DRUG CAN HEAL OR DESTROY

Methadone can restore order to a broken life or reduce it to a shattered
ruin. It can take away the craving for the poison of addiction or plunge
the user deeper into despair.

It can take a street junkie hooked on heroin and turn his life around, and
it can heal the suburban housewife strung out from a doctor's pain - killer
prescription. Or it can make them wish they were dead.

It depends on who's using it - and why. It depends on how serious they are
about reclaiming their lives - or if they're just looking to get high.

The world of methadone encompasses both extremes. No one knows this better
than health-care professionals who oversee methadone treatment programs -
some of whom work in non-profit settings, such as the Veterans
Administration in Cincinnati, while others dispense the drug in for-profit
environments such as the East Indiana Treatment Center, or EITC, in nearby
Greendale, Ind.

The latter is vague about the number of clients it treats each day.
Accounts range anywhere from 1,000 to 1,800 - the vast majority of them
from Cincinnati and Northern Kentucky.

And increasingly, EITC is coming under attack, both from its non- profit
counterparts and law enforcement officials in Dearborn County. They say
EITC's for-profit nature gives the clinic little incen(147,1,1)tive to wean
its clients from methadone. They also say EITC's lax procedures are to
blame for widespread abuse of the drug.

EITC spokesman Brian MacConnell acknowledges that the drug is abused,
paving a path to an assortment of other criminal activities.

"However, 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.''

Interviews with users and former users show how methadone can save lives.
But they also show the drug only works if those taking it sincerely want to
restore their lives. Like any drug, its abuse tends to make bad situations
worse.

John Earls, 46, was returning home to Lawrenceburg, Ind., on Feb. 2, 2001,
after dropping off a buddy on work release at a jail in Northern Kentucky.
Earls had been to the East Indiana Treatment Center earlier in the day and
was still high on methadone.

With him in his car was his 5-year-old son, Tyler. The child wasn't wearing
a seat belt.

Earls had pulled off the Interstate 275 exit ramp and was headed west on
U.S. 50 when his car went left of center. At that moment, James Campbell,
also of Lawrenceburg, was eastbound on U.S. 50 on his way home after
visiting his ailing wife at a local nursing home.

Their cars collided head-on. Campbell was killed. An Air Care helicopter
took Earls to University Hospital and his son to Children's Hospital
Medical Center. The child sustained severe head injuries.

Earls pleaded guilty in Dearborn Superior Court July 18 to a series of
charges, including child neglect, driving while intoxicated and reckless
homicide. He has been sentenced to 10 years with the Indiana Department of
Corrections.

The boy's mother, Tricia Courtney, 32, is in the Dearborn County Law
Enforcement Center on charges of dealing in pharmaceuticals. The boy is in
foster care.

On Jan. 14, James E. O'Toole, a 41-year-old EITC client, pleaded guilty in
Dearborn Circuit Court to two felony counts of selling methadone.

Just before his arrest in the spring of 2001, O'Toole had been going every
Tuesday morning to EITC. There, he would pay for a single 100-mg dose of
methadone, which he would consume on the premises, and six 100-mg "take
home'' doses.

He told police he supported himself by selling most of his take-home
supply. Court documents also said he often had to find buyers in EITC's
parking lot to purchase a portion of his methadone so he would have money
up front to pay EITC.

According to the probable cause affidavit O'Toole's arresting officer filed:

"The person buying the methadone gives (O'Toole) the money he needs to dose
- - after (O'Toole) gets his `take homes,' he settles up with the buyer,
giving that person whatever portion of his take home' they agreed on.''

Once that transaction was completed, O'Toole would sell portions of his
supply for $1 a milligram.

"O'Toole stated he just has to live with being sick one or two days a week
in order to pay his bills.

"When he does not have a dose, he is sick that day. And when he sells his
doses, he has to go sick on some days to get by until next Tuesday.''

O'Toole was accepted for treatment at EITC shortly after it opened in 1996.
He told police EITC initially gave him a 30-milligram dose and, within a
year, was giving him 100-milligram doses.

Court documents show he told his arresting officer no one at EITC had ever
suggested anything to him about reducing his dose or being weaned off
methadone.

Ironically, the standard procedure at the Dearborn County Law Enforcement
Center, where O'Toole was taken after his arrest, is to channel prisoners
who show signs of methadone withdrawal into an in- house program that weans
them off the drug.

"In the past few years, we've seen more and more prisoners suffering from
methadone withdrawal,'' said Dearborn County Sheriff David Wismann.

"So we've developed a step-down system where our jail physician gradually
decreases their doses to where they're drug free.''

