THE METHADONE WAY

The synthetic opiate has become B.C.'s major weapon against heroin
addiction.

In a development that has largely escaped the notice of those outside
the drug and drug-treatment worlds, B.C. has acquired something of a
methadone habit -- and as effective as the synthetic narcotic is in
many respects, it is not without side effects.

Doctors have been treating heroin addicts with methadone since the
1960s, but over the past decade, the number of British Columbians
prescribed the drug has increased from about 1,000 to almost 6,000.
With a correct dose, methadone wards off painful withdrawal symptoms
and the craving heroin addicts feel when opiate concentrations in
their body drop, and does this without rewarding them with a feeling
of euphoria. Many heroin users also use cocaine, and studies show that
cocaine use drops during methadone treatments.

According to the New York-based Lindesmith Center Drug Policy
Foundation, hundreds of scientific studies have shown there are almost
no negative health consequences of long-term methadone treatment, even
when it continues for 20 or 30 years. For some patients -- between
five and 20 per cent -- it's a drug they keep taking for the rest of
their lives.

Critics of methadone maintenance say the patients are still addicts;
one drug has just replaced another. Some report few side effects, but
others are clearly in a drugged state. Beyond that, since methadone
use tends to be prolonged, the cost adds up over time. As well, a
substantial proportion ends up being pedalled as a street drug.

But Barry Beyerstein, a pyschopharmacologist at Simon Fraser
University, is among the experts who advocate an even-larger methadone
maintenance program. He describes the drug as a carrot that attracts
heroin users into the system so they don't treat drug counsellors and
addiction doctors like enemies. "If you define success as total
abstinence in perpetuity and users becoming Sunday school teachers,"
methadone, like all drug treatments, is a failure, Beyerstein says.

"If you define it more realistically -- like getting someone out of a
criminal lifestyle, improved health, and a substantial proportion of
them returning to productive work -- then well-run maintenance
programs have a reasonable record."

The College of Physicians and Surgeons of B.C. has administered the
methadone program in B.C. since 1995. The addiction-medicine committee
of the B.C. Medical Association says B.C. now has Canada's most
comprehensive methadone maintenance program, "but the program isn't
without deficiencies." Among them is the cost. Addicts who are not on
welfare must pay dispensing fees -- the drug is dispensed in daily
oral doses by selected pharmacies -- as well as counselling and
assessment fees that are not covered by the B.C. Medical Services Plan.