Breaking News:Dangerous Delays: What Washington State (Re)Teaches Us About Cash and Cannabis Store Robberies [REPORT]

Methadone & Other Opiate Maintenance

RSS Feed for this category

Press Release: Results Show that North America's First Heroin Therapy Study Keeps Patients in Treatment, Improves Their Health and Reduces Illegal Activity

[Courtesy of North American Opiate Medication Initiative (NAOMI)] For Immediate Release: October 17, 2008 Contact: Julie Schneiderman at (604) 806-8380 Results show that North America’s first heroin therapy study keeps patients in treatment, improves their health and reduces illegal activity VANCOUVER, BC, October 17, 2008 – Researchers from the North American Opiate Medication Initiative (NAOMI Study) today released final data on the primary outcomes from the three-year randomized controlled clinical trial. “Our data show remarkable retention rates and significant improvements in illicit heroin use, illegal activity and health for participants receiving injection assisted therapy, as well as those assigned to optimized methadone maintenance,” says Dr. Martin Schechter, NAOMI’s Principal Investigator, Centre for Health Evaluation and Outcome Sciences and Professor and Director, University of British Columbia School of Population and Public Health. “Prior to NAOMI, all of the study participants had not benefited from repeated standard addiction treatments. Society had basically written them off as impossible to treat.” The data, which was collected from 251 participants at sites in Vancouver and Montreal, demonstrate that a combination of optimized methadone maintenance therapy (MMT) and heroin assisted treatment (HAT) can attract and retain the most difficult-to-reach and the hardest-to-treat individuals who have not been well served by the existing treatment system. Key findings at the 12-month point of the treatment-phase of the study showed that HAT and MMT achieved high retention rates: 88 per cent and 54 per cent respectively. Illicit heroin use fell by almost 70 per cent. The proportion of participants involved in illegal activity fell by almost half from just over 70 per cent to approximately 36 per cent. Similarly, the number of days of illegal activity and the amount spent on drugs both decreased by almost half. In fact, participants once spending on average $1,500 per month on drugs reported spending between $300-$500 per month by the end of the treatment phase. Marked improvements were also seen in participants’ medical status with scores improving by 27 per cent. Of particular note amongst the findings, participants receiving hydromorphone (DilaudidTM) instead of heroin on a double-blind basis (neither they nor the researchers knew) did not distinguish this drug from heroin. Moreover, hydromorphone – an opiate licensed for the relief of pain - appeared to be equally effective as heroin, although the study was not designed to test this conclusively. According to the NAOMI Study Investigators, further research could help to confirm these observations, allowing hydromorphone assisted therapy to be made more widely available. While a comprehensive health economics study is pending, researchers have already determined that the cost of continued treatment is much less than that of relapse. “We now have evidence to show that heroin-assisted therapy is a safe and effective treatment for people with chronic heroin addiction who have not benefited from previous treatments. A combination of optimal therapies – as delivered in the NAOMI clinics - can attract those most severely addicted to heroin, keep them in treatment and more importantly, help to improve their social and medical conditions,” explains Schechter. A summary report of the findings and background information on the study are available at: www.naomistudy.ca.

Why has Russia said no to Methadone?

Despite having nearly a million heroin addicts, with HIV spreading rapidly through that population, Russia's government has very tragically said no to methadone maintenance. According to a short video posted by the Hungarian Civil Liberties Union (HCLU), 80% of all new HIV cases in Russia are due to needle sharing by injection drug users. Check out the video here: Check out HCLU here.

Australia: Strong Support for Medical Marijuana, Needle Exchange Programs, National Survey Finds

Australia's 2007 National Drug Strategy Household Survey, in which more than 23,000 people over the age of 12 were quizzed by the Australian Institute of Health and Welfare about their drug use and attitudes toward various drug policy positions, has demonstrated broad support for medical marijuana and harm reduction measures aimed at hard drug users.

Regarding heroin use, the survey found that 67% supported needle exchange programs, 68% supported methadone maintenance, 75% supported the use of naltrexone for overdose avoidance, and 79% supported the use of rapid detox therapy. On the other hand, only 50% supported heroin injection sites, and only 33% supported heroin maintenance therapy.