O'Toole was sentenced in Dearborn Circuit Court to 30 years in prison, with
20 years suspended. He also was ordered to have no contact with EITC.

His two teen-age sons did not attend the sentencing. At the time, they were
living at the home of Steve Thalheimer, an English teacher at Lawrenceburg
High School. Thalheimer had invited them to move in with him after learning
they had no place to live and that their mother was in rehab.

"At first, the boys had wanted it to appear that they came from a normal
home,'' Thalheimer said.

"When I got to know them, they told me their parents used drugs. The father
had worked in construction in Florida, then his business folded.

"They moved to Cincinnati, where the mother's family lived. Then they moved
to Lawrenceburg to be close to the clinic.''

Warren and Norm are recovering addicts, each with a different perspective
on methadone, each with different feelings about the East Indiana Treatment
Center.

Both prefer to keep their last names to themselves, they say, mainly so
family members won't learn about that part of their pasts.

Warren is a 38-year-old chef who lives in Park Hills. He says he became
addicted to pain-killers and, eventually, heroin after breaking his
shoulder during a bar fight in 1997. He overcame his dependency nine months
ago during a five-month stretch in the Kenton County jail on a
check-forging charge.

Gene is 50, a Vietnam-era Marine who was shot point-blank in the chest with
a .45 during an altercation at Camp Lejeune, N.C., in 1971. While
recovering from his wound in a military hospital, he became addicted to
morphine. He has been clean for 16 months.

Warren believes EITC is saving lives. Gene blames EITC's "take-home''
policy for the deaths of three users in the past 18 months.

"Cincinnati for years was known as a pill town, not a powder town. Dayton
was always the powder town,'' Gene says.

"But with heroin in Cincinnati now, it's full speed ahead. In the '70s and
'80s, you might've had 30 or 40 dope fiends in town. By that, I mean down
dope: heroin, morphine, the opiates.

"But now, there's got to be 1,500 (heroin users) or more out there. Add to
that, now there's OxyContin, which is relatively new. With Oxy, it's
flat-out blam, boy, it'll knock you to your knees.

"So whether it's powder or pills, most people in Cincinnati drive to
Indiana because they can get their methadone dose as high as they want. You
can get a big drink at EITC.

"And EITC doesn't do detox - it does maintenance. If they did detox, they
put themselves out of business.''

After his shoulder was broken, Warren says his physician gave him a
two-month prescription of Percocet. When the prescription ran out, the
withdrawal symptoms - a lack of energy and enthusiasm, nausea, diarrhea -
took him by surprise. He began buying on the street.

"There's a few places in Covington and Cincinnati where they sell it on the
street. The Percocet was $8 for a 5-milligram pill.

"Or you could get Oxy on the street. A 20-milligram pill was $20, so I
figured I was saving money if I cut a 20 in half. Then I found out they
made a 40-milligram Oxy, then an 80.''

After a couple of years, Warren was using three 80s a day. He says he was
addicted to OxyContin for five years.

"Finally, I worked my way into heroin because I thought it was cheaper -
but I ended up breaking my neck because I nodded off and fell down a flight
of stairs. With heroin, they don't print the milligrams on the side of the
package.

"All this time, I'd go to EITC off and on. I probably would've stuck with
it, but it was the consistency of having to get there every morning.

"I lost my (driver's) license in the process. Plus, I blew two car engines
going down there. They close at 1 p.m. I mean, if you're running late, and
it's almost closing time, you don't want to miss your drink.''

Gene says his sister-in-law is a client at EITC. He took her to the Central
Community Health Board, only to find a waiting list for methadone treatment.

"So I drive her to EITC, we went through the process and she got her drink
that day. I think that's great. But now all she does is sit around and nod
because she's on too big of a drink. At EITC, they give you whatever and
take your money.

"EITC needs better control over the clients. At the VA (methadone treatment
program), I talk to a counselor once a week. At the VA, you've got to show
them you're doing something with your life, working or getting an education.

"EITC counselors will tell you they'll do this and that when you first come
in. Then they don't do anything. Yeah, there are people going to EITC who
are getting help, trying to get better. But they're doing it themselves.''

At one point when he was in treatment at EITC, Warren says he was receiving
100-milligram doses of methadone.

(SIDEBAR)

Pro and con

* Critics of EITC say the for-profit agency distributes methadone too
generously - with not enough supervision and not enough effort to wean its
clients off the substitute drug - and does little to solve drug users'
addictions.

* EITC blames its clients. Administered properly to users who sincerely
want to get free of their habits, methadone immediately eliminates criminal
behavior, clinic officials say.