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clinton
10-28-2012, 12:23 AM
Methadone: Miracle or menace?





When he found out there was a methadone clinic opening in Lodi, a 49-year-old man who says methadone helped him kick his decades-long heroin habit hoped he could start going there.

A local doctor openly questioned whether this clinic will actually help patients or if it is solely focused on making a profit.

Lodi Middle School, which is across the intersection from the clinic, sent out an automated phone message and letter home to parents informing them about the new clinic.

And Dr. Ernie Vasti, who started seeing patients on Oct. 15, said he is ready to bring a much-needed service to the Lodi community.

"There were so many people from Lodi coming to Stockton, and there was such an explosion of drug use. It just got harder and harder for parents and patients to travel to the clinics," Vasti said.

The debate around the use of methadone to treat drug addicts began to escalate in Lodi recently when Vasti opened Healthy Connections, a clinic at the corner of Ham Lane and Vine Street.

Supporters argue that the clinic will help more people stay off of opiates, because addicts won't have the additional burden of finding daily transportation out of town for treatment. They also contend it is a safe, legal way to make it through horrific heroin withdrawal symptoms, and that the opening of the clinic will likely reduce crime because there will be fewer opiate addicts stealing and committing other illegal activities to buy drugs.

Opponents worry it could bring drug addicts to a clinic across from the school. They are also concerned that the clinic is just swapping one addictive substance for another, and that it could lead to a rise of illegal methadone use among addicts. Moreover, they say the clinic is opening at a time when prescribed narcotic abuse is more pervasive and dangerous than ever.

Providing a local treatment center

The new clinic is located in the Lodi Memorial Hospital Urgent Care building, where Vasti is renting space from the hospital and operating the clinic in the morning before the Urgent Care clinic opens.

The new clinic is not affiliated with Lodi Memorial Hospital, according to Debbe Moreno, the hospital's chief nursing officer.

Vasti decided to expand his practice from his two clinics in Stockton to Lodi because of the increase in opiate use.

"Over the past several years, perhaps since the introduction of Oxycontin, there has been a shocking rise in the incidence of opioid prescription abuse and dependence," he said.

That dependence then flipped from pills to heroin, Vasti said.

The new generation of addicts tends to be young, white males from affluent neighborhoods, he said.

About a year ago, Vasti met with Lodi Memorial Hospital and did a needs assessment, which included examining Lodi Police Department data, to see if a clinic could benefit Lodi. Then, he met with hospital representatives and checked local ordinances.

While his goal was never to open near a school, Vasti said he wanted to be across from the hospital and within the medical complex. His south Stockton clinic, which has been open since 2005, is a block from St. George's Church and Grammar School.

"We have maintained good relations with our community and the two churches, and have not had any issues which would discredit me, my staff or my patients," he said.

According to county and state regulations, Vasti is allowed to see a maximum of 150 patients at the Lodi clinic, and he said at least 30 or 40 of them are from Lodi. He imagines that number will increase as people find out about the clinic, because he believes there are at least a couple hundred and possibly as many as a couple thousand people addicted to opiates in the Lodi area.

"It's much bigger than we think," he said.

This week, Lodi Middle School Principal Scott McGregor said administrators sent out an automated message and a note home to parents informing them of the clinic.

"We wanted parents to know we continue to monitor the safety of the children on an ongoing basis, like we always do," he said.

Lodi police also said they are aware the clinic opened. They are watching for any problems such as impaired driving, Sgt. Sierra Brucia said.

As a police officer, Brucia said he has encountered people on opiates, on methadone and on both drugs. While he has no medical background, he said it is concerning that people are substituting one controlled substance for another.

"I don't know the actual value of someone being on methadone instead of heroin, but if they are under the influence of a controlled substance, does it really matter which one?" Brucia said.

On the other hand, the new clinic could help heroin addicts with withdrawal symptoms and would prevent sharing of needles, Brucia said.