Medical marijuana also won strong support. Some 69% supported legal medical marijuana, while an even larger number, 75%, supported clinical trials for medical marijuana. In all the policy choices cited here, support was at higher levels than the most recent national survey in 2004.

Marijuana legalization for personal use did not fare so well. Only 21% supported legalization, down from 27% in 2004. The intervening period has been one of Reefer Madness Down Under, with Australian authorities and a complicit media waxing hysterical about the alleged dangers of the weed.

When it comes to legalizing other drugs, support was in the single digits, and relatively unchanged from 2004.

Frighteningly, large majorities of Australians favored increased criminal penalties for drug sales offenses. More than 80% favored harsher sentences for hard drug sales, while even for marijuana, nearly two-thirds (63%) wanted stiffer penalties.

Feature: Amsterdam, Connecticut? Drug Reformer With Bold Vision Seeks State Office, Radical Change

Like the rest of inner city America, Bridgeport, Connecticut's 130th District has for decades been ground zero in the war on drugs. Mostly black and Latino, like other majority minority neighborhoods across the land, it has suffered the twin ravages of drug abuse and drug prohibition. Now, a former drug-fighting Navy officer turned drug reformer is seeking to change all that with a bold vision and an upstart bid for the state House of Representatives.

https://stopthedrugwar.org/files/sylvestersalcedo.jpg
Sylvester Salcedo (2nd from right)
In late May, Bridgeport attorney Sylvester Salcedo announced he was seeking the Democratic Party nomination for November's House race in the 130th. Salcedo is best known in drug reform circles for being the first and only former military officer to protest the drug war by sending back his Navy and Marine Corps Achievement medal to then President Bill Clinton.

"Narcotics use and abuse is our problem here at home," he wrote at the time in a letter sent to Clinton. "The solutions should be applied here and not in Colombia or elsewhere. To spend this additional amount of money overseas is wasteful and counterproductive."

Fast forward eight years and little has changed. The war on drugs continues apace, drug arrests and drug war prisoners reach new highs every year. The violence associated with drug prohibition continues to plague cities like Bridgeport. And Salcedo has had enough.

"The war on drugs is one of our nation's longest wars, at home and abroad," he said as he announced his candidacy May 29. "It is senseless, wasteful and counterproductive. It is highly discriminatory on a racial and economic basis. I said so on the steps of the US Congress in Washington, DC flanked and supported by Minnesota Republican Congressman Jim Ramstad and California Republican Congressman Tom Campbell in the summer of 2000," he said.

"Eight years later, the conditions are the same, if not worse, especially for the isolated and abandoned residents of ethnic minority enclaves and neighborhoods like the 130th District," Salcedo continued. "I want to win this State Representative seat to be a leader of change. I want to lead the way to peace, understanding and cooperation, not through the politics of fear, and racial and ethnic discord and conflict. This senseless war on the poor and the voiceless must end."

Salcedo is not one for half-measures. He is proposing turning the 130th District into a sort of mini-Amsterdam, a zone of drug tolerance replete with safe injection sites, opiate maintenance facilities, and taxed and regulated marijuana sales. "I'm floating around this idea of the Covenant of the 130th District, which is to declare the district as a zone of tolerance," he said.

"I want to borrow from models like Amsterdam or Frankfort," he elaborated. "I'm not pushing legalization legislation, but acknowledging the fact that the 130th is a high drug trafficking and consumption area, from marijuana to heroin to cocaine. I want to try those approaches here. If you live in the district and are a heroin addict, we would work with you, whether it's a treatment and rehabilitation regime or a maintenance regime. If you select maintenance, you get the level of pharmaceutical grade heroin you need. In either case, you get medical, psychological, and social services, an intake exam, a social worker and a drug counselor to work with you. But this won't be a coercive or punitive program; instead it will be designed to develop the relationship with the addict."

Citing Bridgeport's chronically under-funded schools, libraries, and other services, Salcedo also called for regulated marijuana sales as a revenue raiser. "I want to open up a number of marijuana coffee shops in this district," he said. "They could be city sponsored, or they could be a joint private-public project. If people want to come here and imbibe, we will welcome them, let them pay the market price, and tax their purchases. The profits can go to the city general fund, or, if it's a joint venture, a share to the entrepreneurs," he said. "We will follow the experience of Amsterdam, with the police working collaboratively, so they're not arresting people coming from the coffee shops."

