Responding to the Demand : Treatment Programs Multiplying

Ten years ago, the heroin addict had few treatment options. But now there are a number of programs to meet the needs of the expanded addict population.

“A lot of these middle-class addicts aren’t going to go to some methadone clinic where half the people have tattoos or criminal records,” said Richard Rawson, director of the Matrix Center, a drug treatment program in Beverly Hills.

“They’re not going to go to some hard-core place where they have to shave their head and wear signs. They’ve put a lot of pressure on us to come up with new kinds of treatment and new kinds of facilities.”

There are about 130 drug treatment programs and hospital clinics in the county--more than double the number in 1975, estimated Robert Roberton, who heads the state Division of Drug Programs. The increase reflects both the growing problem and the growing market for clinics now that an increasing number of companies reimburse employees for drug detoxification.

The traditional treatment for heroin addicts is the substitution of methadone, a synthetic drug that is even more addictive than most street heroin. Methadone detoxification programs provide addicts with a decreasing dosage of the drug, usually over a 21-day period, until the addict is clean. Maintenance--for the hard-core addicts--provides methadone for longer periods, sometimes indefinitely.

Methadone removes an addict’s physical need to take heroin, obviates his need to steal for the drug and can be an successful tool for detoxification, some clinic directors say. But its detractors claim that one addictive drug is simply being substituted for another.

About 15 “investigational new drugs” are being tested on heroin addicts in hospitals throughout the country for maintenance and for treatment of withdrawal symptoms, said Dr. Edward Tocus, chief of the Food and Drug Administration’s drug abuse staff. When the studies are completed, the FDA will evaluate the data and determine if a drug is “safe and effective,” he said.

Beverly Glen Hospital in West Los Angeles is now prescribing an IND--a natural hormone--to treat withdrawal symptoms. A Los Angeles-based group of drug abuse clinics is experimenting with two other INDs--one for maintenance and the other for effectiveness in removing withdrawal symptoms.

Naltrexone, a drug that blocks the effects of opiates and ensures that addicts will not get high if they try heroin, has been approved by the drug agency and, doctors say, has been used successfully at a number of clinics. And doctors have found that withdrawal symptoms can be treated effectively with several medications normally used for treating high blood pressure.

Small, exclusive hospitals like Beverly Glen and Las Encinas Hospital in Pasadena charge several thousand dollars a week for treatment. Most patients have health insurance, but some are wealthy enough to pay cash. Most of the out-patient methadone maintenance centers charge between $100 and $200 a month.