a common prescription for the
problem.

The cure can often be as bad as the disease. Methadone has been used for
more than three decades to treat opiate addiction, since it can both block
the heroin high and dampen the cravings associated with heroin withdrawal.
A single dose of methadone lasts between four and six times as long as a
hit of heroin, so the habit is easier to service. Unfortunately, like
heroin, methadone can be found on the illegal market. Like heroin, it can
also kill.

The problem is that putting a heroin addict on methadone is somewhat akin
to putting a five-martini-lunch alcoholic on a two-vodka-tonic diet. The
cravings are reduced, but the chemical crutch remains. That might be
appropriate while attempting to wean an individual off a heroin habit, but,
at a certain point, the crutch should come off lest the individual be
permanently enthralled by another addiction.

According to the Drug Enforcement Agency (DEA), methadone withdrawal can be
more prolonged, albeit less severe, than heroin addiction. "Chronic
administration of methadone results in the development of tolerance and
dependence," the DEA notes on its Web site

One problem is that chronic administration of the drug is often the
prescribed treatment. The Institute of Medicine now recommends methadone
maintenance - the indefinite use of the drug - as the best treatment for
opiate addiction. While studies have shown that methadone maintenance works
reasonably well when coupled with long- term psycho-social counseling, not
everyone uses their prescriptions in the proper manner. In fact, since
methadone is often prescribed on an outpatient basis (and is also
prescribed to treat other opiates, such as oxycodine), potential abusers
have numerous opportunities to sell their personal pharmaceuticals - or buy
others.

The result can be a "McPharmacy." That was the description applied to an
open-air drug market located near three methadone treatment centers in a
neighborhood in Northeast Washington. Such methadone treatment centers are
magnets for drug abusers and perpetuate health- and crime- related problems.

And not just in the District. Portland, Maine, has seen more than 10
methadone-related deaths this year. Florida saw a 71 percent increase in
deaths related to methadone between 2000 and 2001. The problem also seems
to be growing in Virginia. According to the Drug Abuse Warning Network,
methadone-related emergency-room visits almost doubled between 1999 and 2001.

Last month, the Food and Drug Administration approved Buprenorphine, a
chemical cousin of methadone, for treating heroin addictions. While it will
be another important tool for physicians, public-health administrators must
take a closer look at treating heroin addiction. As things now stand,
methadone has become another source of addiction - at taxpayer expense.