Part Two

INSIDE THE CLINIC

Editor's note: This is the second in a three-part series examining the
debate about a possible methadone clinic in Champaign. Friday: Treatment
methods -- abstinence vs. methadone.

It's 9:30 a.m. on an overcast, humid Thursday in July, and the addicts
mingle about the small parking lot at the Duane Dean Behavioral Health
Center in Kankakee. The light gray-and-white stucco building, which sits on
a busy downtown corner, looks like it could be a diner.

The addicts are on break from morning group therapy sessions. They are
young and old, male and female, white and black, but they all look scruffy
with tattered jeans and untucked shirts. Their conversations are filled
with gestures, swear words and puffs of cigarette smoke. Soon, the addicts
stub out their cigarettes and file inside the clinic for the rest of the
group session.

Inside, a sign that hangs over the door in the waiting room warns that no
swearing will be tolerated in the clinic. Through the door is a large, dark
room with chairs and couches along the walls. A Pepsi machine stands in the
center of the room. A large neon green sticker on the machine reads,
"Believe in Jesus."

Jasper Jay Jones, supervisor of the methadone maintenance program at Duane
Dean, explains that the clinic is not religiously affiliated, but some
client probably put the sticker up.

"You need to believe in something to do this," he says with a smile.

Each morning, the room is filled with clients who wait for nurses to hand
out their daily methadone doses from a window across the hall. Clients are
given cups to drink the pills diluted in water or juice.

Champaign resident Katy Kalman traveled to the Duane Dean Center for more
than six months in an effort to get off heroin. The clinic dispenses
methadone, an opiate like heroin that has a similar effect on the body,
except instead of producing a high, it removes the intense physical pain of
heroin withdrawal.

Although going to the clinic helped Kalman stay off heroin, she weaned
herself off the methadone earlier this year so she didn't have to travel to
Kankakee six days a week. "I couldn't do it," she says. "My car couldn't do
it."

Kalman, who attended college and is a licensed pharmacy technician, wasn't
able get a job at a pharmacy while she was taking methadone because she
wasn't able to work "normal" hours. Instead, she worked "the shit hours" at
a job she didn't like at Kmart. Kalman is angry there is no methadone
clinic nearby.

"If I work here and pay bills here, why can't I get medical care here?" she
asks. "It's really ridiculous that I have to drive to Kankakee."

Jones hears similar complaints from the roughly 30 addicts who travel from
Champaign to the clinic. But he says that when heroin addicts are using,
they might spend as many as 17 hours a day trying to get high.

"We're giving you the ability to use five hours a day to manage a clean and
efficient lifestyle," Jones says, noting that time includes travel,
dispensing of methadone and group and individual therapy.

If a patient at the clinic regularly passes random drug tests, he or she
eventually would have to come to the clinic only once every few weeks for a
take-home methadone supply.

Jones explains that most of the clients who come to Duane Dean are
destitute, which is why the clinic operates on a sliding-scale fee system
based on a person's ability to pay. For most clients, Medicaid pays clinic
bills. The center has a contract with the Illinois Office of Alcohol and
Substance Abuse to help addicts. The clinic is also regulated by the U.S.
Drug Enforcement Agency and the U.S. Food and Drug Administration.

Of the clinic's roughly 250 clients, 103 are taking methadone. The rest
receive only group and individual counseling.

John Peterson, emergency room doctor at Provena Covenant Hospital, dictates
a patient encounter on Oct. 22. Peterson is a proponent of locating a
methadone clinic in Champaign-Urbana and plans to work with the clinic by
visiting three times a week to do medical evaluations.

"I would venture to say probably two-thirds of our heroin population have
used heroin for 20 to 30 years prior to entering treatment," Jones says.

Kendric Speagle, 26 and senior in LAS, operates Harm Reduction Resource,
which allows addicts in Champaign-Urbana to exchange used needles for clean
ones to reduce the spread of AIDS and other diseases. Speagle proposed
starting a methadone clinic in downtown Champaign because he says local
heroin addicts he sees are "begging" for one.

He says the lack of a methadone clinic in Champaign-Urbana means "a
significant number of people in this city are being deprived of treatment
that's effective, and that's unfortunate."

Julie Pryde, director of social services for the Champaign Public Health
District, has supported Speagle's efforts to start a methadone clinic. With
the relapse rate of heroin use at more than 90 percent, Pryde says the
clinic might be the only way addicts like Kalman can get clean.
Additionally, Pryde says a local methadone clinic could reduce the spread
of disease; 75 percent of HIV infection cases in women and children in the
county are caused by intravenous drug use of heroin and cocaine.

"If you're using methadone, you're not spreading HIV (through needles),"
she says.

Jones says 10 to 20 percent of the clients at Duane Dean are infected with
HIV or hepatitis from sharing needles they used to inject drugs. New
clients are given an AIDS test and receive education about the disease.