Salcedo's will undoubtedly be an uphill battle against the entrenched Bridgeport Democratic Party political establishment and to convince skeptical voters that more of the drug war same old same old is not the solution. But he has already passed the first hurdle by getting 290 district residents to sign his nominating petitions. Now he has to raise $5,000 by August to show he is a viable candidate and qualify for another $20,000 in primary funding from the state of Connecticut. At least 150 Bridgeport residents must donate to his campaign for him to qualify. (That doesn't mean people from outside Bridgeport or Connecticut cannot donate -- they can.)

He can do it, Salcedo said. "The primaries are eight weeks away, and nobody expected me to even get the required signatures, but I did. And I met every person who signed my nomination papers. I think I can meet this challenge, too."

He's going to need some help, from the drug reform community at large and from Connecticut activists in particular if he is to have a chance. One prominent Connecticut drug reformer, Efficacy founder and 2006 Green Party gubernatorial candidate Cliff Thornton is among the first to step up.

"I'll definitely be going down there and doing a few things for Sylvester," said Thornton. "I have to help the reformer."

One thing he will advise Salcedo to do is put his drug reform message in the background. "We'll try to sharpen his message," Thornton said. "He doesn't have to lead with drug policy. He's already known as the drug reformer, and he won't have to talk about it because people are going to ask him about it.

Another thing Salcedo can do is try to tie drug reform into other issues facing the community, Thornton said. "We're spending somewhere between $600 million and $800 million on prisons in Connecticut every year," he said. "If we took that and put it toward health care, we could take care of everyone in the state. That's the kind of connection we need to be drawing."

It would be a good thing if national drug reform organizations provided more than token support, Thornton said, looking back at his 2006 campaign. "When it came to actually supporting that run, everybody disappeared," he said. "The flagship organizations sent a few bucks here and there, but not enough to make a difference. And that's a shame. We are starting to elect good drug reform politicians, like Roger Goodman in Washington state and Chris Murphy here in Connecticut. Their opponents attack them as soft on drug policy, and they go up in the polls. We can elect people, if we support them," Thornton said.

Salcedo could use the help, he said. "Right now this is basically a one-man campaign, and I have a full-time job."

Still, he said, he may be able to pull off a surprise victory. "This is going to be a low turnout election, no other issues on the ballot here, and the only reason people are likely to go to the ballot box is to vote for me for change or because they're tied to one of the establishment candidates," he said. "In this district in this election, maybe 200 or 300 votes can win it. I'll be beating the bushes and talking face to face with people. I'll do everything I can, and then it's up to the voters.

(This blog post was published by StoptheDrugWar.org's lobbying arm, the Drug Reform Coordination Network, which also shares the cost of maintaining this web site. DRCNet Foundation takes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code, and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

Europe: Scottish Parliament Think-Tank Calls for Prescription Heroin, Safe Injection Sites, Legalized Marijuana

A think-tank established by the Scottish parliament and tasked with looking at new approaches to drug policy has issued a report calling for radical changes in the way Scotland deals with the damage of drug and alcohol use. Parliament asked the think-tank, the Scottish Futures Forum, to determine how the country could cut the damage in half by 2025.

https://stopthedrugwar.org/files/urquhart-castle-wikimedia.jpg
Urquhart Castle on Loch Ness, Scotland (photo from Sam Fentress via Wikimedia)
The forum's report, Approaches to Drugs and Alcohol in Scotland: A Question of Architecture, landed like a stink-bomb in the middle of the ongoing Scottish debate over drug policy, which in recent months has been dominated by calls for a renewed "tough" approach to drug use and trafficking. It recommended that all substance use, including legal drugs like alcohol and tobacco, should be subsumed under a single policy dominated by a public health approach and was harshly critical of over-reliance on the criminal justice system to reduce the harms caused by substance use.

"Historically, we have seen, in particular, drug use mainly as a justice issue," the report noted. "This is mistaken and alcohol and drugs should be seen predominantly as a health, lifestyle and social issue to be considered along with smoking, obesity and other lifestyle challenges. The current level of enforcement activity tackling low level use of illegal drugs may not be the most effective deployment of enforcement resources and is likely to fail in reducing drug and alcohol related damage by half by 2025. It should be recognized that sending people to prison for low-level alcohol and drug-related crime is unproductive and probably unsustainable."

