New Rules for Methadone Clinics

Wednesday, January 17th 2001, 12:00 am

By: News On 6

WASHINGTON (AP) â€” Methadone clinics for the first time must be accredited in a manner similar to other health facilities, say new government rules intended to improve quality of treatment for heroin addiction.

Under the rules, published Wednesday by the Substance Abuse and Mental Health Services Administration, clinics that distribute methadone and other addiction-treating medication must tailor therapy to addicts' differing needs, provide more physician supervision and take other steps proving quality.

``We want to promote state-of-the-art treatment services,'' said Dr. H. Westley Clark, the agency's substance abuse treatment chief. ``We already know every program is not going to survive this,'' although he added that most methadone clinics will meet the new accreditation standards.

Until now, methadone clinics have been inspected by the Food and Drug Administration, but those inspections were widely criticized as inadequate and the FDA is quitting them.

Instead, SAMHSA will contract with private organizations â€” the one that accredits hospitals is a candidate â€” to inspect clinics and report which ones meet new government quality standards. Clinics will have two years to comply. SAMHSA is part of the Health and Human Services Department.

Methadone, a synthetic narcotic, has been used for more than 30 years to treat heroin addiction, by suppressing withdrawal symptoms and curbing craving. Another substance called LAAM also is used. Doctors are anticipating FDA approval of a third therapy, another synthetic narcotic called buprenorphine, later this year.

The White House drug policy office estimates the nation has 980,000 heroin addicts but that only about 20 percent receive methadone or LAAM.

There are about 1,000 U.S. methadone treatment programs. They're controversial, as some neighborhoods object to the clinics despite scientific evidence of their effectiveness. Some states have no clinics; others have only one or two in the entire state. Still more have long waiting lists of addicts seeking treatment.

The new rules are ``a positive step forward,'' but it's unclear how much they will improve patient care, said Holly Catania of the Lindesmith Center-Drug Policy Foundation, a New York-based institute that advocates drug policy reform.

``I don't know if that in fact will happen from this change,'' she said. ``What is disappointing is there's nothing in the regulations that would expand access to this lifesaving treatment.''

The foundation had pushed the government to allow private doctors to dispense methadone, something not in the new rules.

Clark said the first step is to improve existing care, but that he also hopes to address accessibility.

One new rule, however, should free some room in crowded methadone clinics, he said: Instead of restricting recovering addicts to a six-day methadone supply, those who do well after a year's treatment can take home a two-week supply and those doing well after two years of treatment can take home a month's supply.