CITY'S NEW HEROIN PROGRAM ENLISTS DOCTOR'S HELP

By early spring a treatment that neutralizes addicts' lust for the heroin
high should be available through private physicians, expanding access to
treatment and potentially reducing the social consequences of addiction,
health officials say.

The $1.1 million federal grant accepted Monday by the Board of Supervisors
will fund the nation's first pilot program enabling physicians to prescribe
methadone directly to heroin addicts.

San Francisco's estimated 15,000 addicts cost The City $1.6 billion a year,
including treatment expenses, criminal justice costs and lost economic
productivity.

San Francisco General Hospital spent more than $40 million in a recent
two-year period to treat injection-related diagnoses.

By allowing private physicians to administer methadone directly to heroin
addicts, health officials expect to treat more addicts and trim overall
costs.

Doctors already use methadone as a painkiller, but so far state and federal
regulations have only allowed special clinics to administer it as an
antidote for heroin addiction. San Francisco has six clinics that treat
2,500 to 3,000 addicts each year.

The program, Office-Based Opiate Addiction Treatment, should be running
within six months, said Mitch Katz, director of The City's Department of
Public Health. Smaller test programs have been tried in New York,
Connecticut, Baltimore and Toronto.

San Francisco ranks third among U.S. cities in the number of heroin addicts
per capita. Baltimore heads the list, followed by Newark, N.J.

In a typical year in San Francisco, 200 people die of heroin overdose. The
City leads all California cities in the number of drug-related deaths per
capita.

Exactly how many more addicts will be treated through OBOAT depends on the
number of local physicians who join the program, according to Katz, and by
the willingness of addicts to undergo treatment.

"Ultimately there's no limit," he said.

Each participating physician could treat a maximum of 30 patients, according
to DPH documents.

The federal government has waived certain methadone distribution
restrictions for local governments with specific plans for expanding
treatment of opiate addicts. San Francisco health officials began developing
OBOAT more than two years ago.

"We're way ahead of everybody else," said Supervisor Gavin Newsom, a
persistent advocate of alternative drug-treatment programs.

Although some critics allege that treating heroin addiction with methadone
merely substitutes one addiction for another, Katz endorses the methadone
treatment.

"On methadone, people regain their lives," he said.

The drug, a relatively inexpensive pharmaceutical, has been shown to control
addicts' cravings and prevent withdrawal symptoms for 24 to 36 hours,
allowing them to lead productive lives. Taken every day, many addicts are
able to hold jobs, Katz said.