Clinic Helps Heroin Users Kick The Habit Methadone Program Controversial, But Addicts Say It Saves Their Lives

They line up six days a week to swallow Dixie cups of reddish liquid that tastes like old cough syrup and stops them from sticking needles in their veins.

Eric and Michelle are trying to kick heroin habits that stretch back years.

They’re taking methadone, a medication that squelches the urge to do opiates. Most mornings, they take the bus together to the Spokane Regional Health District, sometimes before the sun is up, to take the liquid before going to work.

“Our quality of life has improved 100 percent,” said Michelle, sitting in the couple’s apartment. “We have a full refrigerator of groceries.”

“We were starving to death,” added Eric, fishing potato chips out of a bag.

The Spokane clinic has more than doubled its client list in six years, to about 85 people, depending on the week. Spokane doesn’t have the heroin problem of larger cities. But drug counselors and law enforcement have noticed a growing use of the drug, long frowned upon because of its junkie image.

The drug’s tracked into the mainstream. Gaunt Calvin Klein models sport the suggestion of needle marks. Movies such as “Trainspotting” don’t necessarily promote the use of heroin but at times glorify it. The drug has become hip again, with use among young people nationwide rising. The purity is up. The price is down.

It’s a tough drug to quit, addicts agree. Methadone, a synthetic drug tightly regulated by federal and state government, was developed as a treatment for heroin addiction in the 1960s. It’s still the major crutch for quitters.

An estimated 600,000 people use heroin in America. It’s tougher to get methadone, with about 115,000 treatment slots in clinics nationwide. There are no methadone clinics in eight states, including Idaho and Montana.

Washington has nine clinics statewide, including seven on the West Side and one in Yakima.

The Spokane clinic is smaller than the West Side clinics. The programs cost about $10 per client per day to run, which includes the methadone, counseling and random drug testing. Many of the patients’ costs are subsidized through grants, insurance or Medicaid.

“There’s absolutely a growth in the use of heroin,” said John Harris, who supervises the Spokane County methadone program. “It just fits with the national headlines, that heroin use is on the rise and it has been since 1994.

“Spokane didn’t skip a beat in staying up on heroin.”

Or on heroin side-effects. In November, one Spokane man was hospitalized after suffering a case of botulism. He injected black tar heroin just beneath the surface of his buttocks, after running out of veins. The wound became infected with botulism.

Raul Diaz, 33, nearly died. He said he wanted to warn people against using heroin. He spent almost two months in hospitals, learning to brush his teeth and talk again, before being sent to a drug rehabilitation center.

Diaz said addicts needed more help than methadone, which he said he’s tried.

“Nothing’s going to work unless there’s actually real help,” Diaz said. “Methadone isn’t going to help anybody. It’s just another chemical substance. Those people are not free from their addiction.”

Methadone has always been controversial. Critics complain that this treatment is no treatment at all, but merely substituting one drug for another. They argue that government money shouldn’t be spent on giving drugs to drug users.

Proponents claim that methadone is one of the only ways to wean hard-core heroin users off the drug without severe withdrawal effects.

They say methadone doesn’t deliver the highs normally associated with heroin and stabilizes drug addicts. Advocates say methadone allows addicts to function and work in society, stops heroin-related crime and lowers health-care costs.

“They’re both addictive drugs,” said Dr. Dennis Simpson, director of the specialty program in alcohol and drug abuse at the University of Michigan, which runs 13 drug clinics.

“You just become a socially acceptable addict if you’re maintained on methadone.”

There are two methods of treating heroin addicts with methadone.

They can be detoxified, their daily methadone doses slowly reduced in potency over a period from weeks to months. Eventually, the hope is the clients will be drug-free.

But some addicts are maintained on methadone for years, even a lifetime.

In the Spokane County clinic, six people are in a new detox program that weans them off all drugs in six months. They are all required to go to more counseling sessions than regular patients.

Eleven more people, including Eric and Michelle, are in another six-month detox program.

Most of the other clients will be weaned off methadone within two years. But about a dozen people are on maintenance, resigned to swallowing the liquid for the rest of their lives.

One man said he’d rather be on methadone for life than heroin, which he used on and off for 10 years. He said he knew 30 people who had died of the lifestyle.

“For me, methadone is saving my life,” the 44-year-old man said. “I’m very grateful for this program. At the same time, I don’t like it because it’s very, very addictive. Yet it’s enabled me to have a job and become functional again.”

The county has about 50 more clients than when it took over the program six years ago.

More than half are women. The average patient age is 39. Forty pay with medical coupons or get free services; 45 cobble together the daily fee from public money and their own money.

All clients are required to be tested for drug use and go through individual and group counseling.

There’s a waiting list of dozens of people who are required to check in weekly with a program counselor to hold their slot. Sometimes they beg. Sometimes they threaten suicide. Occasionally they stop calling because they’re in trouble or dead.

“It’s the least favorite part of the job,” Harris said. “I have people who come in my office and call me on the telephone and threaten me. I have people who are suicidal, people in here throwing up, people crying, people begging.”

The average wait is between eight and 12 weeks. That’s better than in 1995, when the average wait was 5-1/2 months.

Eric and Michelle, who didn’t want their last names used, waited 11 weeks before slots opened up Jan. 21.

Now, they give a urine sample when asked. They also go through counseling, in one of seven different support groups.

“We just need to heal inside,” Eric said. “I have no interest in staying on methadone the rest of my life. I sure don’t want that as my only option.”

, DataTimes MEMO: This sidebar appeared with the story: METHADONE Methadone, a synthetic drug tightly regulated by federal and state government, was developed as a treatment for heroin addiction in the 1960s.