NIH
Panel
Urges
Loosening
of
Restrictions
on
Methadone
11/23/97
A report released Wednesday by a federal scientific committee at the National Institutes of Health found that heroin addiction is a medical problem which is curable, but that the federal government acts as an impediment by maintaining unnecessary regulations on the drug methadone. The committee findings concur with a previous request, made in September, by Drug Czar Barry McCaffrey to reallocate the authority for prescribing and dispensing methadone to physicians rather than federal agencies. Committee Chairman Dr. Lewis L. Judd of the University of California San Diego, quoted in the Associated Press, 11/19, concluded that "onerous" regulations imposed by both federal and state agencies deter physicians from treating heroin addicts. The prescribing and dispensing of methadone is regulated federally by the Food and Drug Administration along with the Drug Enforcement Administration and the Department of Health and Human Services. Nearly every state has additional mandates controlling the particularities of methadone use as well. Judd argues that "If extra levels of regulation were eliminated, many more physicians and pharmacies could prescribe and dispense methadone." Dr. Marc Shinderman, Medical Director of the Center for Addictive Problems (CAP) in Chicago told The Week Online, "while methadone maintenance is the most effective and valuable treatment for opiate addiction, current regulations and lack of public and private insurance funding prevent effective treatment from being both offered and received." Currently only 115,000 of the estimated 600,000 heroin addicts nationwide are enrolled in methadone maintenance programs, according to Judd. The committee also found that addicts participating in methadone maintenance programs for at least a year have a good probability of stopping the abuse of heroin and other opiates. However, according to Shinderman, "approximately thirty percent of individuals now receiving methadone treatment are still abusing opiates." He attributes this to program administrators' punitive attitudes and low dosing practices fostered by their own prejudices as well as local, state and federal regulations. Shinderman further comments that "if more doctors were actually involved with clinical treatment in more methadone maintenance clinics, patients would reap the benefits of methadone treatment. Properly implemented methadone treatment in clinics with flexible policies and appropriate services can reduce heroin abuse to five percent or less. Some patients, once stabilized in such a clinic could move on to be treated by their own physician." Shinderman added that he hopes this report will prompt the necessary reforms. The NIH report can be found online at http://consensus.nih.gov/. Information on methadone maintenance and advocacy can be found through the National Alliance of Methadone Advocates, http://www.methadone.org.
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