The Associated Press State & Local Wire, May 3, 2005.
DATELINE: Baltimore
The state health department has stopped running laboratory tests for Maryland’s methadone clinics, removing a safeguard against misuse of the drug, potentially worsening what authorities say is a growing problem.
Methadone, a heroin replacement medication, is used by about 13,400 recovering addicts in Maryland. To start on the medication, addicts must go to one of the state’s 40 approved clinics. Federal law allows clients who have gone through months of daily visits without relapse can earn the opportunity to take home at least some doses.
For at least 20 years, clinics have had one reliable method of making sure take-home doses don’t end up being abused for a high by the clients or resold on the street: They have randomly called some clients and ordered them to return their doses within a day.
Because it’s difficult to tell whether the returned bottles holding the syruplike drug have been tampered with, clinics have sent them to a state lab to make sure they match the dosage given to clients. If the lab found a mismatch, as occurred in about 10 percent of the 4,000 samples it checked annually, the client lost his or her take-home privileges.
But last month, the Laboratories Administration of the Department of Health and Mental Hygiene notified clinics that, because of budget cuts, the state would no longer do the testing.
Clinic directors say the move will make it much harder to ensure that clients are using their take-home doses as directed.
The lab testing “is the only tool we have with which to determine that the people we’re giving the bottles to are making responsible use of their medication,” said Carol Butler, director of the Reach clinic, which serves 450 clients at a van parked in Baltimore’s Barclay neighborhood. “We take our jobs seriously, and we have no other way to enforce to make sure that the people we think are doing well really are.”
The move occurs at a time of growing concern about the risks of methadone abuse. Fatal overdoses involving methadone increased fivefold in the state between 1998 and last year, to 124, a rise attributed to the diversion of methadone from clinics and of methadone prescribed as pain medication.
“It’s penny-wise and pound-foolish. I don’t understand it,” said Frank Satterfield, director of Glenwood Life, in Baltimore’s Govans neighborhood.