"There are people who are getting legitimate prescriptions for methadone. As long as they are not breaking the law, they are free to use those services," he said.

The debate: Does methadone work?

Questioning whether addicts are replacing one drug heroin with another methadone is a common argument against clinics, but it is factually inaccurate, said J.R. Neuberger, a member of the board of directors for the National Alliance for Medication Assisted Recovery. The organization advocates for methadone treatment throughout the United States.

Methadone is a synthetic opiate that helps addicts get over the initial withdrawal period. In the long term, it helps regulate the brain's chemistry that in many cases has been altered by years of drug use, Neuberger said.

"Methadone patients are frequently pressured by families asking, 'How long are you going to stay on this stuff?' That's an insane question. If we had an aunt or an uncle, or a son or a daughter who has cancer, we wouldn't tell them to get off their chemotherapy," he said.

Lodi resident Pat Richardson is not a medical professional, but has talked with people in the community and researched methadone clinics because she was concerned about one opening locally.

From her research, Richardson said she believes for-profit clinics, like the one in Lodi, exist only to dispense drugs at the highest rate possible to keep turning a profit.

"The bottom line is this clinic is not set up to wean people from narcotics. It is a clinic to get them addicted and keep them addicted. They are a multibillion-dollar industry. Livable, loveable Lodi doesn't get that connection," she said.

Richardson worries the clinic could lead to people on methadone driving while impaired, users on both heroin and methadone going to the clinic and patients selling their take-home medicine on the street.

"It is likely that methadone will go into the street and that will result in more addiction and crime," Richardson said.

A 61-year-old Lodi woman said she also is concerned the methadone will be resold to addicts, based on her experiences getting treated for heroin more than 30 years ago in Mountain View. The woman requested her name not be used because she is a member of an anonymous 12-step program.

The woman was on methadone for seven years before going to college and becoming a vocational counselor. While she supports using methadone to detox, she said it should not be a long-term treatment.

In her experience, people on methadone no longer feel the effects of heroin, so then they would do two to three times the usual amount of heroin to get high.

When she went into the clinic, she would often pretend to swallow the liquid methadone but then sell it later for heroin. Addicts who were able to take doses home would sell them for drugs.

"I haven't really met anybody who really wanted to get off heroin when they were on methadone. Methadone helped you from getting sick and stopped withdrawals. It was a good tool, and an excuse to use for probation officers and parole," she said.

However, the woman said she is not concerned about addicts selling to nearby school children, because they only want to sell the methadone in exchange for heroin and other drugs.

But other former addicts credit methadone with saving their lives. Richard, a 51-year-old former addict, said he used methadone to get off of heroin, and now he has been substance-free for two years. He asked that his last name not be used.

"This clinic is one of the best things to happen for drug addicts in Lodi and Galt. It will clear out a lot of the crime. People will steal, lie and cheat when they are on heroin, but that will change if they can get on methadone," he said.

Dr. Gary Wisner, a Lodi orthopedic surgeon, has deep concerns about the new clinic, ranging from the possible leakage of methadone onto the streets of Lodi to the threat of patients imperiling Lodi Middle School students as they drive to and from the clinic.

The clinic serves only recovering addicts. But Wisner says it reflects a troubling trend toward methadone and other painkillers being widely prescribed and abused. In recent years, according to The New York Times, federal officials have seen a huge increase in methadone being prescribed as a painkiller and a national surge in fatal overdoses.

To prevent the drug from being sold on the street, Vasti said the clinic has a variety of safeguards in place. Much of the methadone illegally on the street is in pill form, and he only uses liquid medication.

Patients have to remain off of opiates and attend appointments on time for a set period before they can earn the privilege of receiving take-home doses.

For patients who can take home medication, he usually only gives them a week or two-week supply, even though legally he can give a 30-day supply. He does not support giving a month-long supply because logistically it is difficult for a patient to keep track of that many vials at home, and the clinic cannot monitor the patient.