In the past year, all heroin addicts who initially have gone to the clinic
for help have had heroin in their systems.

"They have to, or else they wouldn't be able to sit and talk to us," Jones
says, referring to the painful effects of heroin withdrawal, including
cramps, diarrhea, nausea and flu-like symptoms.

The National Institute of Drug Abuse reports that the number of heroin
users steadily has increased since 1992.

"Heroin use has made a resurgence nationally, and Champaign County is
following that," says Mike Carey, a county probation officer who handles a
caseload of nearly 300 drug abusers.

Thomas Gilbert, a drug counselor at Prairie Center's residential facility
in downtown Champaign, knows of a group of about six heroin addicts in
their mid-to late 20s who hang out and party together. Many of them are
middle class, and some are in college. "I think a big misconception is that
all intravenous drug users are down and out," he says.

Lt. Scott Swan of the Champaign Police Department, a former member of the
Narcotics Task Force of the Illinois State Police, explains that heroin
users tend to know each other. Swan also says heroin dealers tend to sell
the drug only to support their habit.

"Those people party together," Swan says. "They know each other."

In a recent report of the Drug Abuse Warning Network, which tracks drug
abuse deaths in major U.S. cities, heroin-related deaths increased steadily
from 1992 to 1998.

John Peterson has been an emergency room doctor at Provena Covenant
Hospital in Urbana for four years. During the past 18 months, he has seen
at least one heroin addict a month come into the emergency room; before he
might have seen only one or two a year.

Peterson supports a methadone clinic for the area and says the public
doesn't understand the extent of the community's heroin problem. For
example, many people opposed to the downtown location for the clinic are
not aware that many drugs, including heroin, already are sold in the area.

"The fact of the matter is one of the biggest heroin exchange points in
Champaign-Urbana is a block and a half away (from where the clinic would
be)," in the vicinity of a Bigfoot gas station, Peterson says.

He says the five-year mortality rate of heroin use is 50 percent.

"It goes directly to the brain," he says. "It crosses the blood/brain barrier."

Peterson says many heroin addicts are medicating themselves for depression.

Peterson treated one such heroin addict who had a managerial job.

"This guy supervised 300 people," Peterson says. "He did his best work on
heroin. He also went through his wife's savings account."

Kalman's heroin use escalated when she had to deal with an antagonistic
co-worker at her previous job at McKinley Health Center's pharmacy. She
worked there for seven years, and during her last three years, she
sometimes would get so upset about a co-worker that she would use heroin up
to three times a day.

"I was a basketcase," Kalman remembers.

Peterson says he thinks local police are resistant to do much about heroin
in the community because they don't see it as a big problem. When a friend
of his became addicted to heroin, Peterson tried to get police to put the
dealer out of business.

"I didn't get them to respond even though it was a fairly big operation,"
Peterson says. Finally, he went to the mayor, and the drug dealer was
arrested and sent to jail.

"He's back out of jail," Peterson says. "He's dealing, but he's not dealing
to my friend." Swan estimates 95 percent of the calls the Narcotics Task
Force handles are about crack.

"There is a (heroin) problem in this community," he says, "but it's a
problem that's not so widespread that you're constantly fielding calls on it."

Sgt. Jon Swenson of the Narcotics Task Force notes that although an ounce
of heroin can sell for $6,500 while an ounce of crack can sell for $900,
crack can bring in a greater profit because of the great local demand.

"(Heroin is) certainly not as widespread as crack," Swenson says.

Kalman lets out a bitter laugh when she's told local police don't consider
heroin a major problem.

"Let them lie to themselves," she says.

When Kalman moved back to her native Champaign-Urbana with her husband in
the early '90s, she chose to do heroin for one reason: "It was just the
easiest to get."

Jones says heroin addicts steal or sell drugs to support their habits.

"They commit the same number of crimes (as other drug users)," he says.
"They're just more devious."

Kalman says the people she knows who buy heroin tend to be young, white and
affluent.

"These are people with decent jobs and decent money and spending it,"
Kalman says. The longer a person has been using heroin, the more painful
the withdrawal. Champaign County Probation Officer Mike Carey has one
client, a 63-year-old man, who has been using heroin for decades.

"This man, at age 63, if he were to go through that physical withdrawal, he
wouldn't make it at his age," Carey says.

Instead, the man travels to Duane Dean in Kankakee every day to receive
methadone treatments.

"Methadone is a harm reducer," Jones says. "The person does not have to go
out and steal to support their habit."

Jones estimates that there are roughly 20 methadone clinics around Chicago.
But he says that beyond the Duane Dean Center and a similar clinic in
Decatur, few methadone clinics exist south of Chicago.

"It's not enough facilities for the state of Illinois," he says. "Between
all of the facilities, we're probably touching a tenth of the population
that would benefit from treatment."