Hello!   Welcome!  My name is Deborah Shrira.
I am --- The Director of  "Medical Assisted Treat-ment."  It has been one wonderful year since we started.  I can say we have helped a lot of people ...   and even though it has been a lot of work ... It has been worth every second I spent.   I want to thank all of you who have joined with us --- as you have enabled us to help others with your member -ship fees.  It has been all my pleasure to serve you during the year.  I hope we have met  all -- your  expectations of us - and will continue through the remainder of the year.  It
is going to be a great year - expect miracles!  It's is going to be a great year!

He who will not learn when told must learn by experience!

"To do nothing is to live in denial and accept the lie of our existence.   To sit in silent complacency is to welcome the domination over our lives. The failure to act is an act in failure and a warm embrace to an unmitigated corruption befalling mankind."  Manuel Valenzuela 

I want to wish everyone a warm welcome and to thank you for all your wonderful comments. We have to ask for your patience if we are slow getting your questions answered.  It has been very busy here with attempting to handle complaints  from all of you.  - - - I haven't been able to keep the website updated as before but I am trying to take some time and get some news and information on for you.  We have not had enough volunteers to give all of you the time you needed but I give you my word - we have all certainly done our best to meet your needs and be there for you. 

We had a question about the medication below just last week from a patient.  I wasn't familiar with the medication neither was our physician.  We did take the time to look it up to discover it was given for narcolepsy.  She said it was given to her for fatigue and wondered if it could be interfering with her Peak and Trough levels.  It is a stimulant but when we checked it out  - - we were told it was not addictive.   - -I personally believe it could interfere with your Peak and Trough but since it is a fairly new medication, it has not been tested for any reactions with methadone.  I will be searching for more and I would be careful if you are taking the medication for they have been wrong before.  My guess is it is addictive and can interfere with your methadone levels - Take some time and read the article below. 

Maia Szalavitz

Modafinil raises questions about drug coverage.

For its "Superman" series, Slate writer David Plotz tries modafinil (Provigil), a drug
approved by the FDA for narcolepsy, but touted by the press and its manafacturer, Cephalon Incorporated, as a potential wakefulness drug without the potential for  the addiction, mood crash and ensuing sleep deficit  following  the use of other stimulants.  The idea that modafinil simply eliminates the need for sleep, allowing greater productivity, with no downside.

Earlier, The New Yorker had profiled the drug, claiming that it has a completely
different mechanism of action than other stimulants, and acts only on the cells necces-sary to promote alertness - which secrete a substance called hypocretin.(also known as orexin - th battle over which name should stick has not yet been won.

However, in people with narcolepsy, these cells are either in very short supply or non-existent  and the disease is thought to result from progressive loss of these cells or a congenital absence.  In other words, if the drug worked only on these cells, it couldn't possibly effectively treat a condition in which they are missing or depleted.  The thing is,  it does. 

Another hint that all is not as it seems comes in Plotz's article.  He describes the drug with the luxuriant praise usually only seen in early accounts of addiction, before the worm turns. 

The FDA has already warned Cephalon to stop making exaggerated claims about it.
In its letter, the agency states that, as Plotz discovered, modafinil produces euphoria, just like other stimulants. - In fact, tests proved it produces a euphoria level similar to that seen as Ritalin®, a drug that is already known to have abuse potential

The history of addiction is marked by ecstatic claims of new, non-addictive drugs which later prove to be trouble for some users.  Heroin, for example, was  introduced by Bayer as a non-addictive morphine.   More recently, benzodiazepines, like Valium were touted as alternatives to barbiturates.  In that case, benzodiazepines did prove to be safer - but the risk of both addiction and overdose were only reduced, not eliminated.

The truth about modafinil remains to be seen.  Media coverage of drugs is almost always filled with hyperbole - with both fears and potential benefits tending to be greatly exaggerated.    - - - The American Medical Association newsletter recently described Cephalon's latest studies, which support the use of the drug to help shift worker's stay alert. If the FDA approves such use, the manafacturer could legally
make claim that the drugs can be used to fight ordinary fatigue.

America needs to ask itself whether it wants to accept the use of drugs for such life-style" reasons - whether, for example, an alert late night trucker is better than one who drowses and can potentially kill. The military, as many learned during a recent trial of several  American pilots who accidentally bombed Canadian troops in Afghanistan, al-ready believes that amphetamines - the use of which gets truckers arrested - improve pilot's performance, and there is data to support their  view.

The press needs to avoid drug promotion and anti-drug hysteria  - and be careful to examine the value inherent in judgements about risks related to drugs.  Aside from this story in Reason, almost no one asked  why some government agents devote their careers to putting speed-takers in prison, while others hand-out vitually the same stuff to their top guns.  - - - - - - - Apparently, the military has recently become very interested in modafinil.   

Reference:  Stats at George Mason University
Written by:   Maia Szalavitz      

 - - -Mexican President Vicente Fox will sign a bill that would legalize the use of nearly every drug and narcotic sold by the same Mexican cartels he's vowed to fight during his five years in office.

- - - - - -The list includes cocaine, heroin, LSD, marijuana, PCP, opium, synthetic opiates, mescaline, peyote, psilocybin mushrooms and methamphetamines.

The per-person amounts approved for possession by anyone 18 or older amount to * Half a gram of coke
*Couple of Ecstasy pills
*Several doses of LSD
*A few marijuana joints
*A spoonful of heroin
* 5 grams of opium
* 2 pounds or more of peyote, (the hallucinogenic cactus)

The law would be among the most permissive in the world, putting Mexico in the company of the Netherlands.

Critics, including the U.S. drug policy officials, worry that it will spur a domestic addiction problem and make Mexico a narco-tourism destination.

"Any country that embarks on policies that encourage drug use will get more drug use and more drug addiction," said Tom Riley of the White House Office of National Drug Policy.  Mexico has long blamed Americans for fueling the multi-billion dollar illegal drug trade with their $10, $50, and $100 drug purchases.

Reference:  Los Angeles Times            Date:   May 3, 2006 

Question:  We have had a few requests from clients to stop methadone therapy.
What can we do in this case - how will we decrease the dosage?

Patients will almost always express the desire at some point to leave treatment - it is a major burden the frequency of visits, interference with life and travels, and a constant reminder that one has a disease that requires medications and pressure from family and/or friends/employers mount. The most one can do - and the least one must do - is to ensure that patients know that there's  a very high liklihood of
relapse to illicit opiates when methadone is discontinued. Sure - a few make it and
and achieve and maintain abstinence, but they are the small exception. So ... they
should be well informed.  If they insist, I'd encourage them to proceed as slowly as possible - maybe 5mg each week --  and tell them that any time they say the word
you're prepared to discontinue further decrease in doses and go back up.  - - - No
shame - no problem.  Finally, I would make sure they know that if they do relapse
at any time, you will welocme them back with open arms.

Reference:   RG Newman MD

 Thank You for your time.  If you have any questions you would like to ask - remember
we have opened "Ask The Doctors?" Click on the button and it opens up -- then follow
instructions where it  says "Click Here."  It opens up to "Ask The Doctors?'"  - - If you glance over to the left side you will see the word Messages.   -   - Click and write your question out and as soon as they can find time, which is possible your wait could be a week or more but they will answer it.         The Director

 - -I had planned to write about Mothers today but Methadone Girl® had the same idea. I chose another subject but I want to take the time to wish all our Mothers the very best on their day.  - - You are always a Mother even after they are grown and have children of their own.  You never stop caring and wondering how they are.  I'm sharing with you how Mothers feel about their children. 

We then must think about our own Mother.  - I know a lot of us maybe never got along with our Mothers.  - - I'm sure a lot of us had issues with them as I did with mine. ... I know some of you blamed your parents for what happened to you as a
child.  Some of you had every right to. I have heard  some  horrid  stories...  You must be able to let go and let God help you to forgive ... otherwise you will carry the emotional baggage around with you the rest of your life. 

Let's not forget our Father either.  - - Just to remind all of you June 18 is Father's Day. - - - - Teach your children it takes much more than matching DNA to make a
Father, or Mother.   They are the ones present when you are sick, stay awake all night waiting to see if you arrive Home safely at night, take the time to truly listen to you, provide shelter for you, and see you have food to eat. - They take care of you and consider you their responsibility.  - - - They don't walk out on you when things are going rough, - - they stick it out with you and put your needs ahead of theirs.

- - - It takes much more than just your name given to them to make you a Father.  No, even Mothers and Fathers make mistakes -  because they too are only human but,  if you stay and give it all you got to give then you can call yourself a Father.  Most of all children need your time and love.  If you fail to give either to them - - -they will find it either in drugs, sex, pornography and almost anyone that will give them any attention.  It would be better for your child to go hungry and know that they are loved and have you spend time with them - then spoil them with all the toys in the world and later money and think they will take the place of you.

 It will never take the place of you.  They need you to be strong and to show them by spending time with them, but not only in your actions, - - they need you to tell them.  - -  Who doesn't like to hear you are loved?  You think they know you love them - but then you are only assuming - - never assume.  Tell them!

Methadone  ignorance can be combated  by  education, and  the  science  that backs up this education is indisputable.  But facts do not impact fear.  Fear is a primitive emotion.   I  believe one component of this fear is  that  opiate addicts      do not  want  to own  that chronic disease  called  protracted  endorphin system derangement.

Some addicts' systems will re-balance themselves during abstinence.   - -These should be the most grateful.    - - - - Others, due to biology beyond their control (powerlessness) will find their opiate receptors starving for endogenous opiates throughout their lives.  - - - - For these,the comfort of stability is an unattainable    goal without the introduction of exogenous opiates.   - - - - - The introduction of medicine to treat a disease is usually met with hope,  - - -  but the medicine that    is methadone is met with jeers.

Could fear be fueling these negative beliefs?   - - - Fear that if I did a searching inventory of my health status, - - I may discover that I function at an improved level when more of my opiate receptors are filled.  - - - If comfort and recovery     are to be married, for many opiate addicts, methadone must be the best man. 

Discomfort and instability are not hallmarks of recovery rather, quality of life, improved function, and increased range of choices are what we strive for. 

To condemn someone to the ravages that accompany the brain disease of addiction when effective medicine is available is unconscionable, -  and rather should be emphatically embraced as a viable, authentic tool that saves people's  lives. - - For 12-step programs to deny  the benefits of their meetings, deeper contact with our spiritual nature, ............ and fellowship to methadone- maintained recovering persons is a crime that cries out for redemption.
Peter Moinechen 

Reference:  Peter Moinechen    Center For Addictive Problems 

I would like to take a moment to welcome you to "The Director's View"  if it is your
first visit with us.  We are very happy to have you looking over our website.  It is a website for the people that need information abour addiction.  We haven't been up yet two years but we are growing.  We care about you, because as you can see, we are the one group of people that are despised more than any. - - We are the ones!!!

We are discriminated against more than any other class.  - - -They treat us as if we have leprosy.  Thinking of the word leprosy now reminds me of a comparison of how the patient is shunned and ostracized just as the leper was.

"The pain of leprosy originates in the eye of the beholder and becomes pain for  for the patient as he is shunned and ostracized, ... as he loses the humanness he once possessed.  The pain of leprosy is not inflicted by the bacillus ... but by his fellowman. "   

Think about it?  Don't you agree with me it is true?  I'm really just thinking aloud with you.  I'm sharing my thoughts with you as finally some of you have begun to share yours with us.  - - Maybe it took some of you time to test us but most of you have  found out we go the extra mile for you.  

Easter represents Life...He arose!!!  We too have a chance for a New Beginning ---We just have to reach out and accept it.  The world can be very cruel but there are still caring people around.  - - Yes, I know sometimes it is very hard to find them... 
Sunday, as we celebrate Easter with your family, whether it be hiding Easter Eggs
for your children to find - whatever way, be it "Sunrise Service"  however, -- you choose. - - If you are addicted to opiates and it is destroying your life but you are unable to quit.  You have tried and each time it has been a disappointment to you
and even more of a let down to your family.  - - You know you are breaking their hearts and they have no idea it is hurting you much more than them but they only see you must not love them as much because if you did you could stop!!!

I am here to tell them and you it is a lie straight from the "Gates of Hell."   I say to all of you "Knowledge is Power."   Take the time to study addiction. Knowledge is power but along with wisdom, get understanding.  - - - - - - If all you have tried is
"Abstinent-Oriented Rehabilitation Programs"  - - - then I can understand why you believe your family would be better off without you.  I have been down the road -they did nothing for me, but make me feel worse about myself,- each time I tried them and failed.  I began to believe I was defective merchandise.  I had reached a point in my life I was ready to give up, I truly believed there was no help for me. 

