- The Washington Times - Monday, November 25, 2002

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.


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