Instead of current policies, Scotland should shift to evidence-based policies emphasizing a public health approach, the forum said. Such policies would include consideration of safe injection sites to reduce the spread of infectious disease, prescribing of heroin to addicts, and the taxation and regulation of marijuana. More resources should go to prevention and treatment of substance abuse, as opposed to law enforcement, the forum said.

The Scottish government was not pleased, and a spokesman ruled out any quick establishment of safe injection sites. "There are complex legal and ethical issues around consumption rooms that cannot be easily resolved," the spokesman said. As for prescribing heroin, Scotland will "wait and see" how pilot programs in England are working out, he said.

Scottish Conservatives were appalled, with Tory leader Annabel Goldie calling safe injection sites "shooting galleries" and saying they and marijuana legalization were ideas out of the past.

But Liberal Democrats were more open. Their spokeswoman, Margaret Smith, said: "Drugs misuse is a global problem and if other countries have developed new and radical solutions, then it is sensible to consider them for use in Scotland."

Feature: Western Hemisphere's Only Heroin Maintenance Program Coming to an End

Every day for 15 months, Vancouver heroin addict Rob Scott Vincent, 36, went into a nondescript building on the city's Downtown Eastside where a nurse would hand him a syringe loaded with pharmaceutical grade heroin. Sitting at a sterile, stainless steel counter, Vincent would inject himself with the drug, then sit in an equally sterile waiting room for awhile as the drug took hold before heading out to do his daily business.

https://stopthedrugwar.org/files/hastings.jpg
Hastings Street, on Vancouver's East Side (courtesy VANDU)
Vincent was one of 251 participants -- 192 in Vancouver and the rest in Montreal -- in the only heroin maintenance program in the hemisphere, a pilot program known as the North American Opiate Maintenance Initiative (NAOMI). Originally intended to operate in both Canada and the US, the US component never got off the ground in the drug war atmosphere there. And now, NAOMI is winding down in Vancouver and Montreal. The last handful of participants in the program will get their last fixes at the end of this month.

In the program, which was limited to long-time addicts over 25 who had failed to kick the habit at least twice in previous treatment tries, participants used treatments of oral methadone or injected heroin. A small percentage received a pharmaceutical opiate called Dilaudid. Participants also received counseling and other support services. The Canadian federal government (then under control of the Liberals) funded the project with $1.8 million and agreed to allow the importation of pharmaceutical heroin for the project.

Similar pilot opiate maintenance projects in Switzerland, Germany and the Netherlands produced results showing reductions in criminality, drug use, and economic costs to society, and increases in health, stability, and employability among participants. NAOMI researchers and supporters are hoping it will produce similar results. While the final research report from NAOMI is not expected until the fall, preliminary results suggest the findings will be similar to those in Europe.

In a March briefing paper, NAOMI reported that 85% of participants taking injected heroin had stayed with the program for 12 months, that the treatment had proven to be "extremely safe," and that there had been no security issues or evidence that NAOMI had had a deleterious impact on the neighborhood. The paper also suggested that the program would show a positive economic impact.

Canada estimates that each heroin addict costs the country $45,000 a year. The studies of European opiate maintenance programs report that they save host countries $20,000 a year for each participant.

"What we know now is that we were able to recruit people with long-term dependence on heroin who repeatedly failed other treatments and who had many health and social problems when they entered," said Dr. David Marsh, one of the co-investigators and lead clinical physician for the study. "From a doctor's perspective, whether they were treated with methadone or heroin, many of them improved dramatically. We'll know from the formal research results how much and in what ways they improved."

The provision of methadone or heroin was only part of the treatment, Marsh said. "The medication is a component of a broader package of primary care, mental health care, addiction counseling, and case management to provide participants with access to a range of welfare and other benefits," said Marsh. "We work with people to try to manage the negative consequences of their drug use and help them improve their lives."

Vincent had been addicted to opiates for nearly 15 years when he decided to participate in NAOMI. "I wanted to see if it could better my life, and it did," he said. "It helped me slowly wean down. I'm still using, but not even one-third of what I was using."