It was then a patient told me about methadone.  - - - - - I didn't know much about methadone but I was willing to try any suggestion to save my life.   It took me over half of the day to even find the number of one.  I called and made an appointment for the very next day. What can I say to you?  It worked.  - - I came out of the grave and rose again. It gave me a new life just as God gives us one if we believe in Him. I didn't realize there was so much stigma and discrimination attached to the drug.
I never dreamed of all the Rules and Regulations that accompanied the use of the
medication.  I didn't know most of the community considered it exchanging one medication for another. -  Never before had I encountered such cruelty to patients.
I just knew methadone had saved my life - - I would just bear with the conditions. 

Does your addiction make   you feel like you are caught  in a trap and you can't  get   out?   "Addiction Is A Disease !!!  - -We are treated not like   patients but like criminals.  If you really want help,and  nothing else has worked?  Try Methadone!!!

I know there are alot of you thinking I don't want to trade one habit for another.  If you are thinking it is a substitution then you are admitting you don't believe it is a disease. If you believe it is a matter of your will then by all means leave it alone!  I ask you before you make the decision - take the time to study about addiction, - -Please read "Addiction Science" on my website.  - - - It explains the basics of why  "Addiction Is A Disease."  - -  Then take the time to read about methadone with an open mind. 

- - - Once you have used medications for many years, they discovered by the new technology available, they actually cause physiological and molecular changes in  your brain.  Methadone is different from any other medication. It builds up and is stored in your body, so it lasts even longer when used for maintenance. - -  Most  people find that once they are stabilized on a dose of methadone that's right for them, a single oral dose will "hold" them for at least a full 24-hour day.

 - -You are free to start a new life but there is a possibility you may have to stay on on the medication the remainder of your life.  It is similiar to Diabetes. Many  stay on insulin all their life.   It's your decision - most of you need to examine what you have heard all of your life.  - - Examine the evidence and make up your own mind.

Deborah Shrira                                                       April 2006

Greetings!  Better Late Than Never.  March was a very busy month for us in every
way.  We received more of everything doubling our work load.  I'm not complain-ing, it is our pleasure to be  available to all of you.   - - - If you failed to receive an answer  from us at anytime, you failed to leave us an address or phone number we could reach you at.  We answer everyone!!! Please send it to us again and include how we can reach you.

I want to share with you today a topic that is very close to my heart.  Some of you will probably turn away in disbelief and others may say,they put themselves there.
Some people just won't care because their hearts have already turned to stone.

Withdrawal can kill you!  -  If you have any doubts click on the link below and read how a needless death occurred to a woman who was incarcerated in Orlando....  Doubt it ??? Read it. I dare you. It could have been your daughter,  wife or possibly your husband...    http://www.MedicalAssistedTreatment.org/474928/471119.html

Every week that passes, - - We receive at least one call from a patient incarcerated  needing their methadone.  - - I personally know what it is like---and we spend time each  week helping patients get dosed.   - - - Absolutely no one should be denied  their medication.    -  - -  We have discovered it is not only addicts, but others like  diabetics, not receiving their insulin, and patients needing medications to sustain their heart and/or lower their blood pressure.   A dog is treated better than people incarcerated in most of our jails.   Wake up, people, we who are aware of the truth are responsible for taking action. This is the equivalent to murder!

04/02/2006
I am trying to get some help for the prisoners at The Big Sandy Regional Detention Center in Paintsville, Kentucky.  There have been several deaths from the prisoners
laying there withdrawing from drugs.  This is senseless, due to the fact  that there is      a Methadone  Maintenance Treatment Center and a Hospital less than a mile away
from the jail. Some of the prisoners were already going to a Methadone Maintenance
Treatment Center when they were brought to jail. - - Please let me know how we can help those guys and prevent this from happening.   Thanks  ________

I want to take a moment- - to thank the person that sent us the message above letting us know people are dying from withdrawal. -They are not receiving the medication they need for withdrawal.   --Please, we are trying to get as many dosed as we can, and we certainly would like to make the public more aware  of what is happening in our own jails.  

- - - - I'm asking all of you to send me information of anyone you know that has died from not receiving their methadone.  - - -If you know of Detention Centers refusing to dose patients that are already on Methadone, - - send us a message and let us know.  This is not an issue to be taken lightly. People, like you and I are actually dying as she writes to tell you of it. --I'm asking you, viewers, what are you going to do about it?   Wake up?  We are killing our own! 

- - - - - - - -  As the time approaches for what would have been the addict's next administration of the drug, - - - - - - one notices that he glances frequently in the direction of the clock and manifests a certain degree of restlessness.  - - - -If the administration is omitted, he begins to move about in a rather aimless way, - - -failing to remain in one position long.  - - - He is either in bed, sitting on a chair, standing up, or walking about, constantly changing from one to another.

With this restlessness, yawning soon appears, which becomes more and more violent.  - - -  -At the end of a period of about eight hours, restlessness becomes marked. He will throw himself onto a bed, curl up and wrap the blankets tightly around his shoulders, sometimes burying his head in the pillows. - - - For a few minutes he will toss from side to side, - - and then suddenly jump out of the bed and start to walk back and forth, bead bowed, shoulders stooping.   - -This lasts  only a few minutes.  He may then lie on the floor close to the radiator, trying to keep warm. -  Even here he is not contented, and he either resumes his pacing about, or again throws himself onto the bed, - - - wrapping himself under heavy blankets. At the same time he complains bitterly of suffering with cold and then hot flashes, but mostly chills.

He breathes like a person who is cold, in short, jerky, powerful respirations. His skin shows the characteristic pilomotor activity well known to those persons as "cold turkey." The similarity of the skin at this stage to that of a plucked turkey is striking. Coincident with this feeling of chilliness, he complains of being unable to breathe through his nose. Nasal secretion is excessive. He has a most abject appearance, but is fairly docile in his behavior.  - - - - - - - This is a picture of his appearance during the first eight hours.

 - -Often at the end of this period the addict may become extremely, drowsy and unable to keep his eyes open. If he falls asleep, which is often the case, he falls into a deep slumber well known as the "yen" sleep. - - It takes unusual noises to awaken him. The sleep may last for as long as eight or twelve hours. - - - - -  On awakening, he is more restless than ever.  - - Lacrimination, yawning, sneezing, and chilliness are extreme.  -A feeling of suffocation at the back of the throat is frequently mentioned.  - - -Usually at this stage, the addict complains of cramps, locating them most frequently in the abdomen, but often in the back and lower extremities.  - - - - A right rectus rigidity with pain localized over the appendical region is not uncommon; one can easily be misled in the diagnosis, since at this stage a leucocytosis is frequently present.

- -   Vomiting and diarrhea appear. He may vomit large quantities of bile-stained fluid.  - - -  Perspiration is excessive. The underwear and pajamas may become saturated with sweat. - - - Muscular twitchings are commonly present; they may occur anywhere, but are most violent in the lower extremities. He may sit in bed with his leg flexed, grasping it tightly below the knee, - - - fearing the twitch will suddenly throw it into a complete extension which be cannot control. - -  If he is handed a cigarette to smoke, his hands tremble so violently that he may have difficulty in placing it in his mouth. The tremor is so marked that he is unable to light it himself. He refuses all food and water, and frequently sleep is unknown from this point.

 - -It is at this stage that he may one minute beg for a "shot" and the next minute threaten physical violence. Nothing can make him smile. - He will beat his head against the wall, or throw himself violently on the floor. - Any behavior which he thinks will bring about the administration of the drug will be resorted to.

Occasionally he may complain of diplopia.  -  Seminal emission in the male and orgasms in the female frequently occur.  - - - We believe that the height of these withdrawal symptoms is reached somewhere - between the period of forty-eight hours and seventy-two hours following the last dose of the drug taken.

The readministration of the drug promptly brings about a dramatic change.  The patient becomes exceedingly docile almost with the puncture of the hypodermic needle.    - - - - In a few minutes he begins to feel warm, and the goose flesh and perspiration are no longer visible.He speaks about a "heaviness" in his stomach  but, regards this as a welcome symptom presaging relief.

 - - In a period ranging from thirty minutes to one hour the tremors disappear. - -He has become strong and well.  - - - He no longer walks with bowed head and stooped shoulders. -He stands erect, is quite cheerful, - - - and begins to light his cigarette like any normal person. - - He becomes profuse in his apologies for his conduct during the abrupt withdrawal of the drug.

Thank you for your time. Think about what I have written.  People are dying every day and not just in jail because they are unable to acquire their medication.  The poor are
dying because they can't afford the medication.    The Director®

Risk-Taking Is the Main Game

Risk-taking and pushing yourself further than you thought you could
go is normal for young people. It starts in childhood: toddlers
always do it, then run back to the safety of their parents.

Those who can afford it do these amazing feats,  - - - - sailing round the
world or bungee-jumping.   But if you are an ordinary kid what can you
do to risk-take?  Drugs are a big attraction because they seem foolhardy             and wicked, and taking them is a way of getting your own back on adults. 

 When it comes to alcohol, there is always a tendency to drink more because     you shouldn't.  - - And the industry is partly to  blame for making up drinks         such as Long Island Ice Tea with all types of alcohol in them. -  Remember,       wwhen you're 17 you think you're immortal.

My generation didn't need to go out and do stupid things because they
went to war and society always treated them as heroes.  - - - If they got
drunk, it was accepted because they were young people who had gone                to war.  Look at those poor soldiers in Iraq.  They are risk-taking with
huge government approval.

Although we are the fourth richest country in the world, we still have
 an obscene number of people on the poverty line. And many young
people have non-coping parents, which means they have grown up
disillusioned with the adult world.  - -  It hurts dreadfully when your
family breaks up. Your world shakes.

As for body image, teenagers are made to be self-hating much too
young. They look at these absurd images of hollow-cheeked so-called
beauties. - - My idea of beauty is built on that war-time and post-war
image of glowing health.  But young girls now want to be skinny. They
want their breasts blown up like balloons. It's heart-breaking. - - And
their parents collude.  No one tells children they are pretty any more
because they think they will spoil them.

The children grow up with no self-esteem. They haven't got that sense
of 'I am a special person. - -   I'm as valuable and beautiful as they are.                     The problem is you will pass this low self-esteem on to the next generation.

**********UCLA researcher has developed a low-cost test for a genetic marker for addiction, the New York Daily News . Ernest Noble, Professor of Psychiatry and Director of the UCLA Alcohol Research Center, developed the test for the A1 allele, which researchers have identified as signaling elevated risk of addiction.

The gene is found in people who have lower levels of the neurotransmitter dopamine; most addictive drugs work by increasing dopamine production.

Users swab the inside of their mouth and send a sample to a lab for analysis. "With the test, we can get parents to concentrate and educate children on the problems of drugs and alcoholism when they're younger and more amenable to prevention," said Noble. "It's like any other disease, and if you identify it early, like diabetes, you've got a better chance of defeating it."

The test, now under development, will cost about $35; - - Noble's research was funded by the Christopher D. Smithers Foundation. "The test is going to be very meaningful for education and prevention of alcoholism and drug addiction," said foundation President Adele Smithers-Fornaci. "Once you've had this terrible disease strike your family you don't want to see it repeated, - - - and this test is a terrific diagnostic tool."

Reference:  New York Daily News     11 February 2006 

Findings from a collaboration between scientists at the University at Buffalo's Research Institute on Addictions (RIA) and George Mason University in Fairfax, Virginia have established the importance of distinguishing between feelings of shame and guilt when providing treatment for substance abuse and in develop- ing substance-abuse prevention programs.

According to Ronda Dearing, Ph.D., RIA research scientist and lead author on the study published in the August 2005 issue of Addictive Behaviors, shame and guilt or a personal tendency toward either emotion have important implications regarding misuse of alcohol and drugs.

The study included three groups of participants with different levels of alcohol and drug problems. Two groups were primarily female college students about 20 years of age. The third group was comprised of predominantly male inmates from a metropolitan area jail who were, on average, 31 years of age.

Shame is the tendency to feel bad about yourself following a specific event. It appears that individuals who are prone to shame when dealing with a variety of life problems may also have a tendency to turn toward alcohol and other drugs to cope with this feeling.

Guilt, or the tendency to Dearing's colleagues in the investigation were Jeffrey Stuewig, Ph.D., and June Price Tangney, Ph.D., of the Department of Psycho-logy at George Mason University in Fairfax, Virginia feel bad about a specific behavior or action, was largely unrelated to substance-use problems. This is one of the first studies to scientifically validate the importance of shame versus guilt and their relation to alcohol and drugs.

Clinically, I believe this study suggests a point of intervention for the treatment of substance-use problems. Specifically, counselors and other medical providers might effectively work with clients toward decreasing shame-proneness and enhancing guilt-proneness.

"Whether or not shame is a cause of problematic substance use,"  - - Dearing explained, "other problems that go hand-in-hand with shame such as anger or interpersonal difficulties are sufficient justification for implementing shame-reduction interventions into treatment. Successfully reducing shame is likely to result in better treatment outcomes."

