Pubdate: Thu, 24 Feb 2005 Source: Kingsport Times-News (TN) Copyright: 2005 Kingsport Publishing Corporation Contact: http://gotricities.net/domains/timesnews.net/lettertoEditor.dna?action=new Website: http://www.timesnews.net/ Details: http://www.mapinc.org/media/1437 Bookmark: http://www.mapinc.org/find?136 (Methadone) SCOTT MAY HAVE DODGED METHADONE BULLET Thanks to Virginia Delegate Terry Kilgore and unanimous votes by both chambers of the Virginia General Assembly, the prospect of a methadone clinic locating in Scott County looks increasingly unlikely, and that accrues to the good of the community. Feeding the habit of drug addicts does not end their addiction. Kilgore's bill effectively establishes a moratorium on new methadone clinics' ability to locate in rural areas that lack zoning regulations. It also directs the Mental Health, Mental Retardation and Substance Abuse Services Board to establish standards to evaluate the need and appropriateness for the issuance of new methadone clinic licenses. The standards will include common-sense criteria relating to the number of persons needing such treatment in the service area, the proposed site of the clinic, the existing access to such treatment, the geographic and demographic parameters of the service area, and the proposed clinic's security and accountability measures. The moratorium and a new set of ground rules for methadone clinics are certainly steps in the right direction. But it is the increasingly questionable rationale for these clinics that fundamentally needs to be addressed. Designed to wean addicts off heroin, methadone and the clinics that dispense it have sparked a great deal of concern. In Tennessee and Virginia the regulation of methadone clinics is a state responsibility, effectively leaving local governments with no voice in the matter. That's plainly wrong. If a locality can decide whether it wants liquor-by-the-drink, it ought to be able to determine whether it wants to allow a for-profit business to dispense drugs. But lack of local control over such clinics is only part of the problem. There are literally thousands of addicts in Virginia and Tennessee receiving methadone "treatment.'' But methadone is a highly addictive Schedule II drug, which places it in the same category as morphine and other potent painkillers and opiates. Methadone doesn't cure or rehabilitate a drug addict in the clinical sense, but merely steers the individual from being addicted from one drug to another. Even those who operate methadone clinics admit that only a fraction of their clientele ultimately kick their methadone habit and go completely drug-free. There's a good reason for that: money. Since methadone treatment moved out of carefully monitored, intensive hospital settings into for-profit clinics, there is a powerful economic disincentive to terminate "treatment.'' That means most methadone patients simply continue their medication indefinitely. If these individuals were diabetics needing insulin, such lifelong medication would be understandable, but a diabetic's need for insulin and a drug addict's artificially induced desire for opiates are not the same thing. Methadone was originally introduced as a means to an end, a way to wean hard-core heroin addicts away from their addiction and eventually to reintroduce them into society as useful, working, crime-free citizens. Instead, it has become an alternate addiction not only for its patients but the clinics that have come to depend on the profits derived from it. If the location of methadone clinics is going to be regulated by the state rather than by localities, then state lawmakers need to radically reconsider the rules under which this drug is distributed. A good start would be to bring methadone treatment back into a hospital setting where only physicians could dispense the drug. Frequent, unannounced drug screenings would catch those using other drugs, and they would lose their chance to continue in the program. Most important, physicians would be required by the state to eventually wean a patient from methadone at a date certain. Drug addiction is a terrible thing. But we do no kindness to addicts by allowing for-profit clinics to prey upon them in the name of compassion. Methadone's use, which is sadly all too common, should be as regulated as it is rare. - --- MAP posted-by: Larry Seguin