Citing the "moral superiority" of abstinence over reliance on methadone, New York City Mayor Rudolph Giuliani announced this week that the 2,000 patients who are currently enrolled in city-funded methadone programs will have 90 days to wean themselves from the medication after which it will no longer be offered. Numerous drug treatment experts, including some providers of methadone-to-abstinence programs, have criticized the mayor's action, as flying in the face of years of research showing that methadone is by far the most effective path to a stable and productive life for the vast majority of recovering addicts. Studies show that only a small percentage of opiate addicts can successfully become abstinent, while the majority will return to the street in search of relief from their withdrawal in the form of black market methadone or, more likely, heroin.
Ty Trippet, spokesman for The Lindesmith Center, a New York-based drug policy think tank, told The Week Online, "The shortsightedness of this decision is astounding. With virtually every credible medical professional in the world in support of greater access to methadone, Mayor Giuliani has taken it upon himself to play doctor, or, more disturbingly, to play god. Methadone is the single most effective tool at our disposal to stabilize the lives of the addicted. History shows that almost 90% of those who are forced off of methadone will relapse into heroin use. It is difficult to see the logic here."
Keith Cylar, Co-executive director of Housing Works, a full-service harm reduction agency serving formerly homeless people with AIDS told The Week Online, "This is simply outrageous. Giuliani is sentencing these people to yet another plunge back into heroin addiction. The majority of them will wind up with a needle in their arm. Many of them will wind up in jail, whereas with methadone, they could be gainfully employed and rebuilding their lives." Cylar continued, "the devious part of this, of course, boils down to money. New York City pays twenty-five cents on every federal dollar they receive for Medicaid. By pushing 2,000 people off of methadone, you are guaranteeing that their lives will revert to chaos. Couple that with the fact that public assistance in New York is very high-threshhold. In other words, they make you jump through numerous hoops in order to keep your status. Methadone clinics, for a lot of these people, become case-management centers, helping clients to do what they need to do to keep their Medicaid cards valid. By disordering their lives in this manner, Giuliani has found a back door to push these people off of the public rolls, both in terms of Medicaid, and the city's contribution to that, and for local assistance. These people, back on the street, will no longer exist in that system. There are legitimate ways to help people off of public assistance. But cutting them off at the knees and making it impossible for them to function at a high enough level to claim their benefits is pure evil."
E-MAIL THE MAYOR! Don't be rude, but do let Giuliani know that you've read the evidence on the Internet and that he is clearly misinformed on the issue. Send e-mail to [email protected]. Or, call the Mayor at (212) 788-9600 or write to: Mayor Rudolph W. Giuliani, City Hall, New York, NY 10007. As always, send us copies of your letters, or a note letting us know what actions you've taken, to [email protected].
(A few weeks ago, during the midst of our technical troubles, when many of you didn't receive The Week Online, we published an interview with Dr. Robert Newman, one of the world's leading authorities on methadone maintenance, commenting on the Mayor's threat and what Dr. Newman views as the self-inflicted wounds of the methadone establishment. Check out this fascinating discussion on our web site at http://www.drcnet.org/wol/051.html#newman. You can also read our news coverage from that issue at http://www.drcnet.org/wol/051.html#giuliani. For further information on methadone maintenance, we recommend the National Alliance of Methadone Advocates (NAMA), at http://www.methadone.org, and The Lindesmith Center's methadone focal point, online at http://www.lindesmith.org/library/focal3.html.)