Supported by a $585,000 award from the National Institute on Alcohol Abuse and Alcoholism, - - - - - -  Dearing is investigating help-seeking for alcohol problems, specifically whether attitudes about alcohol and alcohol treatment predict how or whether people seek help for alcohol problems.

Dearing wants to understand how people who seek alcohol- and substance-use treatment are different from other people who have similar problems, but do not seek help.  In addition, she hopes to learn whether a proneness to shame is a risk factor for drug and alcohol problems and, secondly, whether the tendency to experience guilt is a protective factor against the same problems.

This research was supported in part by a training grant to Rearch Institute On    Addictions from the National Institute on Alcohol Abuse and Alcoholism and in part by a grant from the National Institute on Drug Abuse to Tangney.

The Research Institute on Addictions has been a leader in the study of addictions since 1970 and a research center of the University at Buffalo since 1999.

The University at Buffalo is a premier research-intensive public university the largest and most comprehensive campus in the State University of New York.

Kathleen Weaver
weaver@ria.buffalo.edu
716-887-2585
University at Buffalo
buffalo.edu

I hope you enjoyed the articles I share with you.  - Each one of them had a nugget of wisdom  hidden inside as a box of chocolates have an assortment  of candies in each.  I hope you found each one, Think on it and se if it applies to your life in any way.  Until next month,  take time to help another person.  Make the world a better environment for all of us.    Thank you foy your time.

Deborah Shrira, RPH, CMA 

 January 2006      "The Director's View"         Happy New Year!

This  is going   to  be the year that makes the  difference in  "Medication Assisted  Treatment!"

 A Word From Your Director: 

I can hardly believe a whole year has passed and - we are still hanging in there with the best of them.  I never expected the response we have received from all of you and even though we are somewhat overloaded with mail, calls, - - - and scouting for new talent, we have brought on extra staff (volunteers)  to help with the problems and to be part of the solution.

I can share with you that we at "Medical  Assisted Treatment of America,"  -are busy as beavers, trying to make ours the one you want to visit every week, even if you have no problems.   We are looking for more State Chapter Directors - we have recently started constructing websites in other states in order to give you more individualized service .

 We are located near Metro-Atlanta and we no longer can we meet the needs of every one the way we would like to.  You can still expect the same service you have been receiving from us and nothing short of it.  - - - I am extremely careful and thorough with the people I hire to assist you and if you find that any of them are mistreating you in any way - - you just send a message my way - - -  - and we will certainly look into the incident.

We are here to serve (You ) mainly being the patient, your significant other and others that are interested in educating themselves about "Addiction" and we can prove you obtain the best results using "Medication Assisted Treatment."   - - We are not here to push methadone nor any  medications off on you.  We are here to see you set free and whatever it is that stops you from using.  Some of us are stronger than others . all of our systems are different . -  I'm for whatever works for you. 

I like to check from  time to time with my audience to let you know where I am coming from and I like to hear feedback from you .  We really work very hard just for you and we are working secretly on agendas we haven't even revealed to you of yet.  -  I think in dealing with all of your problems last year and really listening to what you had to say, (many times in the middle of the night), we did manage to get an idea of what most of you would like to see happen - - -   with "Medication  Assisted Treatment."  There still are many problems in the system that need to be taken care of.  I'm sure there will be no arguments from any of you with the remark I just made.

Until then, - -  We will continue to try and keep you up-dated on what we feel is significant to you.  If there is a subject, an issue or a medication that you would like to hear more about then let us know about it.  -"You have not, because you ask not!"  We are here to meet your needs,  - - don't complain they aren't being met, if you never let us know what they are.  - -  I think the article on Paxil® will interest a lot of you - the news came unexpected to me.  I never tried Paxil® but actually none of them ever worked for me anyway.   - -  It is an issue if you are expecting and taking Paxil® that you should discuss with your Obstetrician.

The Food and Drug Administration reccommends that pregnant women be warned about the dangers of Paxil in pregnancy after the preliminary results of two studies showed that the rate of heart defects in babies born to women taking Paxil was 2% compared to the 1% from a general population.  This increase in the risks of birth defects from taking Paxil has promted the FDA to discourage women from taking Paxil at all during pregnancy, requesting that they switch to another medication under advice from their doctors.  - They also remind women that they should not suddenly stop taking Paxil, though this choice is ultimately up to a woman and her doctor.

The Food and Drug Administration says that preliminary data suggest that there is double the rate of birth defects,specifically heart defects in babies born to Mothers who took Paxil in the first three months of pregnancy.

Paxil®  (Paroxetine, Paxil CR, Pexeva, and generic paroxetine hydrochloride.) is approved as an anti-depressant. Previously the Food and Drug Administration had it listed a a Category C Drug in pregnancy, now they are asking GlaxoSmithKlein to label it as a Category D Drug, " meaning that the drug has known effects on a fetus, but that the benefits may still outweigh that risk."

Food and Drug Administration Letter/Press Release

KImberly Read & Marcia Purse             8 December 2005

The US Food and Drug Administration today released an alert regarding use of the SSRI antidepressant Paxil (generic Paroxetine) during pregnancy. Two studies, one in Sweden and one in the United States, showed that when Paxil is used during the first three months of pregnancy - - - there was a significantly increased risk of heart defects in the fetus.

In the Swedish study, heart defects occurred twice as often with Paxil use than with -out - in 2% of births compared to 1%.  - - In the US study, the rate of heart defects with  Paxil was 1.5% compared to 1% with other antidepressants;   - - when all birth defects were taken into account,  - - - - - - - the rate for Paxil use compared to other antidepressants was 1.8% greater.

Based on these results, the FDA urges physicians to consult with women patients taking Paxil who are pregnant or are of child-bearing age.

The agency points out that the benefits of taking Paxil may outweigh the risks, and warns women not to discontinue Paxil except with the advice of their physicians and according to prescribing information, as serious side effects can occur when an SSRI antidepressant is discontinued abruptly.  (For more, see SSRI )

The FDA has also asked GlaxoSmithKline, the manufacturer of Paxil, to strengthen the warning labels on prescriptions.

References:  * FDA Advisory of Risk of Birth Defects with Paxil
                     * FDA Public Health Advisory 

- The drug-addicted babies, whose Mothers were charged with neglect, by The Arkansas  Senate in a vote of 30-0 may have to answer to these children before it all ends.   - Why, they ask, did they not get their Mothers the help they needed, instead of incarcerating them like they were criminals???

*****  The Arkansas Senate voted 30-0 to charge women who give birth to drug-addicted babies with neglect, - - - - but the state House defeated a measure to increase criminal penalties on drug-using pregnant women. 

*****  The Arkansas News Bureau reported that the state Senate unanimously approved S-114, - - - which would require doctors to report births of addicted    babies to the Department of Human Services.

Sponsor Senator Tim Wooldridge (D-Paragould) -  said the measure was in the best interest of the child and the mother.  But another supporter, Senator Percy Moore (D-Arkadelphia), - was less concerned about the welfare of the addicted mothers.  "I submit they're not mothers at all, " he said,  - adding that addiction changes users' personailities and leads to abuse and neglect cases - "that will make you nauseous."     

In the state house, however, H-1265 failed by one vote to clear the House Judiciary Committee, the Northwest Arkansas News reported.

The House bill would have toughened criminal penalties on pregnant women who use drugs; - - - for instance, a pregnant woman found in possession of an amount of drugs that normally would call for prosecution - - - - - - - as a Class A Misdemeanor would have faced Class D Felony charges. 

Cynthia Crone of the Arkansas CARES Treatment Program for mothers noted that alcohol use is a bigger threat during pregnancy than illicit-drug use, - - and said treatment would be a better option than jailing women for drug use.  -"The best way to help the children is to help their mothers, " Crone said. 

Both the Senate and House bills have been motivated by increasing numbers of children born addicted to methamphetamine in Arkansas.

Reference:  Arkansas News Bureau       Dated:  17 February 2005
Reference:  Northwest Arkansas News   Dated:  18 February 2005 

    The Director
     Thank You

Hello, Everyone!!!   It's that time of the year again - - - when there is love in the air.  I Love Christmas but if you are all alone - it can be a very lonely time for you.   It's a time for families and children, sharing with each other and friends.  - I think we forget sometimes what Christmas is all about  - - -but I want us to take the time to tonight  for a few minutes to remember. 

Tonight in a stable a child was born to Mary and Joseph and they called his name Jesus.  He was God's gift to us .  He sent his son to save us from sin. -  He gave us the ultimate present.  He asked nothing of us but to believe that He sent his son to pay the price for our sins.  -  -All we have to do is ask for his forgiveness if we sin. The blood he shed on Calvary paid the price.  Who could ask for any present  that is equivalent to His?  Forgiveness and everlasting life  - - it is available to everyone just for the asking.   -  - Take some time out to thank Him for His  precious gift to us tomorrow while you are celebrating Christmas.   

More than 40 people age 60 and over have been caught illegally selling
prescription painkillers in Kentucky since April 2004, according to a
local anti-drug task force.

The Associated Press reported December 12 that an 87-year-old woman was
recently arrested and imprisoned for reselling her prescription drugs for
cash.

"When a person is on Social Security, drawing $500 a month, and they can
sell their pain pills for $10 apiece, they'll take half of them for themselves and    sell the other half to pay their electric bills or buy groceries," said Floyd      County jailer Roger Webb. "It used to be a rare occasion to have an elderly  inmate.  Five years ago it was a rarity."

Experts say the problem may not be limited to Kentucky.  "We haven't heard
a lot about senior citizens being a source of those drugs," said Erin Artigiani       of the University of Maryland Center for Substance Abuse Research. "We know college students do this. It's not much of a stretch to think that seniors could       do it, too."

Physician Anita Cornett has heard from formerly addicted patients that they got their drugs from elderly neighbors; now, she randomly drug-tests her patients to make sure they are taking -- not selling -- their medications.  -  Patients also are asked to bring in their prescription bottles so that pills can be counted.

 Reference:   13 December 2005  Associated Press   

- -Researchers  have come with a novel finding that love and addiction may go hand in hand due to shared similarities. For example, the physiological effects manifested as a result of dopamine release (neurotransmitter) after having seen somebody attractive are nothing more than a simulation of the effects observed following drug abuse with cocaine or marijuana. In addition, both love and drug abuse leaves the user with an insatiable feeling, probing for a want or craving. 

- - - - - -  A number of changes take place inside the human body as the brain is processing feelings of love. The heart starts beating thrice as fast as the normal rate (72 beats/minute). There is an increased blood flow to the cheeks (blushing) and sexual organs (sensation of butterflies in the stomach). The only difference between drug abuse in this regard is that the above-mentioned effect is less pronounced.

Furthermore, the study also highlights the fact that ‘Birds of the same feather flock together’.  - - - In other words people tend to look for mates with similar features to themselves.

- - - -"It might look like we are all after the perfect partner to wine and dine but underneath, - - our animal instincts are seeking out an ideal mate to share our genes with. - We tend to go for the smell of somebody who has a very different immune system and that stops you fancying your family. Our biology drives us to find a perfect compromise between sameness and difference and we strike that balance all the time when it comes to choosing faces and smells", according to a senior researcher involved in the study.

The study also states that the frequency of sex determines the bonding between two individuals. Better is the bonding when the partners have sex often. Even if a person has frequent sex with somebody he/she doesn’t love, -  there's a good chance to get trapped in love with the same person over a period of time. More-over, the fundamental aim of the human body to reproduce and multiply would be sufficient to drag you in that direction.

 -  -The development of this want and bonding confers love it’s addictive powers and accounts for the withdrawal symptoms following a break up. Following such findings - -  may be it is time to better understand why love failure leads to habit formation in most of the cases. Perhaps such explorations could eventually pave way for the effective treatment of depression and drug abuse. .

 Reference:   MeIndia  Health News                6 December 2005

The family of a methadone patient who died at a Kentucky clinic recently
won $2.8 million in damages, and the case has prompted the state to begin
tracking such deaths, the Lexington Herald-Leader reported August 10th.

In the jury trial in Perry County court, Hazard Professional Services Inc.
was ordered to pay $2.8 million to the family of Jason Caldwell, 21. The
wrongful-death suit alleged that the clinic overprescribed methadone to
Caldwell, who had sought treatment for an addiction to OxyContin.

Caldwell died five days after entering the program.

State officials say they get reports of about five deaths annually from
methadone clinics, but "there is no investigation process for the state
with the death of a client," said Mac Bell, administrator for the State
Narcotic Authority.

Bell said his agency, which oversees methadone clinics in Kentucky, will
begin keeping track of deaths among the 1,000 or so methadone patients           in the state. "Now, since we've gotten so large, we are in the process- and
have been for the last year ------ of implementing a data-collection system
that will look at mortality and morbidity rates in our state," Bell said.