Vincent's stint in NAOMI ended in March. Since then, he has had to return to the streets to find his drugs. "It's not too bad," he said. "I mostly use morphine pills, and I pick up a pill for $5 bucks every morning and I'm good for the day." Vincent pays for his fixes by collecting and recycling cans. But sometimes, he can't find what he wants and has to spend time searching for a substitute opiate -- heroin, dilaudid, whatever is around. "It's usually readily available," he said, "but sometimes I have to scrounge around."

Getting participants completely off opiates wasn't the be-all and end-all of the pilot program, said Marsh. "Patients benefit in a lot of ways," he said. "Some were able to stop taking illegal opiates, and in my view, if a patient is prescribed methadone and is using it properly, I consider that a success. Methadone treatment has been available for many years, and there are thousands of studies showing its benefits."

The Vancouver Area Network of Drug Users (VANDU) was one of the key supporters of NAOMI, despite its complaints about the restrictiveness of the standards for qualifying for the study. The program needs to continue, VANDU said.

"Regardless of the parameters they set that made it tough to qualify, this is a badly needed service and it's a shame it's just a pilot project and is not continuing," said VANDU president Richard Utendale. "I've talked to a lot of people who have been helped by it. They were able to improve their day-to-day lives by not having to struggle to feed their drug habits. NAOMI provided a safe place and support, and participants didn't have to worry about being jacked up by the police or ripped off or sold inferior products or dope with adulterants."

The Downtown Eastside, where both VANDU and NAOMI are located is the epicenter of one of the largest hard drug scenes in the hemisphere. The program had an impact on the area, said Utendale. "I think NAOMI also improved the neighborhood, with less street and property crime."

There was a downside to NAOMI, though, said Utendale. "The drawback is that when people are finished with the program, they have to go back on the street and resort to the same old means of getting their drugs. That's why this needs to be permanent."

Vincent said he wished the program could continue. "I would most definitely participate in a permanent program," he said. "It was very, very helpful. It's a lot easier to quit or reduce my intake with pharmaceutical grade heroin. Most of the stuff on the street is cut with other things -- that's why I like to use morphine. I can't see any reason for not keeping this open," he said. "NAOMI is a medical facility, just like Insite [the Vancouver safe injection site]. They should not shut it down."

But that is what is going to happen at the end of this month. Last November, doctors appealed on compassionate grounds to extend the program on behalf of five participants. So far there has been no agreement from either Health Canada or the regional health authority.

"Dreams are free," Utendale sighed, "but the way things are looking right now, this isn't going forward without some changes in Ottawa."

Marsh said it was "premature" to try to predict what would happen. "But I'm optimistic we'll find funding and get the regulatory approval at some point to apply the lessons we've learned from this study," he said.

But given the current Conservative federal government's ideological opposition to harm reduction, as evidenced by its losing battle to shut down Vancouver's safe injection site, it is going to take a new national election before there is any chance that Canada will follow the Europeans' lead and make heroin maintenance part of a broader public health policy.

Europe: Denmark Parliament Approves Heroin Maintenance Pilot Project

The Danish parliament Monday has given its approval for a heroin maintenance pilot project, Agence France-Presse reported, citing the Danish Health Ministry. The project will be aimed at the Scandinavian nation's most recalcitrant heroin users.

If it goes according to plan, the pilot project will begin this year and last through 2009. It will cost about $14 million dollars and some 500 of Denmark's most marginalized and most affected heroin users will participate. Heroin will be prescribed in combination with methadone. The aim is to rehabilitate problem drug users and reduce their criminal activity, the health ministry said.

Denmark will join a select group of European countries, including Germany, Switzerland and the Netherlands, where such programs have consistently resulted in a decline in property crime, as well as improvements in clients' health and welfare. Also allowing experimentation with heroin maintenance are Great Britain, which restarted it last year well over a decade after the conservative government of Margaret Thatcher had shut it down, and Canada, where Vancouver hosts the North American Opiate Maintenance Initiative (NAOMI), the only such program in North America. Earlier this month, the city of Tel Aviv announced it was seeking permission from the Ministry of Health to initiate a pilot program as well.

