Mismanagement in Methadone Clinics

Re “State, DEA Probe Mismanagement in Methadone Clinics,” July 21:

I am a former addict and up until 1993 was on methadone. I experienced the different policies in regard to protocol and treatment both here in California and in London, where I worked as an assistant at a clinic specializing in the treatment of addiction. I believe that California has the most archaic, impractical and conflicting rules and regulations regarding dispensing and treatment for opiate-dependent addicts.

The whole approach to addiction treatment is failing. Under the current law a person on methadone has to attend his/her clinic every day. As a job-seeking individual, I quickly found that just getting to the clinic every day between 5 a.m. and 8 a.m. (clinics can be over an hour away) became a job. In the event of being late, doses are withheld.

I suggest a more individualistic approach. If addicts can prove themselves accountable and sincere about getting help, more options should be available to them in the dispensing of methadone. It would help to let physicians practice as they are licensed to do, and accordingly make choices based on their expert opinions. To let the DEA dictate what is or is not acceptable is to let crane operators do brain surgery.

Methadone treatment should be one of many options. The current “one size fits all” approach does not work.

CLAUS CASTENSKIOLD

Los Angeles

* After 16 years in the California alcohol and drug treatment field, nothing in your article surprised me. Especially astounding are the complaints by clinic operators that massive allegations of fraud were the result of “confusing” state regulations. The California Organization of Methadone Providers, a powerful and well-financed lobbying group, has provided input into the development of state and federal methadone regulations for years. For clinics to now claim that they did not understand the rules is absurd. For industry reps to posture that some clinics would pay fines over a half million dollars without clear evidence of wrongdoing is equally absurd.

In addition to forcing this industry to eliminate fraud, many of us hope that your article will ignite a new debate about the future role of taxpayer-funded methadone treatment. Should taxpayers continue paying for an addiction management strategy that substitutes dependence on one drug for another at the expense of treatment approaches that foster independence, self-help and permanent drug-free living? As a taxpayer, I think not.

CHARLES “BUD” HAYES

Santa Monica