- - - - - Lawyers for the Caldwell family said the clinic prescribed too much
methadone too quickly. But the clinic maintained that Caldwell was taking
methadone bought from street dealers on top of the drugs he received from
the program.

Reference:  10 August  2005    Lexington Herald-Leader

From your Director:

The article above certainly throws a bad light on our 'methadone maintenance programs' and even though some of them I certainly believe should not receive their accreditation, somehow the one above I don't believe got a fair shake in these dealings. Whether you realize it or not -this kind of bad publicity doesn't help us as patients.  I can see where it could affect us receiving a more difficult time asking for an increase in our dosage. It is this issue we already have many complaints with.

  It is hard for me to believe the guy overdosed on the amount he received from the clinic when it was only his fifth day. You know as well as I do that the first ninety days -you must attend every day.- - -  If one of those five days was a Sunday or Holiday then he would have received a Take-Home Dose - He could have easily taken it if his dose was not high to hold him .  I can sympathesize with the boys parents but putting the blame where it does not belong will not help the others who come after him.  - - - I would like to hear from others concerning the case or if any of you have more information on the case.  

 I want to wish each and everyone of you a very Merry Christmas!    Thank you !
I hope all of you will join with me next year.  I promise you to make it a thought-provoking and educational one for all of us.   I have put together some really great articles for you and I promise to keep you in the middle of "What's Happening" on Addiction Research - it is going to be an interesting year.  Take the time and find our Membership and join up.  - It is only $30.00 yearly.  I will make it worth every cent plus we are on call twenty-four hours a day for you.  If you need us and can 't afford a long-distance call - then send us a message with your name, number, and the best time to call and we will call you.  What else can you ask for ? 

--I want to mention the fact that we still have openings available for State Chapter Directors .  If you are interested please fel free to contact us. We prefer before you send us your number to give you a call - just send me a letter attached to your E-mail telling me why you are interested in working with us in this field. What was it that inspired you? You must possess a computer , (we cannot supply this for you) and of course be some- what literate on it. - - - We will furnish you a website for your state and we will help you get started  plus we provide 24-hour technical help to assist you.  You are not required to have webmaster experience. Send us your letter to MATDirector@aol.com along with your name, phone number, and the best time to call.  Thank you. 

Merry Christmas!   2005
Your Director,   Deborah Shrira

I am finally back and I am hoping everyone had a very " Special Thanksgiving" with their family and friends.  I am ashamed to say I spent all my day working but thanking God for all He had given me.  We remained open trying to catch up on unfinished work and to be here for any of you who may need us.  It's very rewarding to hear someone's voice when you return their call and they are completely shocked because we answered their calls.
- - -They are so many people in the world that doesn't care and that's exactly why people are really caught off guard when they are shown any compassion. People have become lovers of their-selves and could care less about their brother.

How many people give out of their excess?  - - How many people give out of their need?  It cost you nothing to give out of your excess but to give out of your need - it will cost you.  Which one or you? Time is drawing nigh - I think  it is time you decide  which one you are?

"Tomorrow is not promised to us .. ...............tell somebody you care today."

I think we all know wherein the problem lies.  - - People cannot decide whether it is  a disease  - - -  - - or  an inherent weakness in people.  Even the medical profession disagree. - - - - - The American Medical Association along with our World Health Organization has decreed it as a Disease." Why I ask  is Washington still sending people with drug possession to prison.?"  Why do we all just set back and allow this to happen?  I wonder why the children are not taught about our" History of Drugs " and how our government took contol.

An ex-convict says we cannot address poverty and race in America, nor can we talk about needless death and expense, without addressing the drug war.  

 Malcolm X once said, "Any person who claims to have deep feeling for other human beings should think a long, long time before he votes to have other men kept behind bars -- caged. I am not saying there shouldn't be prisons, but there shouldn't be bars. Behind bars, a man never reforms."

On Friday, September 9, I became one of the roughly 25,000 people released from an Illinois prison this year -- 600,000 nationally -- after completing only 10 weeks of a one-year sentence due to extreme overcrowding. My crime was victimless -- simple possession of a controlled substance, specifically, a small amount of marijuana and MDMA.

But as the rare upper-middle class, educated white American in prison, I found myself in a truly alien, self-perpetuating world of crushing poverty and ignorance, violent dehumanization, institutionalized racism, and an entire sub-culture of recidivists, some of whom had done nine and 10 stints, many dating back to the '70s.

Most used prison as a form of criminal networking knowing full well they would be left to fend for themselves when released. We were told on many occasions that an inmate was worth more inside prison than backawaiting the resolution of their cases -- so a quick plea is the lesser of  in society. Considering it costs an average of $37,000 a year to incarcerate offenders, and the average income for black Americans is $24,000, and only $8,000-$12,000 for poor blacks, one can easily see their point.

But unlike the vast majority of ex-offenders, I was fortunate enough to return to an established life and work, and a support system of friends, family, and colleagues.

The Chicago Tribune reported this year that about two-thirds of the more than 600,000 ex-convicts released in 2005 will be re-arrested within three years, and about half will return to prison for a new crime or violation of parole. Despite having "paid their debt to society," once released, their punishment is not nearly over. These days there is little to no hope of any real reform, as within the various Departments of Corrections, "correction" is a painfully misleading euphemism for the warehousing of offenders.

There are few, if any, re-entry programs for ex-offenders and virtually no jobs or social services to help keep them afloat in an increasingly difficult and unforgiving society. Thus, most ex-offenders have no choice but to return to their old crime-infested neighborhoods, destitute and desperate to survive any way they can. A significant majority of the new crimes or parole violations are drug related, often nothing more than testing positive on a monthly drug screen.

This lack of any employment, training, or rehabilitative opportunities has created a permanent underclass of ex-offenders who remain trapped in poverty, unable to provide for themselves or their families without resorting to the few, generally illegal means available to them.  - - - Faced with their very survival, most have no compunction about engaging (or re-engaging, as the case may be) in drug dealing rather than starving.

What may be even worse is that for some, their ongoing "crimes" are only those of association, or in some cases, the consequences of being black and poor. Laws prohibiting ex-felons from associating with other ex-felons and gang members, such as the Illinois Street Gang Terrorism Omnibus Prevention Act, or those preventing ex-offenders from being in areas designated as "high crime" or where "controlled substances are illegally sold, used, distributed, or administered" means that many ex-offenders are in violation of their parole simply by going home, where the majority in their neighborhood, including family members, have criminal records, and drugs are sold on almost every corner.

I cannot begin to recount all the men I met, particularly those with prior records or those on parole, who were re-incarcerated for crimes they did not commit, simply because they were in the wrong place at the wrong time with the wrong people. Not possible! Our system is just!

True, it is for those who can afford justice in the form of a bond and a private lawyer, or for those against whom the system is not already unduly prejudiced.  But in a system with corrupt cops eager for arrests, zealous state attorneys eager for convictions, jaded and overwhelmed public defenders eager for quick pleas, and rigid bond judges eager to set bail far beyond what anyone in the defendant's socio-economic class could reasonably afford, there is little opportunity for a fair trial.

For so many, including myself, the conditions in the penitentiary were preferable to those in Cook County Jail -- where some 30,000 detainees languish all evils and the shortest route to freedom. Had I chosen to fight my case, there is little doubt I would still be there today. In the end, what does that say about our criminal justice system?

 Instead of correction and rehabilitation, what we have is what criminal justice Professor Richard Shelden, of the University of Nevada-Las Vegas, calls a "criminal justice industrial complex" where "the police, the courts and the prison system have become huge, self-serving and self-perpetuating bureaucracies, which along with corporations have a vested interest in keeping crime at a certain level. They need victims and they need criminals, even if they have to invent them, as they have throughout the 'war on drugs' and 'war on gangs.'"

Thirty years ago Gore Vidal noted that "roughly 80 percent of police work in the United States has to do with the regulation of our private morals…controlling what we drink, eat, smoke, put into our veins ... with whom and how we have sex or gamble."

Then there were roughly 250,000 prisoners in the nation. Today there are more than 2 million, with another million in county jails awaiting trial or sentencing, and another roughly 3 million under "correctional supervision" on probation or parole.

The total national cost of incarceration then was $4 billion annually; today it's $64 billion, with another $20 billion in federal money and $22-24 billion in money from state governments earmarked for waging the so-called "War on Drugs."

Nationally, around 60 percent or more of these prisoners are drug criminals. Yet, throughout all this time and expense there has not been the slightest decrease in either drug use or supply.

And amidst all the talk of race as a factor in the Katrina disaster let us not forget a bigger disaster: one in every 20 black men over the age of 18 is in prison compared to 1 in 180 white men. Despite African Americans comprising only 12% of the total population, in five states, including Illinois, the ratio of black to white prisoners is 13 to 1.

The U.S. Department of Justice reports that blacks comprise 56.7% of all drug offenders admitted to state prisons while whites comprise only 23.3% (in my Illinois prison -- one of 28 in the State -- of the 1,076 inmates, 689 were black, 251 were white, and 123 were latino). Based upon these numbers, a full 30% of African-Americans will see time in prison during their life, compared with only 5% of white Americans, even though white drug users outnumber blacks by a five-to-one margin.

Anyone familiar with these facts was not surprised by the response to the largely poor and black victims of Katrina. It was simply a further affirmation of their invisible status within our society, further proof of the Third World existing within the First in America.

What may be the biggest shame in all of it is how New Orleans Mayor Ray Nagin himself reinforced all the most miserable black stereotypes by characterizing the looters as "drug starved crazy addicts wreaking havoc" in an attempt to expedite federal assistance and justify a declaration of martial law. It spoke volumes to what resonates within the public consciousness, stirring up some of our deepest fears.

It's time to realize, once and for all, that this war is lost. It's akin to trying to empty flooded New Orleans streets one teaspoon at a time. - - -  -  But sadly, Americans have forgotten this war amongst the multitude of more fashionable, media-friendly wars that have arisen in the last five years.

No matter how much money the government pours into the "war on drugs," it doesn't appear to make a dent in drug use or drug-related crime. The body count still rises. Dead and corrupt cops, dead gang youth, dead traffickers and couriers, dead innocent bystanders. And then there is the urban "collateral damage" -- devastated families, addiction, disease, overdoses from unregulated, poor quality drugs, exploding prisons, crushing costs, corrupt officials, craven politicians, sensationalist media, and a limitless harvest of offenders. - Where does the madness end?

We cannot address poverty and race in America nor can we talk about needless death and expense without addressing the drug war.   - - - - If we don't stop the direction in which we are heading, by 2020 there will be over 6 million people in prison, and thousands more lives extinguished in the crossfire of a domestic war that we had no chance of winning in the first place.

Charles Shaw, a writer and activist, is the publisher and editor-in-chief of Newtopia Magazine. He is writing a series on his recent prison experience. 

Please if you read the article above- take the time to read it once again. I have never heard the truth put so simply and yet be so right. As he says no matter how much money - - - " our government" pours into the "War On Drugs," it doesn't appear to make a dent in drug use or drug-related crime. The body count still rises.  We cannot address poverty  and race in America or can we talk about - - -  - -needless death  and  expense without addressing the drug war.

I think with this article I have left you with plenty of material to think about.  - - My wish is that you will put this issue on your New Year's Resolutions to really take more of an active part in finding a solution before your son or daughter ends up as one of the statistics.  Please think twice before leaving your children incarcerated overnight - remember Addiction is a Sickness.  Get them help but they will never find it incarcerated.  Your Director,  Deborah Shrira  2005

Is everyone ready for another hurricane?   I bet I can answer the question.  I heard we had another one on the way today maybe heading toward Florida.  Personally, I like rain, high-velocity winds, lightening and thunder, and the waves rushing to the shore like -mad - especially in the Fall Season when the leaves are changing colors and the air is crisp and just turning cold. We take so much of God's beauty for grant it.  There is not too many of us that stop - and take the time to smell the roses. 

I just thank God I wasn't a victim of either -   It seems lately there has been a lot of catastrophes happening lately--earthquakes, hurricanes, fires, mud slides, flooding and then there was a wonderful movie made for Home Box Office  " Methadonia."

- - - - Tonight I want to share with you some about the victims of Hurrican Katrina, Addiction, and "Methadonia."  The picture below  was taken by some of our close friends vacationing in the area.    It is an awesome picture of God's power.  

When you get to the point where you throw up your hands, surrender. Strike old glory and run out a bed sheet.  -  - -   You admit you are powerless and go to the Methadone clinic, walk right in there and ask for help and treatment. You clean up, get a job, pay your bills, and begin working your way back into your life and the lives of your family and friends if they'll give you just one more chance.Then you go down to the clinic Monday morning and it's under six feet of water!

