March 3, 1999
Dear Senator McCain:
Your introduction of Senate Bill 423 is
disheartening. That someone with
such an esteemed position as senator would
base public policy on the
hearsay of a proselytizer instead of sound
and extensive scientific
evaluations is wrong. It is unfortunate
that our government once primarily
composed of statesmen today consists of
politicians who have no regard for
the harm they cause in their self promotion.
To quote you Senator McCain,
it is disgusting.
Methadone maintenance was begun during an
administration that was
conservative and Republican. Implemented
during Richard Nixons Presidency
methadone maintenance has restored the
lives of hundred of thousands of
addicts once considered incorrigible and
incurable. The majority of
methadone patients have proven themselves
capable and successful in the
practical world, as lawyers and waitresses,
construction workers and
housewives, teachers and cab drivers. Methadone
maintenance is the greatest
success story waiting to be told: restoring
families and giving hope to the
hopeless.
To not consult the vast wealth of scientific
research is an affront to the
taxpayers who have paid for it. The government
experts at the National
Institute on Drug Abuse (NIDA) and Center
for Substance Abuse Treatment
(CSAT) have been engaged in research for
the past twenty five years. Their
staff are internationally known as experts
in the field and would have been
available to answer your questions and
those of your staff. NIDA was
started during President Nixons administration
and CSAT during President
Reagans administration. It is odd that
as a Republican that you would not
use these agencies and be proud of their
cutting edge research and service
to the American taxpayer.
Legislation should be based on sound scientific
analysis and facts and not
reflect the hearsay of a self-adulator
or ones personal bias. The entire
document S423 contains consistent bias,
falsehoods and wishful thinking.
The only right thing to do is to rewrite
S423 based on consistent science.
S423 is a political document based on prejudice
and in particular it is
harmful to the current and former methadone
patients who owe their lives to
this wonderful medication.
In particular the National Alliance of Methadone
Advocates takes offense
to:
Section 2 (5) Methadone is a synthetic opiate
and the use of methadone in
the treatment of heroin addiction results
in the transfer of addiction from
1 narcotic to another.
This statement demonstrates your lack of
understanding of opiate addiction
and confusion between dependence and addiction.
Addiction is primarily
characterized by a specific set of behavioral
criteria that has been
defined by the American Medical Association
and the DSM as a diagnostic
tool. Methadone does not fit the
criterion.
Dependence on an opiate does not make one
an addict and inferring such is
an insult and demeaning to all pain patients
who must take an opiate to
control their pain as well as to methadone
patients who are prescribed
methadone as a treatment for their addiction.
Legislation should make a
clear distinction between addiction and
dependence and should never blur
the issues.
Section 2 (6) Methadone addicts attempting
detoxification experience the
same difficult withdrawal process as would
be experienced with heroin
detoxification.
It is difficult to calculate if this statement
is referring to the users of
illicit methadone or methadone patients.
Most individuals would think that
the reference to methadone addict meant
an illicit user of methadone.
Legislation should never be confusing or
contain prejudicial tenor as this
statement does.
This statement erroneously makes the assumption
that the key to addiction
is the substance and that if one gets rid
of the dependence that with some
help afterward you have cured the addiction.
Unfortunately this method
has been utilized in the United States
and internationally for the past 150
years with unsuccessful results. Only 30%
remain abstinent after two years.
When one considers the crime and violence,
infectious disease and other
social problems associated with drug use
a 70% relapse rate is unacceptable
and particularily when safety, health and
a productive live is available.
In comparison patients maintained on methadone
have improved health, a
reduction of criminal behavior, become
employable and find work despite the
prejudice towards them. Methadone patients
are indistinguishable within
society.
Section 2 (7) The Federal Government should
adopt a zero-tolerance, non-
pharmacological policy that has as its
defined objective Independence from
drug addiction.
Is this legislation indicating that the
government should abandon all the
promising new pharmacotherapies developed
at the taxpayers expense during
the Reagan and Bush administration. This
is ridiculous. We should use every
available tool to help those who seek it.
SEC. 3. PROHIBITION ON THE USE OF MEDICAID
FUNDS FOR CERTAIN
METHADONE MAINTENANCE PROGRAMS.
SEC. 4. PROHIBITION ON THE USE OF CERTAIN
PUBLIC HEALTH SERVICE
ACT FUNDS FOR CERTAIN METHADONE MAINTENANCE PROGRAMS.
These sections interfere with the ability
of experts who have undergone
years of training in order to treat addiction.
Time limits should never be
placed on any medical procedure that is
used to treat a chronic relapsing
medical condition. Opiate addiction has
been qualified by the National
Institutes of Health as a chronic and relapsing
and that it has a specific set
of symptoms as any other medical condition.
Many of the conditions set
forth in this section are already guidelines
within the program (i.e. Parts
C and D). Any addict seeking help for their
addiction should never be
turned away and sent back to the streets.
Parts E and F would return to the
streets pregnant addicts, HIV/TB infected,
the mentally ill, and
poly-addicted. It creates a situation whereby
those who have sought help
and fail are returned to the hell of heroin
addiction. Legislation should
not be involved in the specifics of any
medical procedure because
politicians are not trained in medicine
or the specialty of addiction
treatment.
SEC. 5. STUDY OF TREATMENT PROGRAMS.
The studies that are proposed have been
undertaken for the past twenty-five
years by NIDA and CSAT. A number of states
also conduct the same
evaluations. It is difficult to ascertain
whether you are proposing
additional studies at the taxpayers expense
or if you just did not know
about the thirty five years of rigorous
analysis that methadone maintenance
treatment has undergone. No other treatment
modality, or medical procedure
for that matter has receive the scientific
scrutiny that methadone
maintenance has and their is no need to
contribute additional expenses.
Methadone patients are heroes and their
struggles to regain their lives and
their families should not be diminished
by legislation that is intended to
harm and stigmatize. As a large number
of methadone patients are veterans
NAMA finds it strange that a professed
advocate for veterans your
legislation that would send them back to
the streets. Methadone patients
have fought to regain their humanity against
far difficult odds than any
residential treatment facility where you
are told what to do and when to do
it and where everything is given to you.
From the day an addict walks
through the clinic Door and becomes a methadone
patient they must pay their
rent, feed their family, find work and
every task is that is expected of
them as a citizen.
It is unethical to use legislation as an
instrument for self promotion.
NAMA opposes this legislation as document
of bias that will create havoc to
those who have stable lives and harm those
who may need treatment in the
future.
Since its beginning over 30 years ago methadone
maintenance has been the
preferred treatment for narcotic addiction
by the drug user. It has been
demonstrated many times to be the most
effective treatment for heroin
addiction, resulting in the termination
both of heroin use and of criminal
behavior. In spite of its success,
methadone maintenance is often
disparaged as a “substitute drug” by those
who ignore the positive benefits
that it has clearly brought to society.
Such attitudes negatively impact
on methadone treatment in a variety of
ways, but it is the methadone
patients themselves who are particularly
stigmatized and harmed. Patients
are mistreated and misinformed and treated
as social outcasts. They are
victims of discrimination in health care,
the job market, education,
insurance and housing. Even treatment professionals
are often ashamed to
admit that they work in this field. This
atmosphere will not change as long
as there is no organization or formal mechanism
for methadone patients to
voice their own needs and to form a strong,
unified public presence on
their behalf.
Together, we can make a difference.
Joycelyn Woods
Executive Vice President
Last Update: February 6, 2000 |
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