Pubdate: Fri, 18 Mar 2005
Source: Princeton Times, The (WV)
Copyright: 2005 The Princeton Times
Contact:  http://www.bdtonline.com/ptonline/
Details: http://www.mapinc.org/media/3692
Author: Tammie Toler
Series: http://www.mapinc.org/source/Princeton+Times
Bookmark: http://www.mapinc.org/find?136 (Methadone)

TO POLICE, METHADONE IS A PROBLEM

Editor's note: This is the conclusion of Methadone in the Mountain State, a 
series on the powerful opiate painkiller often used to treat withdrawal 
from other narcotics. Available both through physician prescriptions and 
clinic treatment programs, methadone is a source of relief for patients in 
pain or the throes of withdrawal, but for local police, it's also a source 
of frustration.

PRINCETON - It's a powerful prescription painkiller and a recommended 
treatment for opiate addiction. For people suffering from either chronic 
pain or the agonizing symptoms of withdrawal, it represents a dose of hope 
in the form of a pill or a vial of red liquid. It's been called a lifesaver.

But, for law enforcement officials, sometimes methadone is just a "major 
problem."

An extremely powerful synthetic opioid created as a painkiller during World 
War II, methadone is growing in popularity in southern West Virginia and 
across the nation.

Affordable and available either through a doctor's prescription or 
methadone maintenance treatment (MMT) clinics, the drug is also becoming 
more abundant on the streets, according to West Virginia State Police Sgt. 
M.R. Crowder, of the Princeton detachment.

"It's almost on a daily basis one of my officers deals with some type of 
methadone case," he said. "We're just having a time with them."

As a painkiller, methadone works like other opiates, such as OxyContin, 
Percocet and LorTab. It has proven useful to treat addiction to those drugs 
and heroin because it dulls the symptoms of withdrawal without the high, or 
feeling of euphoria, associated with the other narcotics.

However, methadone itself is extremely addictive, and its long-acting 
nature makes it potentially fatal when ingested in large quantities or 
mixed with other drugs, especially other opiates.

Along with illicit sales, overdose deaths are mounting. In just the first 
seven months of 2004, there were 63 methadone-related deaths reported in 
West Virginia.

Since the drug remains in the body much longer than most substances, it 
often takes hours for the person to feel the drug's effects and days to 
reach full potency, psychiatrist and addiction specialist Dr. Michael 
McNeer said.

Methadone's potency can be hazardous. According to McNeer, 30 milligrams of 
methadone could kill an "opioid-naive" person, and 50 milligrams would be 
much more likely to be fatal. The typical daily dose of an MMT patient is 
80-120 milligrams.

Most of the people who die of methadone overdoses simply go to sleep and 
stop breathing, he said, especially when the drug is taken in conjunction 
with other substances that depress the respiratory system. The part of the 
brain that tells the body to breathe simply stops working, McNeer said.

The fatalities usually include a mixture of the wrong chemicals, Crowder 
said. "In most cases, we also find evidence of some other drugs, some other 
kinds of narcotics. Methadone is very volatile when mixed with other 
drugs." Part of the controversy surrounding methadone and maintenance 
treatment arises from the practice of take-home doses, which clinic 
officials say are necessary to provide treatment and a consistent 
lifestyle. Opponents argue the doses only put addictive substances into the 
hands of people who already have a problem.

All clinics are required under federal law to implement diversion control 
policies to ensure the methadone that leaves their structures is 
administered as intended. Casey Aust, administrator of the Beckley 
Treatment Center, said the clinic requires patients to exhibit a stable 
lifestyle, submit to regular drug screenings and prove they have a way to 
lock their methadone up before they get more than one take-home dose weekly.

Methadone maintenance treatment continues years, or even for a lifetime, 
because the patients are still addicted to the opiates during the therapy. 
The methadone keeps their bodies from going into withdrawal and allows them 
to focus on mental health, education, employment and family issues without 
the added stress and sickness of stopping the drugs "cold turkey," Aust said.

If patients choose, they can detox slowly from the methadone and escape 
most of the withdrawal symptoms, but she said some patients will choose to 
remain on the MMT forever.

That's a decision some of the officers can't understand.

"I'm not saying that the clinics haven't helped somebody, but from what I 
see, it's very rare that doses actually go down," Crowder said.

But, clinic officials say the blame for methadone's illicit market 
shouldn't fall on their facilities. They, and even a Department of Health 
and Human Resources study, conclude that most of the methadone illegally on 
the streets is diverted from physician prescriptions in pill form, rather 
than the liquid doses administered to MMT patients.

Bailey concurred. As chief deputy, he said he isn't on the streets as much 
as some officers, but he's also in charge of the evidence room. "What I'm 
seeing is pills," he said.

Crowder said State Police officers are "definitely" encountering both forms 
of the drug, and at least one local investigator reported purchasing the 
liquid in a controlled-buy situation.

Whatever form it takes, its methadone's presence outside of medical 
supervision that weighs on Bailey's mind.

"It's another drug in our opinion, instead of a medication," he said.
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MAP posted-by: Jay Bergstrom