The clinic also randomly asks patients to bring the vials in to check how much they have been using. They conduct urine drug tests regularly for all patients.

Studies have proven that illegal drugs on the street are not coming from methadone clinics, but instead pain management clinics, Neuberger said.

Many of the concerns people bring up about methadone use are red herrings, he said. Clinics help people regain control over their lives and beat their addiction, while using a legal and safe substance.

"There is more misinformation surrounding this treatment than in any other treatment in history. This is the treatment that works. This is the treatment that saves communities," Neuberger said.

Contact Maggie Creamer at maggiec@lodinews.com.

opi,esq
10-28-2012, 12:49 AM
As a police officer, Brucia said he has encountered people on opiates, on methadone and on both drugs. While he has no medical background, he said it is concerning that people are substituting one controlled substance for another.

Of course. I think journalists interview and quote police officers for entertainment purposes only.

clinton
10-28-2012, 01:17 AM
Here is a related article from the same reporter :




He was 17 years old. He had preached for years about the evils of drugs after watching his dad deal heroin. But then he finally tried it.

"I saw people give up their house, car, wives and families for that stuff. I wondered, 'What is so great about it that they keep doing it over and over again?'" he said. "I woke up the next morning and immediately wanted more."

The 49-year-old Lodi resident remembered the moment he started on a more than 30-year battle with addiction. The man, who is a construction worker but out of work currently, asked that his name not be revealed because he does not want to hurt his family.

For a heroin addict, the hardest part is the withdrawals, which the man described as feeling like his bones were being crushed and his blood was turning to ice, with intense waves of nausea and vomiting.

Because addicts are fearful of going through withdrawal symptoms, it can lead people to commit crimes to support their habit, which can cost as much as $200 a day, he said.

"You do a lot of things to the people you love on this stuff. The person who is stealing the stuff, they hate what they are doing, but they can't control it," he said.

With the opening of a new methadone clinic in Lodi, the man said he believes the crime rate will decrease because people will no longer be desperate to "get well," or keep the detox symptoms at bay.

Thanks to methadone, the man was able to kick his habit and has been sober for more than seven years. He is now on a low daily methadone dose that he can take at home, and is looking into transferring to the Lodi clinic from the one in Stockton.

Another man, Richard, who asked that his last name not be used, was a meth addict for 25 years and then started using heroin.

He was staying up for four days at a time on meth, so a fellow addict suggested he try heroin to sleep.

But he quickly noticed a difference with heroin. It was a more intense addiction. With meth, he could take a month-long break and, even though he craved it, he could resist. With heroin, getting more drugs consumed his whole life.

"You'd do anything to keep from getting sick. I was panhandling, I'm not proud of it. I was stealing from stores. You even do things to your family. You burn all of your bridges," Richard said.

Even with the assistance of methadone, he relapsed three times before he was clean. But he attributes his eventual success to methadone. He has been substance-free for two years.

"It's wonder drug for a heroin addict. You don't get sick, but you also don't get high," he said.

One of the problems with methadone treatment is that patients need to get to a clinic every day. Otherwise they can start to spiral into withdrawal symptoms and turn back to heroin to "get well," Richard said.

When he was getting treatment at a clinic, he had to find a way to get from Galt to Sacramento every day. He would take the bus or have his wife take him at 5 a.m. before going to work; work schedules are why clinics often open so early.

Having a clinic in Lodi will keep people from having an excuse to not go get treatment, Richard said.

"When you are a dope fiend, you let little excuses get in your way of thinking," he said. "It's easier to go across town to get heroin instead of going to Stockton (for methadone) every day."

Now, Richard is a "Mr. Dad," staying home with his 7-year-old and 1-year-old while his wife works. He has tried to look for a job but has had trouble because of a felony on his record and no work history during his 30 years of addiction. But he said that every day, it is a blessing to wake up.

"When my oldest son was born, I made a promise to myself, my wife and my son, that I would never drink alcohol or do drugs in front of him," Richard said.