Pubdate: Sun, 01 Aug 1999
Source: Danbury News-Times
Copyright: 1999 The Danbury News-Times (CT)
Contact:  333 Main Street Danbury, CT  06810
Fax: (203) 792-8730
Website: http://www.newstimes.com/
Author:    Henry N. Blansfield

METHADONE TREATMENT HELPS ADDICT AND COMMUNITY

Thanks to rapid advances in the science of neurochemistry, it is
becoming apparent that chemical dependency--addiction, if you
will--possesses similarities to mental illnesses such as depression,
obsessive-compulsive disorder and schizophrenia insofar as their
biochemical origins are concerned.

These conditions seem to be related to certain changes in the levels
of neurotransmitters, including serotonin, norepinephrine and dopamine.

Nerve cells communicate between one another by secreting these
chemicals, which then bind or connect to an adjacent nerve cell.

Evidence is accumulating that the chemically dependent are suffering
from an illness brought about by modifications in the actions of
neurotransmitters and the nerve cell wall receptors upon which they
act.

Drugs that induce and enhance pleasurable feelings--including heroin,
cocaine, alcohol and nicotine--do so by altering the re-uptake of
specific neurotransmitters or, in some instances, changing the
receptor or dock to which the transmitters attach.

That these changes occur is demonstrated by the development of
tolerance to alcohol and other drugs so that larger and larger amounts
have to be taken to get the same effect, symptoms of withdrawal when
alcohol and other drug use is stopped, and craving for the chemical of
choice when abstinent.

Repeated use over time of pleasure-enhancing drugs, including alcohol,
bears the risk of development of these brain changes that may persist
or be slow to normalize.

Changes in brain function induced by alcohol and other drugs fit a
medical paradigm. Chemical dependency is a disease unfortunately
occurring as a result of injudicious use of pleasure-producing agents.

The risk of brain damage must become the focal point of attempts to
educate our youth. The emphasis on moral and ethical considerations is
not and adequate deterrent to "picking up" drugs or consuming alcohol.

Heroin dependency is currently a problem for at least 500,000 people
in this country and from all reports is growing rapidly. There have
been a spate of overdose deaths recently due to the high potency of
the heroin available on the street.

Although many are snorting heroin to avoid the risks of injection,
about one third of the cases of HIV infection occur among drug
injectors. Drug injection also bears the risk of bacterial
contamination and viral hepatitis B and C.

Despite participation in treatment programs emphasizing abstinence,
either long or short term, the relapse rate for heroin use is 85 to 90
percent.

Since 1968, following the research done by Dr. Vincent Dole and Dr.
Marie Nyswander in New York City, methadone has been used to return
relapsing heroin-dependent people to a comfortable, functioning lifestyle.

Heroin addicts on adequate doses of methadone are freed from craving
and the symptoms of withdrawal. They are "normalized." If the dose of
methadone is at optimum levels, "shooting up" will not produce an
additional high.

Methadone was develped in Germany during World War II as a substitute
for morphine. It is a drug of the same class as heroin, an opiate. It
has a slow, even metabolism over 24 hours so that there are minimal
highs and lows.

Heroin injection, which has a short metabolic life, may be needed four
to seven times a day and is accompanied by periods of nodding,
interspersed with withdrawal symptoms and craving for more.

Methadone has the immense advantage of being given orally once daily.
This obivates the need to inject the drug. The risk of HIV and other
blood-borne diseases is considerably lessened.

It is true that the opiate-dependent status of those on methadone is
maintained. But the object of successful medical treatment is to
return sick people to a more productive lifestyle.

Patients on methadone are able to work, support their families, go to
church, vote, play and watch sports just like you and me. They are
able to avoid the drug black market and the criminality associated
with it.

People who are adequately dosed on methadone no longer seek drugs from
other sources. There is no further need to rob and steal to support a
drug habit. Methadone treatment may need to be continued indefinitely,
just as diabetics may need insulin daily for the rest of their lives.

Because of irrational fear, and loathing for drugs and drug users,
society tends to stigmatize, debase and discriminate against those
people who are identified as addicts.

This explains the "not in my back-yard" phenomenon when it comes to
establishing a treatment facility in any neighborhood.

The reality is that heroin addicts who elect methadone treatment want
to change their lives, want to better their social and workplace
conditions and want to abandon the horrors of past drug-seeking
criminal behavior.

The methadone treatment programs distribute the drug daily as a liquid
consumed in full view of clinic personnel in order to avoid the risk
of diversion. They have rules that prevent congregating or loitering
in the clinic area.

The clinics have ancillary psychological, medical and social services
which are designed to help patients improve their general physical and
mental health. For instance, a medical examination may reveal signs
and symptoms of HIV infection, hepatitis or tuberculosis, all of which
are treatable. In this way, the public health is dramatically
benefited by methadone treatement.

In summary, heroin addiction is a disease. It is treatable. Methadone
has been proven effective for close to 30 years. Wisdom dictates its
widespread use and an expansion of its availability.

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