Methadone: No Heroin Highs but No Cravings, Either

Methadone: No Heroin Highs but No Cravings, Either
Posted by FoM on April 17, 2000 at 21:27:21 PT
By David Gram, Associated Press 
Source: Boston Globe
The 77 people who make regular often daily trips to the Community Substance Abuse Centers clinic on the west end of town are using methadone to try to kick a heroin habit. Instead of getting heroin's quick high and then crashing and craving more as little as four hours later, an addict on methadone gets no high but a 24-to-36-hour absence of what clinic director Vincent Tobin calls ''the sick.'' 
''When it starts to wear off you get the sick,'' Tobin says of heroin. ''You start to feel a little edgy, nervous. You get leg aches, cramps. You might get nausea. You get sweaty. You're sick. You have to cop (acquire heroin). You have to get something to take away the sick.'' A typical course of methadone treatment takes one and a half to two years, though some patients remain on methadone indefinitely. Typically, a patient will start with a small daily dose, build it to a maintenance level and then taper off, with the aim of being drug-free at the end of treatment, Tobin said. There's an initial medical screening, the daily methadone doses often involving a long, round-trip drive to the clinic, and frequent counseling sessions. ''You have to completely change your lifestyle ... the criminal activity, the negative, self-defeating type thinking,'' Tobin said. He acknowledged there's a high rate of addicts returning to heroin after treatment. Many people first tried heroin to kill some sort of emotional pain. ''You have to face all kinds of challenges in your life that have to be met and overcome.'' It's difficult, ''especially if you know you can go down the street and cop a bag of dope and take care of all that.'' The treatment costs $105 a week. Massachusetts Medicaid, for which most of the addicts are eligible, pays for it. But not all the addicts are from the Bay State. About 20 come from Vermont, one from New Hampshire. Vermont and New Hampshire are two of the eight states where methadone centers are illegal. Long-term methadone treatment is not the only way heroin addiction gets addressed. Other synthetic opiates are being tried. Vermont Gov. Howard Dean has been talking up buprenorphine, which is undergoing clinical trial at the University of Vermont, as an alternative to methadone. But buprenorphine has yet to win approval from the federal Food and Drug Administration. And the nation's drug policy chief, Gen. Barry McCaffrey, said last week that ''buprenorphine would not be a replacement for methadone ... but an auxiliary treatment option for both physicians and patients.'' McCaffrey said that nationwide, 170,000 patients were in methadone treatment at the end of 1998. But he said 980,000 people were addicted to heroin, indicating a big need for expanded methadone treatment availability. Another group of treatment centers that avoids methadone is Phoenix Houses of New England Inc. There, patients often come in after a short-term four- or five-day detoxification period in which methadone is used, but are drug-free after that, said Pat McEnaney, regional vice president of the substance abuse service. After five days, the physical addiction to heroin should be gone, McEnaney said. ''There might still be a psychological addiction, but there won't be a physical addiction,'' he added. McEnaney said, though, that he and his organization have no position on whether methadone clinics should be allowed. Some patients have come to Phoenix Houses after methadone treatment and been successful, he added. ''We would prefer that people not be involved in methadone,'' McEnaney said. ''But I don't know that we'd say we're the only game in town.'' Greenfield, Mass. (AP)Published: April 17, 2000 Copyright 2000 Boston Globe Electronic Publishing, Inc. Related Articles: Helping Addicts Would Be Best Tactic in Drug War, Education Key Drug War Weapons, Treatment Key in Fighting Drugs Methadone Rx - Salon Magazine Methadone Articles On Methadone:
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