  - - - - This kind of surprize can be very dramatic and devastating to a patient just starting.  "Because we can guest dose for a short time most of the evacuees don't have to transfer their treatment program here." Says Tina McWilliams, clinic director for the Memphis Methadone Clinic.   ----  Some of the clients have decided to stay because they don't have anything to go back to in New Orleans.  McWilliams didn't want to say how many had decided to carry on their programs here but she said there were several clinics in the Metro New Orleans area that are not there anymore. They went to other clinics all over America.  Some came to Memphis, they were just like everybody fleeing the storm, they were scattered across the country. McWilliams has been in social work for over 25 years and has been working in the treatment and recovery community for the last eight years.

 For those who say they are going back to New Orleans they guest dose them. Same for those who say they plan to go back soon as possible to see if they have anything left to go back for. They'll come back to Memphis and decide if they need to make a new life here, get a job, a new place to live and start over. So some have gone back, while others say they are never going back. Some say where they lived in New Orleans was already a kind of a disaster area. They say they just can't go through another experience like that again so they won't go back. McWilliams says "The knowing that at any point in time it could happen and you'd have to start over again will keep lots of people from going back."

Most of the clients say they are living better lifestyles now than they ever did before. They would never have wished for this to happen but now that they have gotten away they are better off. Also no matter how hard some of them would try, they could never have been able to move on their own and now with all these people trying to help, they have a chance. So as McWilliams says: "It's a small positive out of this big negative."

 "Methadonia”, a Home Box Office documentary by award winning filmmaker Michael Negroponte,----- looks at the lives of addicts in New York as they try to recover from addictions to narcotics. McWilliams has heard about the film and has spoken to others in the recovery community who have seen it and they tell her that it is nothing like the programs they have been involved with or have in Memphis.

The stories of 300-milligram doses and people being warehoused for life in the program, no treatment, no hope for getting clean and sober is just not the way it works down here in the South. McWilliams says "Yes, it's true that some people have been on narcotics for so long that they are going to be maintained on as low a dose as possible for the rest of their lives in this clinic and others like it."

This is because as most addictionologists will tell you after taking powerful narcotic drugs for years it changes the way your brain processes the drug. It changes the bodies of addicts and often their metabolism begins to process the drugs in different ways than people that have never taken these kinds of drugs.

Other variables come into play also because addicts often have other problems that come along with their addictions.   HIV and liver disease are just a couple of the reasons they have special needs because weak immune systems and damaged livers are not as efficient. This means that they require higher doses. "If you see someone who says they are on methadone and they look all messed up and nodding out then they are on some other drug with the methadone" McWilliams says. The HBO film shows how the addicts take Benzodiazepine type drugs (such as Valium and Xanax) to enhance the high they don't feel strongly as they did when on street narcotics. If you take the Methadone the right way at the right dose level you don't get high or feel the euphoria, you don't crave more opiates and you can get on with the process of recovery if you are serious about pursuit of a program to become clean and sober.

 Private companies own most of the Methadone clinics so they all have different policies and philosophies. Local municipalities only run a few. The states and federal governments license them all. *** The ones that are managed by states, counties or cities have long waiting lists because there are so many more addicts than programs and funds to treat them.

 Naturally this brings on the ultimate question about methadone treatment. Is it working?  McWilliams said they don't have a typical client. ***They have people that make $100,000 a year and some that are street addicts. We measure success in small steps for the people that come in off the street.  They start the program, get cleaned up, get jobs begin to think about the possibility of making a real change in their lives and these small steps can lead to them either getting off opiates entirely or getting down to a small enough dose that they are not high or feeling any euphoric effect from the methadone.

“We try to get everyone to the point they can detox and get out of the program but there are some who will always need the methadone.”

 McWilliams tells the clients they owe it to themselves to try to get completely off the methadone. If they can't make it they can always go back up on the dosage level but they need to try to get completely off the Methadone. 

Reference:The Daily Mississippian   Edited by:  E.H.  McClary   8 October 2005

October 5, 2005                  The Director's View

Hello!  Hello!  It's been awhile since I touched base with all of you.  I apologize to you but we have been so busy --- I have just not had the time.  I can hardly believe it is already October again --- and Christmas is on the way.  There is just absolutely no way I will be able to catch up - I really could use some volunteers to help but you will not last long in this field unless you have a burning passion inside for the area of addiction.  I am back now to catch you up on a few important events that requires your attention. 

I want to share with you about a movie that is airing on Home Box Office October 6 -- I am cutting it close.  The name of the movie is "Methadonia."  The reason I am bringing the movie to your attention is because it represents a  negative view of methadone.  It is not based on facts nor scientific data .  We have tried everything in our power to prevent them from releasing the movie but to no avail.  It is your decision if you choose to watch it.  I would not give them the pleasure of my valuable time, nor will I contribute to their ratings by viewing it.  I do think some of us should watch it just in case we are asked questions  regarding the movie.  All of us should be able to distinguish the truth from lies about methadone. 

  ---- The viewers it will hurt most of all will be the ones needing methadone -- besides adding to the stigma that already exists about methadone.  It will hurt new owners trying to obtain a zoning permit to open programs  in certain towns and cities.   We want all of you to be aware of it so if you are confronted with questions from others about the movie - you will be prepared to deliver the truth to them.   I think Dr. Newman's letter below gives an accurate summation of the movie -- I think all of you should read his letter then you will have a better idea of what the movie is about- and you will have an idea of how to buffer the remarks made by people viewing "Methadonia."

                                   " METHADONIA"

Movie previewed by Robert Newman M.D. in advance showing in Europe.  If you decide to give them your valuable time to view it-Let us know what your opinion of the movie was.   We really are interested in your opinion whether you agree with us or disagree.

What follows is probably more than most people will want or need to know about the film Methadonia. The essence of the concerns can be readily summarized,how-ever.

--- All subjects were recruited in a drug-free program that offers no methadone   treatment to anyone.  --- Assuming those depicted actually had experience with methadone, it’s generally unclear whether it was before, -------during or after the various segments were recorded.  ----- There is no explanation why the subjects  were enrolled in two addiction treatment programs simultaneously,  -----whether referral of treatment resistant patients was from the methadone to the drug - free program or vice versa, and who paid for the duplicative services.  None of these critical questions is posed – let alone answered.

While one might not be able to tell a book by its cover, the message of this film is conveyed unequivocally by its title. The“urban dictionary”(courtesy of google. com) defines it as follows:  ---- “Methadonia – A fictitious place inhabited by an abundance of meth freaks from all around the world.”  Whatever the “official” definition, however, the strongly pejorative image evoked by this title is inescap-able.  With respect to both the medication and, more importantly, the patients, stigma, prejudice, hostility and fear will be further heightened by the label “methadonia” even if one never sees the film."

Methadonia contains no facts and no research or empirical findings regarding the nature of opiate addiction or its treatment with methadone or any other modality. 

There is not a hint of familiarity with or reliance on the many hundreds of published reports from throughout the world of methadone’s efficacy in abso-lute terms, or in comparison to addiction left untreated or managed by other techniques.  

Accordingly, most viewers of this unwaveringly one-sided presentation, focused exclusively on individuals who purportedly had responded poorly to methadone treatment, would probably be surprised to learn of the favorable conclusions regarding effectiveness that have been publicized for over four decades by a variety of US Government agencies, the World Health Organization and the Unit-ed  Nations, and by governments, clinicians and academicians in such disparate countries as Canada, Switzerland, Spain, Croatia, Iran, China, Australia, and many more.

For example, the US National Institute on Drug Abuse noted more than 20 years ago, “To argue that methadone maintenance is not at least as effective as other available modalities for treatment of this population is to ignore the results of the best designed research studies and the consensus of a varied group of experts in the drug/mental health field.” 1 

The same agency stated in 1997: “Methadone significantly lowers illicit opiate use and related illness and death, reduces crime, enhances social responsibil-ity confirmed that “Methadone continues to be a safe and effective treatment for addiction to heroin." 3 

In 1999, the American Medical Association Council on Scientific Affairs conclud-ed that methadone maintenance “reduce[s] illicit drug use and injecting drug use, and the harmful medical and social  side effects of that use. . . “ 4   And internationally, the World Health Organization and United Nations agencies responsible for HIV-AIDS and drug control confirmed just last year, in a widely publicized position paper, that methadone maintenance is both safe and effec-tive. 5 

While ignoring assessments such as these, the film seems fixated on just one objective to buttress a strongly negative bias against methadone treatment.   Ironically, the subjects portrayed – enrolled simultaneously in both drug-free and maintenance programs –- illustrate the challenge inherent in treating addiction, regardless of approach.  The tragedy is that the focus is exclusively  on the treatment-resistant, rather than the great many others who are helped to radically alter their lives. There is, however, one exception –“Steve” – but his success while receiving methadone maintenance is so inconsistent with the film’s negative message that it is glossed over, giving the production a decided-ly schizophrenic tone.

Steve is first shown barely able to stand or talk, with his eyes rolling back in his head. He is almost obtunded, obviously under the heavy influence of something – but what?  Notwithstanding the clear inference that this typifies “Methadonia,” there is no way to know whether and to what extent prescribed methadone may have contributed to this agonizing caricature of the stereotypical “addict.”  The unfortunate limitations of the treatment he received, reflecting the nature of the illness of addiction, apply no more to methadone maintenance than they do to the drug-free counseling he was provided.

At any rate, in a subsequent segment Steve is shown “reborn.” It is difficult to imagine a more positive portrayal of a “recovering addict” - clean, alert, articu-late, with great pride in his clothing and his physical appearance, charming, God-loving, and referring to the days “when I was still an addict . . . “ And then, in a contradiction so stark that on initial viewing it seems to have been misun-derstood, the narrator mentions in passing that this reborn, reformed, model of an “ex-addict” is “still on high doses of methadone!”

Before the viewer can digest this extraordinary and unexplained transformation Steve is shown once again, undergoing what appears to be sheer hell attributed to the process of detoxification from methadone.  ----- But why does he seem hell-bent on continuing to pursue a course that leads to the pitiful lament, “I’d rather be dead!”  After all, he had experienced – on a high dose of methadone - a dramatically documented, seemingly miraculous, “rebirth.”

These are questions that Steve does not address and the narrator does not pose. Instead, methadone is damned because its therapeutic efficacy does not persist when the medication is withdrawn! As for the healthcare providers who, viewers are told, recommended strongly against termination of treatment, they are denounced as motivated by a venal desire to hang on to every paying customer.

The severity of the withdrawal symptoms that Steve experiences are said to reflect an intent to punish patients for leaving treatment, and to serve as a warning to others not to do the same. In Steve’s words, “They drop you too fast” – a bitter complaint that comes just moments after he stated with satisfaction that he demanded withdrawal be accomplished “quickly.” (In the very final moments of the film Steve is again shown in seemingly excellent physical and mental health, but there’s no clue given as to whether he has been detoxified or is, as during his prior successful transformation, being prescribed methadone.)

Opiate addiction (like alcoholism) is a chronic, notoriously relapsing condition - one that today remains incurable but that, thankfully,  --------   is treatable with methadone and a variety of other regimens. Some treatments rely on medica-tion of various kinds and others are committed to abstinence both as a process and as a goal.  None will be effective with all patients; each has something to offer and must be supported. -----  And as is true of the treatment of all chronic medical conditions, each will result in a broad spectrum of outcomes, from the most extraordinary therapeutic success to abject failure.

It is a terrible disservice to focus a film entirely on one small and undefined group of individuals who presumably are receiving methadone treatment and imply that their experience is typical. ------- It is a slap in the face of those who desperately seek and accept care, and to those who provide it. Consider a film that deals with the treatment of epilepsy, and whose only subjects are indivi-duals who are treatment-resistant.  Such a film, if made in the same manner as Methadonia, would show in painful detail the occur-rence of seizures, the biting of tongues, the total loss of control over speech, gait, communication and – often – bladder function (what a dramatic photo opportunity that would be!).

The Methadonia want to be whose topic is epilepsy would go on to film patients complaining that their lives are constrained by the “handcuffs” their prescribed medication represents,and their frustrated dreams of “getting off it.”   --- It would blame the need for indefinite medical care on doctors whose alleged motivation is to retain patients and the fees they generate.  ----------  Consider applying such criticisms to the medications and healthcare providers involved in the manage-ment not only of Epilepsy,but of Hypertension,Cardiac Disease,Diabetes,Obesity, Depression, Parkinson’s Disease, Arthritis, and other similar diseases.

----- Those who see this film will be left with reinforced stereotypes of addiction treatment – specifically, treatment with methadone ---------   and its patients and providers.  Treatment services now in existence will be jeopardized.   Patients will be further stigmatized and their housing, employment, family stability and health care placed at even greater risk than heretofore. 

