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Treating Heroin Users Effective

Decline in addicts seeking agency help attributed to methadone clinic opening.


By Jerry Wynott

December 15, 2008 Wilkes-Barre, PA. –  Quietly in 2004 the shift began.

Back then the number of people seeking treatment from the Luzerne-Wyoming Counties Drug and Alcohol Program claimed heroin was their drug of choice.

In its latest data for the fiscal years 2007-08, heroin dropped down a notch and program administrator Mike Donahue, zeroed in on the reason – the opening of the methadone treatment clinic in April 2004.

“It reduced the number of heroin addicts who were going in for multiple treatments,” he said.

Under the program’s accounting method, every time a person seeks treatment is counted as an admission. But these repeat admissions for heroin are down, freeing up more spots for other treatment services.

The highpoint for heroin use occurred in 2003-04, according to program data, when 898 people sought treatment. They accounted for 39% of the clients. When the other 101 clients using opiates, including synthetic prescription drugs, were added, the total reached 43% of the 2,295 admissions.

By comparison, there were 597 people who listed heroin as their drug of choice in 2007-8, according to the program data. They accounted for 30% of all 1,979 admissions.

The introduction of medication – assisted treatments that include methadone and suboxone, a prescription drug whose primary active ingredient, buprenorphine, blocks the craving for opiates – has enabled some to sop illegal drug use and stabilize their lives, Donahue said.

They’ve been able to get jobs, take care of their families and in turn no longer rely on social and human service agencies for help.

The treatments are not for everyone, Donahue added, and some people and treatment centers prefer to go the drug-free route.

Getting users into treatment is an effective way of eliminating the market for illegal drugs such as heroin, said Ernest Drucker, Ph.D of the Montefiore Medical Center, Bronx, N.Y.

Drucker has seen familiarity with the county having researched fatal drug overdoses here between 1998 and 2002.

If addicts’ drug use is under control, “they’re taken out of the market as buyer’s and sellers,” Drucker said.

However, there are not enough treatment slots for addicts, he said. Nationally, there are approximately 200,000 slots for methadone treatment, but an estimated 1 million heroin addicts. Given those percentages, the vast majority of addicts go untreated.

It does not have to be that way, nor does one treatment method apply to all.

What also works are different settings for the treatments. Instead of clinics that dispense medications to hundreds of people daily, doctor offices and even pharmacies can be used.

Drucker conducted a case study of a doctor and a pharmacy in Lancaster that ran a pilot program between 2003 and 2005, dispensing the methadone to people who had previously received it at a clinic.

The patients appreciated the social interaction with the pharmacy staff, the doctor and his staff, and welcomed the freedom that gave them back their dignity.

The office-based opiate treatment is commonly used in other countries with success.

The mass dispensing clinics with their regimented routines have soured patients on the treatment and methadone, Drucker said.

“It’s been so maligned that the addicts themselves come to hate it,” he said.

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