MSO Press Release: Colonial Management Group (CMG) now offering Buprenorphine/Suboxone in all their clinics

FOR IMMEDIATE RELEASE: February 23, 2008 Contact Persons: Carol Sholiton, Founder/Director, E: [email protected]; Chuck Hilger, Colonial Management Group, E: [email protected] Colonial Management Group (CMG) Now offering Suboxone in all Clinics Colonial Management Group (CMG), with 54 opiate addiction treatment centers located throughout the United States, announced that as of January 1, 2008 all of their facilities are now offering Buprenorphine (Brand name Suboxone) in addition to their Methadone Maintenance Program. Suboxone (Buprenorphine/Naloxone) received approval by the FDA on October 8, 2002. It is state of the art medication to treat the medical condition of Opioid addiction. It is improving the quality of life for patients in recovery and giving them hope, dignity, and the ability to have a normal life again. CMG focuses the work in their clinics on managing the disease of addiction and strive to improve their patients' quality of life. This involves implementing the most current research findings in the treatment of their patients.
Localização: 
United States

Southeast Asia: Methadone Maintenance Coming to Ho Chi Minh City

Vietnam has generally appeared in these pages in recent months because of its penchant for using the death penalty on drug traffickers, but now Vietnamese authorities have taken a step in a different direction, at least when it comes to users. Last Friday, officials in the capital, Ho Chi Minh City, announced that a methadone maintenance program for opiate users will be getting underway there.

In remarks reported by VietnamNet, Ho Chi Minh City Health Department Deputy Director Le Truong Giang announced that the Ho Chi Minh City AIDS Committee will start providing methadone to heroin users beginning next month. The one-year program sponsored by the World Health Organization will operate out of community counseling centers in several districts in the city, Giang said.

The program in Ho Chi Minh City will be the second to operate in Vietnam. For the past year, some 700 drug users in the northern port city of Haiphong have been participating in a pilot program funded by the US and British governments. That program will end at the end of this year.

Giang said that results from methadone maintenance programs in Australia, China, and Indonesia all showed that providing heroin users with access to methadone maintenance therapy would dramatically reduce crime. Methadone is provided for free to users, he added. If the Ho Chi Minh City and Haiphong programs are proven to be effective, they would be expanded, Giang said.

Opiate Maintenance: Open Season on Methadone Clinics and Clients in the Indiana Legislature

Indiana's methadone clinics and their clients are the target of close scrutiny by the state House of Representatives. Last month, the state Senate passed a bill, SB 174, that would tighten state regulation of the clinics, where people attempting to wean themselves from dependence on opiates are administered or allowed to take home doses of methadone as a substitute opioid.

The Senate bill may represent reasonable regulation of an industry in which some 10,000 people participate in Indiana, but it's a different story in the House. While the bill as passed in the Senate restricted itself to requiring clinics to adhere to state and federal law, register with the state, and meet certain record-keeping requirements, the House is trying to micro-manage not so much the clinics, but their clients.

On Tuesday, the House Health Committee unanimously passed SB 157, but not before approving amendments requiring that patients be tested for marijuana and that they have a designated driver after appointments. The committee narrowly defeated another amendment that would have barred patients from bringing their children with them to the clinics.

According to remarks reported in the Louisville Courier-Journal, the sponsor of the designated driver provision, Rep. Steve Stemler (D-Jeffersonville), said he added it because the FDA considers methadone in the same class of drugs as heroin, Oxycontin, and other opioids. Hospitals and medical centers require patients taking these medicines after outpatient surgeries and other procedures have a designated driver.

One witness, John Dattilo, who lives near the Southern Indiana Treatment Center, told the committee he is concerned about the safety of his family as they travel down a road with hundreds of methadone patients each day. "It's all about safety to me," he said. "We need help. We do need to put some restrictions on this."

But Tim Bohman, regional manager for the health care corporation that owns that clinic, told the committee patients have a high tolerance for opioids and can function normally after treatment.

At least one committee member, Rep. Carolene Mays (D-Indianapolis), worried the measure could push patients away from the methadone clinics. "I'm concerned we'll lose people in treatment who are riding a bus or walking or don't have a designated driver," she said.