Those who abhor the notion of treating opiate dependence in their “backyard” will find added ammunition for their cause, -----------  thus presenting ever more formidable barriers to establishment of new programs (an estimated 80-85% of Americans addicted to opiates have no access to care today).

The real bottom line, is that this film will destroy lives figuratively and  literally.  What a needless , senseless, shameful tragedy !              -----Robert Newman, M. D.

Hurricane Katrina as she swept into New Orleans taken by friends.

Hurricane Katrina displaced thousands of people with addictions from their treatment programs and support networks, added strain on people who may have been walking the line between moderate use and addiction, and put millions at risk of turning to alcohol or other drugs to ease the pain of dislocation, financial ruin, and personal tragedy.

However, the post-storm response to the needs of individuals with addiction problems in states like Louisiana, Mississippi, and Arkansas has been a minor reflection of the larger picture: an outpouring of support from the private sector mixed with criticism of government efforts in a time of crisis.

Media reports in the storm's aftermath included accounts of desperate addicts cut off from their suppliers in New Orleans and treatment programs in Baton Rouge dealing with an influx of addicts in withdrawal. Some officials even laid blame for post-storm looting in New Orleans at the feet of purported addicts stealing to support their habit.

Samantha-Hope Atkins, founder and executive director of Louisiana's Hope Networks, a treatment and prevention advocacy program, calls the post-Katrina period "some of the most challenging times I've experienced in my own recovery."

Louisiana, which had just 32 detox beds and perhaps 400 inpatient treatment beds statewide prior to the storm, has lost "easily one-third of services statewide," said Atkins, including 20 detox beds at New Orleans' Charity Hospital alone.

"We've seen some relapse, especially with people in early recovery who have lost their support network, people who don't know if their spouse is alive or dead, and among methadone patients," she said. "There are so many complex needs, from giving someone a Big Book to connecting them to resources."

Atkins said that Louisiana's 12-step programs, which she said have always been strong because of the lack of government programs, have been working to distribute addiction-related materials in shelters. But she was critical of the public sector in the wake of the storm.

"There has been absolutely no response to the needs of people in addiction recovery," said Atkins, who pointed out that most of the federal money that has trickled into the region has been for mental health, not addiction -- and even some of that has been earmarked for first-responders, not victims of the storm.

"Our needs have been grossly neglected," said Atkins.

SAMHSA: States Set Priorities

On September 13, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced that it was sending $600,000 in emergency mental-health grants to the region affected by Katrina. Of that money, $200,000 was sent to Louisiana to provide mental-health counseling for police, firefighters, and other first-responders; Alabama and Mississippi received $150,000 and $100,000, respectively, for mental-health services, and Texas received $150,000 for methadone services for storm evacuees.

"Each jurisdiction was allowed to prioritize exactly what their need was," said H. Westley Clark, M.D., director of SAMHSA's Center for Substance Abuse Treatment (CSAT).

Clark said that SAMHSA Administrator Charles Curie and Department of Health and Human Services Secretary Mike Leavitt are committed to addressing both addiction and mental health needs post-Katrina. Clark said that SAMHSA officials have toured the region -- and in some cases, have stayed to help -- and that a needs assessment is currently underway. SAMHSA's Emergency Response Center has been given the task of coordinating staff response to Katrina and responding to requests for aid.

CSAT also has funded hotlines in Louisiana (1-877-664-2248 in state or 800-662-4357 out-of-state) for people with addictions, promising referrals to 12-step programs, treatment services, crisis-intervention teams, methadone maintenance, and other resources.

"An inventory [of lost capacity in the region] is still being conducted," said Clark. "People do not have access to services traditionally provided by facilities in New Orleans. We know Mississippi had shortages associated with substance-abuse issues."

Asked how much of the $50 billion in emergency relief approved by Congress would go towards addiction services, Clark replied, "The administration is very much aware of the issue. We have to work with local communities to prioritize how that's allocated."

Addiction Community Steps Up

Meanwhile, the addiction community has stepped up with offers of assistance ranging from volunteer counselors to treatment beds for hurricane victims. Two weeks after the storm hit, Atkins circulated an urgent "wish list" that included the need for medical detox facilities, treatment placement, transportation and case management, and public information and outreach.

"The void of services is enormous," wrote Atkins. "We are doing what we can to respond, as waiting for government resources is not an option."

Atkins got an immediate response from Dr. Al Mooney, a North Carolina physician, who persuaded drug companies to donate medication needed for detox services and drove down to Baton Rouge in a motor home to help people in withdrawal. The Betty Ford Center offered to provide treatment for a half-dozen patients, and the National Council on Alcoholism and Drug Dependence began mobilizing its affiliates nationally to help storm victims, Atkins said.

Then, the National Association of Addiction Treatment Providers (NAATP) -- which happened to be holding its annual meeting in Florida -- pulled together its membership to pledge a total of $5 million worth of primary inpatient and other treatment services for Katrina victims. Hope Networks will help link people in need to the services offered by NAATP members.

"When a crisis of this magnitude hits, and there is no funding available, it's critical for the private sector to take action," said Ronald J. Hunsicker, president and CEO of NAATP. "I am proud that so many of the private treatment centers like Caron Foundation, Betty Ford Center, and others have come forward to donate over 100 treatment beds and airfare, amounting to several million dollars of life-saving alcohol and drug impatient treatment as well as potential longer-term treatment to the victims of this disaster."

"This is a section of the country that's not the best, even in the best of times, at delivering treatment services," Hunsicker told Join Together. "Here we can demonstrate that the private sector -- driven by compassion and mission -- can respond in a way that the federal government can't or won't."

Atkins said she will be able to fill those 100 donated treatment beds "in three days."

"Our only hope is the bond of recovery communities and providers," she said. "The grassroots efforts have just been overwhelming."

Different Populations Seen at Risk

CSAT's Clark said the federal government is still trying to assess the need for services among hurricane victims. He noted that past experience has shown that a variety of different populations tend to be affected by disasters like Katrina.

"In the general population there are people who use alcohol in an acceptable fashion, but because of the magnitude of the storm may engage in dysfunctional coping," he said. "We recognize that as an expected outcome of major traumas [like Katrina]." Clark said the primary response to this population should be prevention materials and messages "because this is not a population with substance-abuse problems per-se." Over time, alcohol and other drug use among this population could be expected to drop to pre-storm levels, he said.

People who were previously in treatment might relapse and need services, added Clark, and those currently in active treatment who were displaced also have a clear need for help. He also warned that the 78 percent of people who meet the criteria for abuse or dependence but don't think they need treatment may have to confront their drug or alcohol use because they have been cut off from their suppliers.

"Those people could cause a rush for detox beds if they suddenly don't have access and start going through withdrawal," said Clark.

Atkins noted that prior to the storm, the Louisiana state Office of Addictive Disorders estimated that 600,000 state residents met the criteria for alcohol or drug dependence, and 1,200 to 1,800 were on waiting lists for treatment every day. But Clark was reluctant to estimate the total numbers of people in the hurricane-afflicted region who need services -- a number that could grow even larger this week depending on the impact of Hurricane Rita.

Clark did note that after the Oklahoma City bombing researchers found a 5-percent increase in alcohol use, while benzodiazepine use rose in New York in the aftermath of 9/11. But those were one-off events, and use tended to decline over time, he said.

"We don't have any accurate epidemiological data on this," said Clark. "We know about 1 million people have been affected ... and we will work with the departments of health and [state] substance-abuse officials to get a handle on it."

However, he added, "Even if we don't speculate on an increased prevalence rate, we know that there is going to be a bump up, which is why we need an accurate assessment of need."

Atkins said that addiction treatment and recovery should be at the top of the list as state and federal officials deal with the societal fallout of Hurricane Katrina. "When recovery is a priority, you can build healthy and safe communities," she said.  -------- "If additional substance-abuse money in Louisiana is not a priority, all other efforts to address these social-service needs will be flawed."

Editor's Note: Hope Networks is coordinating volunteer treatment services for victims of Hurricane Katrina; visit their website at www.hopenetworks.org for more information. Readers can also visit the SAMHSA Disaster Technical Assistance Center online at http://www.mentalhealth.samhsa.gov/dtac/.

A Message From Your Director:

I would like to take the time to thank all of you for your patience these last two months. --- It has been very busy for us with the influx of calls from victims of Hurricane Katrina.  We have survived but we have not been as quick to answer as usual and I apologize if it took us longer to call you.  I believe we did reach all of you but if for some reason we overlooked you, then please let us know. 

We know some of you are still having problems getting your methadone free.  I have not  received any new updates from Center Of Substance Abuse Treatment.  I posted the numbers along with the information I was sent ----- I was told directly that any Katrina victim should receive their methadone at no cost.  If there was any problems - then have please have them call the numbers listed. -- I have reported every program that was reported to me that did not abide by the orders given to me.  We are still working with some of you trying to get you take-outs approved  - I was thrilled yesterday when one was finally approved. 

He was having to drive sixty miles to and from the one he was Guest Dosing at. He had been paying for his methadone each day for they were not aware that Katrina victims should receive their doses free but as soon as we told them - they abided by the orders and gave him free methadone. ---- He was ecstatic but still there was the problem with driving sixty miles back and forth  but thank God he received approval for two weeks of take-outs.  It wasn't just the driving but as we all know gas is not cheap anymore.  This is just one of many stories we have dealt with.

----We are receiving calls now from some Program Directors asking how they are to be reimbursed for the free methadone given out.  They said they had not been able to reach anyone at any of the numbers including Hotline Numbers.  I can understand their problems too-- yesterday we sent complaints in trying to find answers to their questions.   No response of yet - but we want all of you to know we are working overtime trying to locate answers for your questions.   

Thank you for your time and patience.  

Deborah Shrira, Executive Director and Webmaster of Medical Assisted Treatment of America, Incorporated

October 2005 ~~ ~   The Director's View    ~~~~   One-Year Anniversary

Let's "take time to celebrate" our one year  anniversary.  We have been up and running  for one year now and they said we would  not last!!!  We are here to stay!  None of us   knew anything about operating a website ----  we brought it up and took one day at a time.  I can say if you have a will strong enough -  there is always a way.   It takes stamina,  persistence and support from your friends.

Lets' make it even better in the following year to come.  I think we are certainly capable---lets give all we have of ourselves to others.  Take time for yourself to regenerate.  You are important to us.  Therefore, Be good to yourself.  No one deserves it more.       The Director             August 2005

The Director's View              August 30, 2005

Hello, Members and Visitors!!!

It is hard to believe August is practically gone! Time is passing on but I am sure you feel as I do.  You want to stay around?  Methadone is becoming a popular medication on the street.  You will see I am telling you the truth by reading the three articles I chose from the news.  There were many more to choose from but I believed I could make my point in three.  I want you to be around next August.  You can see by reading about these deaths that charges are being brought against these people. 

Please under no circumstances share your medication!  I know at one time or another we all are guilty of sharing some of our medication;  like sharing  some medication for pain, whatever. I beg of you, read the articles.  Remember it is against the law to share any of your medication.  Please keep your medication in the right bottles in case you are stopped by the police. If you have teenagers - please set them down and talk with them especially concerning methadone.            

By Jane Prendergast
Enquirer staff writer

NORWOOD - Three suspected drug-related deaths over the holiday weekend left investigators to cope with what may be a local instance of a growing trend nationally - abuse of methadone, a drug used by heroin addicts to avoid withdrawal.

Two of the dead men, Anthony Hollin Jr.18, and Justin Wright, 19, were partying together Saturday night.  Within hours, police and medics responded to both of their homes and found them not breathing.  Autopsy results were not complete Tuesday, but officers said they found methadone pills in Wright's apartment and later learned that Hollin had ingested some, too.  

A third man, whose name was not released, was found dead Monday, but police released no information about that case.

That man's death was not believed to be related to the other two except that the same drug was involved.

Sgt. Earl Warman knew Hollin and Wright from working in Norwood schools.

"They're good kids," he said. "I wouldn't have expected this of them."

He said investigators did not know where the men got the drug, but that they did not have a legitimate reason for having it.

All three men's bodies were taken to the Hamilton County Coroner's Office for autopsies.

Preliminary toxicology reports could be finished this week.

It will take longer to determine the amounts of drugs in their systems.

Methadone was created by German scientists during World War II because of a shortage of morphine, according to the U.S. Drug Enforcement Administration. Though it's primarily used now to treat heroin addicts to cushion withdrawal symptoms, the drug is increasingly being prescribed for pain by doctors as an alternative to OxyContin, said John Burke, commander of the Warren-Clinton Drug Task Force. His agency has arrested people for selling methadone as well as a physician for falsifying prescriptions.

The growth in prescriptions for pain prompts "doctor-shopping," Burke said.

