New
Hampshire,
Vermont
to
Close
the
Gap
with
Methadone
Legislation
3/10/00
It was a promising week for methadone maintenance advocates in northern New England with both New Hampshire and Vermont moving closer to making the drug more available for residents trying to overcome heroin addiction. Currently, Vermont and New Hampshire residents trying to kick the heroin habit must travel long distances to methadone clinics in neighboring states. For example, some Vermont residents must commute three hours each way, seven days a week to clinics in Greenfield, Massachusetts, Portland, Maine and Albany, New York. Methadone allows users to quit heroin without the painful side effects associated with withdrawal. It is widely considered to be the most effective treatment available for heroin addiction. Methadone maintenance is often likened to insulin treatment for diabetics; its long-term use has allowed many former addicts to lead productive lives with relatively few negative side effects. In the New Hampshire legislature, which passed a ban on methadone treatment in 1995, two bills sponsored by Senator Katie Wheeler were passed in committee and go to the state Senate floor later this week. One bill, S.B. 445, allows the only clinic in the state now providing methadone treatment, Merrimack River Medical Services, to offer long-term methadone maintenance treatment. Currently, the clinic, which opened in October, only offers treatment for a six-month period, despite research showing that arbitrary time limits set on methadone maintenance often lead to relapse and treatment failure. The other bill is an effort to "get rid of our state's prohibition against methadone maintenance and to require the department of health and human services to write rules governing how it should be administered," Senator Wheeler told The Week Online. "We may be one of eight states that doesn't offer methadone maintenance treatment, but we are the only state that prohibits methadone maintenance in our statute." Senator Wheeler expects the bills will pass the Senate and House and does not expect opposition from the governor. "As long as the law enforcement community understands the importance of this as a medical treatment, I can't see there being real opposition that would encourage the governor to veto," she said. Senator Wheeler said she sponsored the legislation because she believes providing substance abuse treatment is a part of good health care overall. "We can't just segregate addiction as some kind of moral failing and not a disease," she said. In Vermont, the state Senate voted 26 to 4 in approving S. 0132, a bill that would allow methadone treatment in both clinics and doctor's offices. Until recently, all methadone treatment programs around the country have operated out of clinics or hospitals, but changes in federal regulations have opened the door to private physician prescribing. Holly Catania, a senior research associate at the Lindesmith Center who works on methadone issues, said passage of the Vermont bill would mean a great deal to patients in that state. "It will be the first time there will be a clinic system and a hub system where doctors are prescribing in rural areas," she said. "This is currently being done in pilot projects in different places like New York, San Francisco and Baltimore. The difference in Vermont is people wouldn't need to have so many years of exemplary performance in a methadone treatment program. It makes sense because Vermont is a very rural state." The next stop for the Vermont bill is the House Committee on Health and Welfare, where Reps. Malcolm Severance, a Republican, and Ann Pugh, a Democrat, hope to give it swift approval. But the bill will need at least a two-thirds majority in the House to override a veto threatened by Governor Howard Dean. Governor Dean, who is also a physician, said making methadone available to heroin addicts will attract drug users to the state, even though most other states in the region already provide methadone treatment. A Vermont legislative study, conducted last summer, found that most heroin treatments fail if they don't use methadone. The report concluded that such failed treatments contribute to the overall crime rate in Vermont as relapsed addicts stole to support their habits. In a strange twist, Governor Dean was a supporter of the state's law supporting needle exchange, which was passed last year. In general, needle exchange programs are thought to be more politically problematic than methadone programs. The irony was not lost on State Senator James Leddy, the director of the largest substance abuse treatment program in Vermont and the methadone bill's sponsor. "How can we, on the one hand, say it is right to give clean and sterile needles to addicts who can not and will not stop their use, while we deny access to the very medication that's been demonstrated to be the most effective part of a heroin treatment program?" he said. "I thought the needle exchange program, which I also sponsored, would be more controversial." When asked if he thought the measure would pass the House, Leddy said the two-thirds majority vote would be difficult to achieve because the House is a much larger body than the Senate. "Much of the challenge in getting support is education," he explained. "Most legislators don't have a real in-depth knowledge of the issues surrounding heroin. We have to convince them that methadone is not just another form of heroin. They also need to be convinced this a problem for Vermonters." Vermont and New Hampshire are the only states in the Northeast that bar the use of methadone maintenance to treat heroin addiction. Six other states around the country have no methadone services for heroin addiction, including Idaho, Mississippi, Montana, North and South Dakota, West Virginia and Wyoming. For more information about methadone maintenance treatment, visit the following links: DRCNet's Special Report on
methadone
The Lindesmith Center's focal
point on methadone
National Alliance of Methadone
Advocates (NAMA)
Find information on New Hampshire legislation online at http://www.state.nh.us/gencourt/ngencourt.html. Legislative info for Vermont is on the web at http://www.leg.state.vt.us/.
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