Pubdate: 30 Sep 1998 Source: The San Francisco Examiner Contact: Website: http://www.examiner.com/ Author: Ulysses Torassa, Examiner Medical Writer S.F. LIKES U.S. PLAN FOR USING METHADONE ; DRUG CZAR MCCAFFREY URGES SUPPORTIVE TREATMENT A White House initiative to expand methadone treatment for heroin addiction is getting a warm response from San Francisco health officials, who say it is precisely in line with their own goals. In February, the Board of Supervisors passed a resolution asking the federal government for a waiver so that doctors with training could prescribe the synthetic narcotic designed to lessen heroin cravings. Currently, strict regulations prevent anyone but specially licensed clinics from dispensing it. White House drug policy chief Gen. Barry McCaffrey said Tuesday there are plans to begin training programs for physicians to become accredited to prescribe methadone. "This is an area where there are too many regulations," said Barbara A. Garcia, director of community substance abuse services for the Department of Public Health. "This puts us in a very, very opportune situation in terms of our ability, on a local level, to push this issue." Currently, about 1,800 people are being served at five methadone clinics in The City, each governed by a complex web of state and federal regulations. Another 415 are on a waiting list for treatment. Garcia said she hopes more people will choose methadone if they know they can get it confidentially through their doctor. It could also lead to better medical care for conditions that often crop up in injection drug users, she said. Still, Garcia said it will likely be at least a year and maybe longer before regulations can be rewritten on both a state and federal level to make methadone access easier. Last year, the National Institutes of Health issued a sharply worded report saying the nation's heroin addiction policies are outdated and that plenty of evidence exists that methadone works well. The treatment remains controversial, however. New York City Mayor Rudolph Giuliani has said it only swaps one addiction for another and announced a plan in that city to get users to quit. A few states have no methadone clinics. The cost for treatment is usually about $ 3,400 a year per person and involves frequent visits to the clinics. Medi-Cal, the state's health insurance for the poor, pays for its members to receive methadone, but some people pay for it themselves, Garcia said. She said they are able to do that because methadone stabilizes addicts and allows them to hold down jobs. Eventually, The City hopes to provide treatment, including methadone, on demand for all addicts. That goal remains years away, Garcia said. Copyright 1998 The Hearst Corporation - --- Checked-by: Richard Lake