It's a considerable problem across the country," he said.The drug can be proble-matic for two reasons, Burke said. Because it is slow to take effect, people want-ing to get high often take more, thinking the first doses aren't working.

It also has a long half-life, meaning it stays in the body and builds up over time.

Hollin's body was found just after 11 a.m. Sunday in a house on Carter Avenue. Police and medics were called there for a report of a person who wasn't breath-ing, according to a police report. Medics performed CPR on Hollin, who had last been seen sleeping in a living room chair an hour earlier.

About two hours later, police and medics responded to a Williams Avenue apartment for another call of a person who wasn't breathing. They found Wright in a bedroom and were told Wright had taken six to eight methadone pills the night before. Police found four methadone pills in the bedroom and another three on the bed of his brother, Daniel, 21.

Hollin and Wright both were taken to University Hospital, where they died. Daniel Wright also went to the hospital, but was out by Tuesday, Warman said.

E-mail jprendergast@enquirer.com

BATAVIA -- A Miami Township woman is jailed in Clermont County today after a grand jury indicted her of on charges of involuntary manslaughter in the drug overdose death of her sister in May.

Caroline Scott, 40, was indicted following following an investigation by the Miami Township police into the death of her sister, Clara Yoder, 30. Yoder died on May 13.

Yoder, of Waverly, was visiting Scott's home when she died of an overdose of methadone, sleeping pills and several other prescription drugs, authorities said.

Miami Township Police Detective John Swing said that Scott admitted to giving the methadone to her sister. Because Scott knew that Yoder had a history of drug abuse, she contributed to her sister's death by giving her the pills, Swing said.

Swing said Scott had awakened during the night and had noticed that Yoder appeared to have trouble breathing but did nothing to help her.

Scott was indicted Wednesday. If convicted of involuntary manslaughter, she faces between four and 10 years in prison.

E-mail smclaughlin@enquirer.com

West Bend- Using the state's "Len Bias Law," a Washington County Judge has ruled that there is enough evidence to put a Mayville man on trial on a homicide charge on the accusation of giving methadone to a co-worker, who died from an overdose of the drug.

The charge of first-degree reckless homicide against Richard S. Dinkelmann, 40, marks the first use of the law in the county, District Attorney Todd Martens said.

Circuit Judge Patrick J. Faragher on Friday set arraignment in the case for Sept. 21.

If convicted, Dinkelmann could be imprisoned up to 46 years.

According to a criminal complaint, Dinkelmann gave methadone to Robert S. "Itchy" Iczkowski, 21, who died Jan. 24, 2004, at his Town of Jackson home.

The law, enacted in 1989, allows for a homicide charge to be filed against a suspected drug supplier if the drug is a "substantial factor" in a person's death.

The law is named after the University of Maryland basketball player who died of a cocaine overdose in 1986.

Dinkelmann is free on $1,000 bail.

Dinkelmann was convicted of felony heroin possession in 2001 in Washington County and felony delivery/manufacture of cocaine in 1995 in Waukesha County, court records show.

Also, he has been charged in a felony drug case that is pending in Waukesha County, the records show.

From the August 17, 2005, editions of the Milwaukee Journal Sentinel
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The Director's View                August 18, 2005

A key component of the body's daily biological clock may influence the brain's response to drugs of abuse, Dallas scientists and their colleagues have found.

The new findings are part of a growing body of evidence suggesting that the body's clock does more than tell you when to sleep and when to wake up.   It may, scientists are realizing, cause ups and downs in a variety of brain functions over the course of the day.

In the new study, researchers from the University of Texas Southwestern Medical Center at Dallas linked the daily clock to a brain chemical known for its role in addiction. The findings could put scientists in a better position to develop treatments for addiction.

"There are so few medications that are effective," said Jay Hirsh, a neuroscientist at the University of Virginia in Charlottesville. "This isn't going to lead to rapid therapies, but long-term, that's the hope."

In recent years, scientists have uncovered a network of genes and proteins that keep a variety of body functions in tune with the rising and setting of the sun. This network is the reason people feel sleepy at night and alert in the day; it also causes daily fluctuations in body temperature, blood pressure and kidney function.

"The classical idea is that the [network] ... is just involved in generating the rhythm," said Rainer Spanagel, a neuropharmacologist at the Central Institute of Mental Health in Mannheim, Germany. "Now we find out that these clocks are ticking everywhere, in the brain and also in other organs and tissues. They profoundly influence other behaviors. This is really astonishing information."

In the new study, researchers from the University of Texas Southwestern Medical Center at Dallas studied laboratory mice that were missing a key gene in the body's clock. These mice lose their natural daily rhythms, and the Dallas scientists also observed that the mice find cocaine more rewarding than normal mice do. The study appears online in The Proceedings of the National Academy of Sciences.

The researchers, led by UT Southwestern neuroscientists Colleen McClung and Eric Nestler, also found that certain cells in the mice's brains released more dopamine, a nerve cell chemical triggered by natural pleasurable experiences, like food and sex. Certain drugs of abuse, including cocaine, also cause release of dopamine in the brain.

Scientists have previously noted that lab animals' interest in drugs of abuse varies over the course of a day. But the new study is the first to connect the body's innate daily clock with dopamine.

More research is needed to figure out why disrupting the clock would make cocaine seem more – and not less, for instance – rewarding, Dr. Nestler said.

Nevertheless, he said, the results show that the gene, known as Clock, influences why some experiences are more rewarding at certain times of day.

"It's a more efficient way to use the brain," he said. "It makes sense to coordinate the brain's functions. When you're trying to get ready for sleep, you don't want to feel like going out and looking for food."

Also participating in the study were scientists from Illinois and Greece.

Reference: Sue Goetinck Ambrose/ The Dallas Morning News / 25 June 2005

E-mail sgoetinck@dallasnews.com 

Frances McCabe                  15 August 2005

Two Mothers take stand after sons die from mixing methadone with Xanax®.

It was supposed to cure heroin addiction. Now authorities say it is killing people in northwest Louisiana.With deadly consequence, methadone has invaded the regimen of recreational prescription drugs being used in the area.

The synthetic drug has long-lasting power and -- when mixed with the wrong dose of other drugs, illegal or prescribed -- will kill, authorities say.

Families confused by the loss of loved ones are learning from toxicology reports that the combination of methadone and the prescription drug Xanax is to blame. Hundreds lay in graves often dug too early for their age.

Now two women, blinded by courage born of mourning their sons, are trying to save lives."I don't want this to happen to another family," Paula Harvey said, teardrops running down her cheeks as she thumbed through pictures of her 23-year-old son, Jeremy Yerton, while sitting on the floor of her Keithville home."

When he died, I was given my purpose," Bea Nash said a week after her 19-year-old son Phillip d'Astre Guilbault was found lifeless in his apartment.

The lives of Phillip and Jeremy were filled with hope and promise, opportunity and future, their mothers say, only to be vanquished by an unknowing lethal concoction of methadone and Xanax.

Nash knew when Shreveport police officers knocked on her door late one June night. "I said to myself, 'Please just say he was in a wreck or he had been arrested.'

But I read it in his face. They explained it to me. I went to the ground, hysterical. Police at the time told her they believed Phillip died from taking Xanax and methadone. An official toxicology report from the Caddo coroner's office has not been completed. Earlier that evening, Nash went to Phillip's apartment after not hearing from him all day. Everything seemed normal from the outside and, not wanting to be too nosey, she didn't knock and went home.

Phillip had taken some methadone - called a "wafer" on the street - about 1 p.m.  He had been hanging out with some friends.  Phillip told them he was tired and wanted to rest.  His friends went to the movies, leaving Phillip in sound sleep.  When they returned,  he wasn't breathing. Nash later would learn from Phillip's friends that he had experimented with drugs, including Xanax, for more than a year.

The 51-year-old educator knew her son was having problems. "He had come to me in November and told me things were not good. But he told me he had it covered ... that he could handle it

."Phillip had been living in an apartment building in downtown Shreveport.  But soon after, left trying to get away from the drug abuse circles he had joined."He told me he was clean. But I learned it is when he started taking drugs that is when they started lying. When you get to that point, honesty is out the door."Nash saw her son every day.

His demeanor was often fidgety, he had red eyes and was  unfocused.  Phillip was a good person who always looked out for others, his friends  told The Times. Phillip had graduated from Caddo Magnet High School.  He played a little golf and loved paintball.  Phillip was attending LSU-Shreveport but was getting ready to transfer to a college in Texas, where he planned on studying to become a firefighter."He had no enemies.  A ton of friends." Nash said.

On December 11, Jeremy arrived at a friend's house in Lewisville, Arkansas, miles from his house.He was tired.  After eating a grilled cheese sandwich a friend made, Jeremy went to sleep.  About 10:30 p.m, he was heard snoring. When his friends checked on him later that night, Jeremy wasn't breathing.   Harvey took the call about her son after 4am, December 12. 

Her "Jere-bear" was gone. She gave the telephone to her husband, John Fridge, ran to the living room and fell to the ground wailing and weeping.

Jeremy was on a  weekend  bender that sent him from Keithville through Springhill in Webster Parish and up to Lewisville.  Sometime before arriving in Lewisville, Jeremy took a combination of methadone and cocaine.

An Arkansas coroner's report indicates he had several drugs in his system, including methadone, Xanax® and cocaine, but not an overwhelming amount. Harvey was unaware her son was that into drugs.  She and her husband didn't know how or why he had died until they received that shocking coroner's report.

In June 2004, Jeremy had been charged with a DWI but since had been living a responsible life, she said.Jeremy was on a career path with Vintage Realty, for which he was maintaining apartments. 

Methadone was created in Germany after World War II.  It was first used to suppress coughing until Doctors in the 1960s found a better use for it.

With its ability to block certain brain receptors, methadone could end the craving of heroin addicts.  Methadone clinics popped up in the nations big cities.  "It used to be restricted, just for treating drug abuse," said Joseph Manno, a pharmacist and forensic toxicologist at LSU Health Sciences Center in Shreveport.  "Now its out in the public." 

As a result, methadone is easier to obtain on the streets.  It also has addictive qualities, though far less than what is associated with heroin.  That  is why it is still popular.  Manno is quick to point out-the good -- Methadone has done for many people. "You wouldn't want everyone in the world to quit taking it. It is helping alot of people."

About 20 percent of the estimated nearly 800,000 heroin addicts in the nation are being treated with methadone.  Caddo Parish has logged 25 drug overdose deaths since the beginning of this year, Caddo Coroner George McCormick said.  More than 100 people in the region have died from a combination of methadone and Xanax® or other drugs in 2004 and 2005, he said. 

Methadone can be fatal by itself, McCormick said.  But most of the cases his office has seen indicate death was brought on by a combination of methadone with other drugs.

Drug users become very savvy on how to combine drugs to get the effect they want to make them feel good, but those combinations are often deadly, McCormick said.  "Methadone will kill the pain.....and if you use a drug like Xanax®, it cuts some of the excitement and agitation of using methadone."Methadone is relatively safe," Manno.  "But if instructions are not followed carefully, you've got a problem.  It's not uncommon that there may be a sudden death. "  

 Unlike other drugs such as morphine, methadone has a long duration in the body, Manno explained. " It may last for one, two or several days."  When that happens, other drugs like Xanax will react with methadone.  "Consequently you would feel it and pass out." Manno said.  The body's respiratory system would stop working and the user would die, he said. 

According to a number of families interviewed by The Times -- most of whom did not want to be indentified in this article --the deaths of their loved ones are eerily similar to Manno's description.  The user would be seen by other people, say they were tired , go to sleep and never wake up. It was the same for Jeremy and Philip.

Law enforcement agencies were caught off guard by the current infestation of methadone use.  " Weekly, we are seeing more and more methadone out there on the streets," said Shreveport Police Captain Mark Holley, supervisor of the department's narcotics unit

.Investigators are trying to find out how the drug is coming into Shreveport  whe-ther through a local doctor's office, pharmacy or being shipped in from Texas.On the streets, the pills are cheaper than crack or methamphetamine , Holley said. 

But unlike those two, which infested the streets seemingly overnight, methadone   use has been slow to come about, he said.  "It is starting to be a drug of choice.  It is underground right now.  We weren't aware the problem was as big as it is.  Our sources were focused on crack and methamphetamine distribution."

 The narcotics unit now is redirecting its sources to learn more about methadone and where it is coming from.  "The majority of users, from what we are seeing, are white men and women...a club-type crowd in their late teens  and early 20s who are experimenting, " Holley said. And he warns that the drug could cross racial boundaries. 

Dealers will add methadone to their inventory as they make more money selling it, Holley said.The deaths make this more of a priority.  We do not see many (overdose) deaths with crack or methamphetamine.   We see deaths from that in turf wars."