Marijuana testing of methadone patients is necessary because some neighboring states require it, said Rep. Stemler. Indiana should not be a magnet for addicts from elsewhere because of its loose methadone laws, he said.

Indeed, about half of the 10,000 patients served by the state's clinics come from out-of-state. But perhaps that's not so shocking given the state's geographic position. At its northwest corner is Chicago, to the near northeast is Detroit, to the near southwest is Cincinnati, and directly across the Ohio River to the south is Louisville.

At least the committee rejected one more attempt to micro-manage methadone patients, an amendment by Rep. Terry Goodin (D-Crothersville) that would have banned patients from bringing their children to clinics. It was supported by Clark County Commissioner Michael Moore, who testified that "too many" patients bring their children with them when they come in early in the morning for treatments. Moore, who owns a restaurant near a clinic, said that he often saw them dozing off or acting erratically before or after treatment. "This is the kind of behavior that would make most social-service agencies jump in and act," Moore said.

But Rep. John Day (D-Indianapolis) managed to blunt Goodin's amendment, saying he worried that a single parent might have to miss an appointment if she could not bring her children. "That's a very real dilemma," Day said.

While Goodin then withdrew his amendment, saying it did not have enough support to pass, he said he would offer a similar proposal later.

This isn't the first time opiophobia has reared its head in the Indiana legislature. Last year, the legislature voted to enact a moratorium on new clinics. But this is the first time the legislature has zeroed in on patients -- with measures ostensibly designed to protect the public safety but whose real world result would be to drive patients away from the clinics.

Drug War Issues

Criminal JusticeAsset Forfeiture, Collateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Court Rulings, Drug Courts, Due Process, Felony Disenfranchisement, Incarceration, Policing (2011 Drug War Killings, 2012 Drug War Killings, 2013 Drug War Killings, 2014 Drug War Killings, 2015 Drug War Killings, 2016 Drug War Killings, 2017 Drug War Killings, Arrests, Eradication, Informants, Interdiction, Lowest Priority Policies, Police Corruption, Police Raids, Profiling, Search and Seizure, SWAT/Paramilitarization, Task Forces, Undercover Work), Probation or Parole, Prosecution, Reentry/Rehabilitation, Sentencing (Alternatives to Incarceration, Clemency and Pardon, Crack/Powder Cocaine Disparity, Death Penalty, Decriminalization, Defelonization, Drug Free Zones, Mandatory Minimums, Rockefeller Drug Laws, Sentencing Guidelines)CultureArt, Celebrities, Counter-Culture, Music, Poetry/Literature, Television, TheaterDrug UseParaphernalia, Vaping, ViolenceIntersecting IssuesCollateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Violence, Border, Budgets/Taxes/Economics, Business, Civil Rights, Driving, Economics, Education (College Aid), Employment, Environment, Families, Free Speech, Gun Policy, Human Rights, Immigration, Militarization, Money Laundering, Pregnancy, Privacy (Search and Seizure, Drug Testing), Race, Religion, Science, Sports, Women's IssuesMarijuana PolicyGateway Theory, Hemp, Marijuana -- Personal Use, Marijuana Industry, Medical MarijuanaMedicineMedical Marijuana, Science of Drugs, Under-treatment of PainPublic HealthAddiction, Addiction Treatment (Science of Drugs), Drug Education, Drug Prevention, Drug-Related AIDS/HIV or Hepatitis C, Harm Reduction (Methadone & Other Opiate Maintenance, Needle Exchange, Overdose Prevention, Pill Testing, Safer Injection Sites)Source and Transit CountriesAndean Drug War, Coca, Hashish, Mexican Drug War, Opium ProductionSpecific DrugsAlcohol, Ayahuasca, Cocaine (Crack Cocaine), Ecstasy, Heroin, Ibogaine, ketamine, Khat, Kratom, Marijuana (Gateway Theory, Marijuana -- Personal Use, Medical Marijuana, Hashish), Methamphetamine, New Synthetic Drugs (Synthetic Cannabinoids, Synthetic Stimulants), Nicotine, Prescription Opiates (Fentanyl, Oxycontin), Psilocybin / Magic Mushrooms, Psychedelics (LSD, Mescaline, Peyote, Salvia Divinorum)YouthGrade School, Post-Secondary School, Raves, Secondary School