The Associated Press; 50 Rockefeller Plaza, New York, NY 10020 - Wednesday, November 19, 1997; 6:26 p.m. EST
Paul Recer, AP Science Writer

The report by a committee at the National Institutes of Health supports an earlier White House call for more physician control of dosing and distribution of methadone, a synthetic narcotic used to wean addicts from heroin.

Committee chairman Dr. Lewis L. Judd of the University of California, San Diego, said physicians are reluctant to treat heroin addiction because of mountains of paperwork and "onerous" regulations imposed on the use of methadone by federal agencies and state governments.

"We know of no other area of medicine where the federal government intrudes so deeply and coercively into the practice of medicine," Judd said. "If extra levels of regulation were eliminated, many more physicians and pharmacies could prescribe and dispense methadone" and make the treatment more readily available.

Methadone is a pill that has some of the same physiological effects on the brain as heroin, which helps blunt the effects of heroin withdrawal. Methadone does not produce a "high" that most addicts crave, and it takes several hours for its biological effects to occur. For these reasons, Judd said, methadone is not considered a drug that is attractive to abusers and should be available for prescription.

"Laws to control methadone diversion are no longer necessary," Judd said. The laws were passed, he said, to limit distribution of methadone because of apprehension it could be sold on the black market to heroin addicts.

The report, drafted by 12 independent experts commissioned by the NIH, is consistent with a proposal made in September by Barry McCaffrey, director of the White House Office of National Drug Control Policy.

McCaffrey said then methadone should be "prescribed by doctors and not by policy" and that trained and monitored physicians should be allowed to dispense methadone.

Bob Weiner, a spokesman for McCaffrey, said the presidential adviser would not comment directly on the new report, but he continues to support changes in federal methadone policy that were proposed earlier.

Dosing of methadone is controlled by the Food and Drug Administration. Distribution of the heroin substitute also comes under regulations of the Drug Enforcement Administration and the Department of Health and Human Services. Additionally, almost every state has laws that closely control how, when and where methadone is to be used, Judd said.

Doctors who attempt to treat addicts with methadone face frequent state and federal inspections and are required to submit paperwork proving that the drug is used within the limits of various laws.

The aggravation discourages most doctors from treating addicts, Judd said. In the meantime, authorized methadone treatment centers have months-long waiting lists, he said, and at least seven states don't even have such centers.

Judd said an estimated 600,000 heroin addicts are in the United States, and only about 115,000 are enrolled in methadone maintenance programs.

The committee said the widespread and deeply ingrained belief that heroin addiction is a self-imposed condition leads many to feel it should be treated as a moral and legal problem.

But the experts said research clearly shows that heroin addiction is a medical problem, a disorder linked to a genetic predisposition and to social conditions, the committee found.

"It should be dealt with as a medical illness, just as are any other medical disorders," Judd said. "It is a no-fault illness."

The committee found that heroin addicts who are on methadone maintenance for at least a year have a good chance of conquering the addiction, although many patients may have to take methadone for life.

Successfully weaning addicts from heroin also requires psychological and social therapy, the committee said.

Judd said patients on methadone maintenance are able to work and avoid criminal activity. In contrast, heroin addicts usually spend most of their time finding ways to support the habit. This usually means stealing.

Additionally, methadone patients are much less likely to contract infections that are common from illegal injected drugs. About 75 percent of all new HIV infections, for instance, are among intravenous drug users, Judd said.

Health care costs associated with heroin addiction was estimated at $1.2 billion a year, the committee found.

Copyright 1997/The Associated Press. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Associated Press, 50 Rockefeller Plaza, New York, NY 10020.
971119
AP971114

Copyright © 1997 - Associated Press. Reproduction of this article (other than one copy for personal reference) must be cleared through the AP Permissions Desk.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, National Library of Medicine, Pacific Life Foundation, and donations from users like you.

Always watch for outdated information. This article first appeared in 1997. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1997. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .