Drug czar wants methadone more readily available

NEW YORK (AP) — The White House’s drug policy chief Tuesday proposed making methadone more readily available to drug addicts by allowing doctors for the first time to dispense the synthetic heroin substitute in their offices.
Currently, methadone is available only at special clinics, making it difficult for some addicts to hold down jobs and receive their daily dose of the liquid narcotic. Some states bar methadone altogether.
Gen. Barry McCaffrey, the White House national drug policy director, said study after study has shown that methadone not only eliminates the misery of heroin addiction but also makes it possible for addicts to lead productive lives and stay out of trouble.
“Methadone treatment is simply not available for Americans in all parts of the country in a manner called for by rational drug policy. We’ve got to do better,” McCaffrey told the American Methadone Treatment Association in New York.
At the same time, McCaffrey announced no additional money for the policy and acknowledged that state and local governments must endorse the changes to make methadone more readily available.
“This is a local decision for city councils, county government and state legislatures,” he said.
McCaffrey’s office set a goal of “adequate methadone treatment capacity for all of America’s opiate drug addicts.”
Eventually, McCaffrey said, individual doctors would be licensed to dispense methadone outside of clinics. The policy for the first time would also establish an accreditation process for methadone clinics and set standards for effective dosages, counseling and care.
There are an estimated 810,000 chronic heroin users in the United States, but only about 115,000 are receiving methadone. At least five states have barred methadone altogether: Mississippi, Montana, South Dakota, Vermont and West Virginia.
New York City has an estimated 32,000 addicts on methadone — more than any other U.S. city — but Mayor Rudolph Giuliani opposes its use, saying it simply swaps one addiction for another.
He recently announced a plan to get methadone patients at city-run hospitals off methadone, despite warnings from some drug abuse experts that the addicts will wind up back on heroin.
On Tuesday, Giuliani said: “I think that morally, philosophically and practically it’s a bad question for America to say, `Let’s double the number of people on methadone.’ Let’s try to make America drug-free.”
McCaffrey refused to criticize Giuliani directly, saying only: “We’ve got a problem based on ignorance. Methadone is the only cheap, effective tool.”
About 900 clinics in the country dispense methadone, which was popularized some 30 years ago. It blunts the craving for heroin.
Sheryl Massaro, a spokeswoman for the National Institute on Drug Abuse, said McCaffrey’s policy was based on recommendations made by a panel of specialists at the National Academy of Sciences who called methadone “more likely to work than any other therapy” for heroin addiction.
Dr. David C. Lewis, project director of the new Physician Leadership on National Drug Policy, composed of prominent doctors and public health leaders, said: “Yes, McCaffrey’s totally right on this one. Yes, medicine and science are behind McCaffrey on this one.”