."And this isn't just a big-city problem! DeSoto Sheriff's Sgt. Horace Womack, also a member of the TRi-Parish Drug Task Force that includes DeSoto, Sabine and Red River parishes, has witnessed an increase in methadone-related arrests in the past 12 to 18 months. "More and more of our arrests these days are involving prescription medications for some reason.

And we are seeing a lot of methadone on the streets."   Womack believed at least six to eight drug deaths in the parish over the past year can be attributed to methadone overdose.  He's discussed his concerns with   Dr. Jack Grindle, DeSoto Coroner.  "I first really started noticing it when I talked to Dr.Grindle about some of the overdose deaths, "

It's commom place now to find methadone during searches of drug suspects' home, Womack said.  An arrest can only be made, though, if the person is caught without a  prescription or is selling the drug on the street.

But narcotic agents have started notifying physicians' offices and clinics when they arrest someone with a prescription who is accused of legally selling the drug.  "It's become a real problem; it really has, " Womack said.  "We've seen a big increase  of methadone street sales, of people abusing it...And I don't know what the answer is." 

"This Combination Will Kill"       

By: Frances McCabe 

"It is very difficult to stop people from using illegal drugs, but we can get the word out that this combination will kill," Holley said. "Talking about it does tend to wake some users up."

Speaking directly with parents in the community, Holley believes they "need to be blunt as possible.  Parents need to talk with their children and find out what they know. Often their children will know more of what is going on than their parents. They need to tell their children that this will kill them. " 

Parents need to find out what their children are doing and take an active role in their lives, he said.  "Once you are gone, you are gone." 

Holley compared methadone use to playing Russian roulette.  "If you keep using it, eventually, you are going to hit that live round. It is just a matter of time."   

Recent publicity surrounding the deaths is having the wanted effect, McCormick said.  "Most (deaths) were in the first quarter of the year, and it's pretty well come to a stop,"  he said, adding that he believes the public is starting to become more educated about the potentially deadly result of mixing methadone and Xanax®.  

"An unusual number of patients are  calling in and saying, "Dr. X is giving     me methadone and Dr. Y is giving me Xanax®.  Should I stop taking them?"
 
Dolophine® is the trade name for methadone tablets.  These are not
given to patients except by "Pain
Specialists."

Anyone with these concerns should immediatly contact their doctors to ensure each is aware of what the other is prescribing.  McCormick said, adding that it is the patient's responsibility to alert their doctors to all medications they are taking.

"The vast majority of calls we've got have been from patients wanting to know if they should go back and question their doctors, and they should.  Since we've kind of shown the spotlight on it, it's really toned down, " he said.

"We've got an awful lot of feedback from the parents of overdose victims telling us where their kids or, in many cases, young adults got the drugs.  McCormick said he and his staff have been compiling that information and passed much of it on to law enforcement.  For their part, Nash and Harvey are begging parents to hear their pain and talk about this problem.

"Too many parents are whitewashing it, " Nash said.  "I hope they will grab their children up and don't believe them."  These are solid kids from solid homes who are using these drugs." And it's not just the parents who need to stand up and speak out - it's friends, Nash said.  "Friends don't think about calling the cops because they don't want to get anyone in trouble.  It is so insignificant getting into trouble."  

Nash is setting up the foundation 4-Phillip in hopes that other young people will stay away from these harmful drugs "for Phillip."  In it's early stages, Nash wants the foundation to raise awareness among young people that methadone will kill.

"He was my only son.  I will never see him walk down the aisle again, " Nash said, adding that she doen't want other parents to experience her agony .

"It needs to get out that this ends in tragedy," Jeremy's stepfather, John Fridge said.  "He had everything going for him.  The kids of today don't know....This madness has got to end.  The pain and suffering and grief ...we shouldn't be going through this.  It needs to be common knowledge.  Methadone taken with drugs is a killer."    

Harvey knows she can't save everyone by speaking out.  But "I don't want anybody to go through what I am going through.  I would not wish this pain on my worst enemy.  He was my best friend."      

Pausing and wiping tears from her eyes, she said , "I miss him.  I miss his hugs.  He just had too many things going for him to doe over a stupid pill."   If talking about it can save one person from going through this pain ......"

Reference:  Times staffers Vickie Welborn and Keri Kirby contributed to this story.   The Shreveport Times  July 10, 2005

In a nutshell:  As more people die from a lethal combination of methadone and Xanax®, parents who have lost their children are begging other parents to talk with their children about the dangers of these drugs.

3 August 2005                      The Director's View

A coalition of 240 health, education, criminal- justice and student groups is is working to repeal a federal law that bars students with drug convictions from receiving federal education aid. 

On July 21, a U.S. House of Representatives committee rebuffed an attempt to repeal the drug provision in the Higher Education Act.  But the House version of the HEA reauthorization does include a measure sponsored by Representative Mark Souder (Republican-Indiana) that applies the drug penalty only to drug offenders who are currently in school, rather than retroactively to students with any lifetime drug conviction on their record.

Advocacy groups like Students For Sensible Drug Policy view the Souder measure as a step in the right direction, but plan to continue to push for full repeal of the HEA drug provision.  "We certainly welcome the change that will reinstate money to some students, but tens of thousands will be left behind, said Tom Angell, communications director for SSDP.  "It still doesn't make sense to yank students in an attempt to reduce drug abuse."

The House Committee on Education and the Workforce voted 29-18 against an
amendment to the HEA proposed by Reps. Danny Davis (D-Ill.), Robert
Andrews (D-N.J.), and Dennis Kucinich (D-Ohio) that would have deleted
language in the law -- written by Souder back in 1998 and in effect since
2000 -- that calls for "a student who is convicted of any offense under
any Federal or State law involving the possession or sale of a controlled
substance for conduct that occurred during a period of enrollment for
which the student was receiving any grant, loan, or work assistance under
this title shall, upon the order of the court imposing such conviction,
not be eligible to receive any grant, loan, or work assistance" from the
federal government.

The House vote was the first in either chamber of Congress on a proposal
for full repeal of the drug provision; Souder's amending language was
attached to multiple pieces of legislation last year, but failed to pass.

Souder has said that the U.S. Department of Education has misinterpreted
the 1998 legislation, stating that the "provision was clearly meant to
apply only to students convicted of drug crimes while receiving financial
aid, not to applicants who may have had drug convictions in years past."
The House has adopted language proposed by the Indiana Republican to
clarify the intent of the law.  --- But Souder actively worked against the
repeal initiative, and ultimately all 26 of his GOP committee colleagues
(and two committee Democrats) chose Souder's revision over that proposed
by Davis, Andrews, and Kucinich.

But the fight over the student-aid provision is far from over, said
Angell. The Senate Committee on Health, Education, Labor and Pensions has yet to mark up its version of the HEA reauthorization   bill, and although no sponsors have yet been lined up to introduce or support    a repeal amendment, Angell said advocates "think we have a much better chance" of getting the Senate to delete the drug-penalty language from the HEA.  If that happened, the Senate and House would then have to work out     the differences in their bills during conference committee meetings.

Souder and other repeal opponents argue that the HEA drug provisions
provide a deterrent to student drug use, denies federal aid to those who
spend money on drugs while in school, and provides student drug users an
incentive to get treatment in order to have their federal aid restored.

But Angell counters that the bottom line for aid should remain whether
students maintain the grade-point average required to qualify for federal
assistance. "Drug use should be irrelevant to whether they get financial
aid," he said.

The coalition supporting repeal also includes Join Together, Faces and
Voices for Recovery (FAVOR), and the Legal Action Center, FAVOR campaign
coordinator Patricia Taylor, whose group sent out an action alert urging
members to contact their Representatives in support of repealing the HEA
drug provision, said FAVOR views the financial-aid issue as part of a
broader campaign to fight policies that discriminate against people with
addictions.

"This is a perfect example of the kinds of barriers that people in recovery
face in getting on with their lives," she said.

Taylor added that even having the drug question on the Free Application
for Federal Student Aid (FAFSA) form "presents a real barrier" to people
in recovery, who may be reluctant to apply for aid because of their past
drug history, regardless of the intent of the Souder law.

Congress' own Advisory Committee on Student Financial Assistance also
recommended earlier this year that the question about past drug convictions
(along with another on draft registration) be deleted from the FAFSA.  "These questions add complexity to the form and can deter some students from apply-ing for financial aid," wrote the committee, terming the questions "irrelevant."

Bob Curley

Join Together is a project of the Boston University School of Public

Page last updated:  August 3, 2005

Wednesday 2 August 2005     The Director's View

METHADONE DEATHS TO BE STUDIED

HAZARD - In the wake of a $2.8 million jury award last week to the family of a Leslie County man who died while being treated for drug addiction at a methadone clinic, state regulators are taking the first steps toward monitoring the deaths of clinic patients.

"There is no investigation process for the state with the death of a client," said Mac Bell, administrator for the State Narcotic Authority, which oversees 11 methadone maintenance programs in Kentucky.

Bell said his office has no legal jurisdiction to investigate deaths reported to his agency. "When there's a death, that goes back to the clinic director -- the doctor in the program," he said.

After a five-day trial in a wrongful-death lawsuit, a Perry County jury decided Friday that the Hazard Professional Associates clinic -- not a doctor and nurse named in the suit -- was negligent in the 2002 death of Jason Caldwell, 21, of Leslie County.

Caldwell was a former coal miner who was injured in a car wreck and became addicted to the powerful painkiller, OxyContin, said Gary C. Johnson, a Pikeville attorney who represented Caldwell's estate.

Caldwell went to the methadone clinic in Hazard to "get off" OxyContin, but died five days later after receiving allegedly toxic doses of methadone, Johnson said.

Bell said his agency receives reports of about five deaths a year at methadone clinics in Kentucky.

The number of methadone patients is rising across the state -- as many as 1,800 patients are being treated in methadone clinics, Bell said.

While state law doesn't allow his agency to conduct a criminal investigation, he said the agency plans to begin compiling data on clinic deaths.

"Now, since we've gotten so large, we are in the process -- and have been for the last year -- of implementing a data collection system that will look at mortality and morbidity rates in our state," Bell said.

Invented in Germany during World War II as a substitute for morphine and used now as a painkiller and to treat heroin addiction, methadone has been available in Kentucky since 1971, Bell said.

Too much methadone

In the Caldwell case, Johnson and his co-counsel, Kenneth Buckle of Hyden, argued the clinic had administered too much methadone too fast.

Defense attorneys claimed Caldwell supplemented the liquid methadone he received at the clinic with methadone pills he bought from street dealers.

While Dr. Ashok Jain of Pittsburgh and nurse Tammy Cornett were absolved of blame, the jury ordered the clinic to pay $1.8 million to Caldwell's mother and $1 million to his four-year-old son.

Attorneys, however, said they settled the case for lesser, undisclosed amounts before the jury announced its decision at midnight.

"We were certainly shocked by the jury's verdict, particularly since they found neither the doctor or the nurse to have been at fault," said H. Brent Brennenstuhl, a Bowling Green attorney who represented all of the defendants.

"Had we not agreed to a settlement that was substantially less than the verdict, we would absolutely appeal it," Brennenstuhl said.

A patient every 21/2 minutes

The Hazard clinic is one of several in Kentucky operated by Bowling Green Professional Associates PLC, which is owned by two licensed practical nurses.

Bell said the clinics are among the nine privately owned methadone clinics that have opened since 1995 when Kentucky first began regulating them. There are also state-operated clinics in Lexington and Louisville.

Buckle said clinics owned by the Bowling Green firm charge methadone patients $85 a week, which includes the cost of the methadone.

He said a nurse testified the Hazard clinic was treating a patient every 21/2 minutes.

"The problem is, the state of Kentucky doesn't enforce the regulations," said Johnson. "When somebody dies from taking methadone at a clinic, there's not a single state agency that investigates it."

Brennenstuhl said Bell's agency in the state Department for Mental Health and Substance Abuse Services has no law-enforcement jurisdiction and fulfills its responsibilities under existing state law.

"There can be a bad outcome in a treatment program, even with the best of care," he said.

Two clinics a decade ago

Bell said that when state regulations were adopted in 1995, the state-operated clinics in Lexington and Louisville were the only methadone clinics in Kentucky.

"We've not had enough client population to do any kind of investigation, even on a single basis," he said. "In other words -- and this is going to sound terrible -- for it to be cost effective, it has to be worth your while to do it. ... We've not had a lot of statistics in the past because we've not had a lot of deaths."

That has changed with the addition of clinics across the state, and that is why Bell's agency has decided to compile data on deaths at the clinics.

But compiling the information does not go far enough for Buckle. The state agency has an obligation to "ferret out" the reasons for any deaths in clinics, he said.Reach Lee Mueller at (606) 789-4800 or e-mail at lmueller1@herald-leader.com. 

Written by: Lee Mueller   

 Updated:  3 August 2005

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