- LATEST REPORTS
Monday, April 16, 2001
- Act
123 An Act Relating To Treatment Of Opiate Addiction
(thislinks you to Vermont’s website and full text of the law – Hit
“Return” to come back to NAMA’s site)
– GovernorDean’s compromise allows treatment to occur only on established hospital or
medical school campuses, patients must be assessed for buprenorphine
treatment before being prescribed methadone and patients must be regularly
assessed for termination of pharmacological treatment as soon as possible.
- Senate,
Dean at odds over methadone
Governor Dean
refusesto consider patients be allowed to take medication home. Anyone in
treatment would have to move close to the hospital or medical school to get
their medication 365 days each year!
- Methadone
Treatment Hits Snag 2-16-01
- Go to Vermont
Public Radio and hear last Tuesday’s (2-20-01) interview with Sen.
Leddy, a representative of Vermont law enforcement and a representative of
the MMT community discuss the current situation and lack of treatment
options for opiate addiction
Leddy presses for methadone
program
February 23, 2001
(from the State section)
By ROSS SNEYD The Associated Press
MONTPELIER – Sen. James Leddy delivered Thursday what amounted to a
point-by-point rebuttal of the governor’s objections to treating heroin addicts
with methadone.
“We must offer hope and help and not despair and punishment,” Leddy
declared as he pushed for a combined heroin treatment and law enforcement plan.
The dual proposal was part of a midyear adjustment of state spending that
received preliminary approval in the state Senate with virtually no debate.
The bill included a plan to spend $24 million in cash from the budget surplus
on state construction projects usually paid for with borrowed money. The House
earlier decided to reserve a big chunk of that money for its pending Act 60
modification bill.
Senate Republicans made a bid in the Appropriations Committee to take the
same approach as their House colleagues but were defeated. They may try to do
the same thing before the full Senate when the bill is up for final approval.
The Senate agreed to Gov. Howard Dean’s request for $230,000 to be
distributed to local law enforcement agencies to increase enforcement of drug
laws. It also agreed to spend $168,000 for treatment clinics, but only if the
treatment includes a provision that addicts could take doses of methadone home
with them.
That take-home treatment option is one of the biggest bones of contention
between Dean and people like Leddy, a fellow Democrat from Chittenden County.
Dean for years blocked attempts to begin prescribing methadone in Vermont,
arguing that it was replacing an addiction for heroin with an addiction for
methadone.
He finally acquiesced last year, but insisted that the treatment centers had
to be based in hospitals. When the Health Department developed rules for the
clinics, though, Dean deleted a provision that would have permitted doses to be
taken home by people who had been weaned off of heroin for a period of time.
Without the take-home option, addicts must visit a treatment clinic every day
for a methadone treatment.
Dean says his objection is that methadone will become another drug traded
illegally. To support his contention, he points to a drug bust in Barre in which
methadone was among the drugs seized.
“That is the fear,” Leddy said. “The reality is this and the
facts are these: That heroin is an addictive intoxicating drug that creates
cravings; that methadone is a treatment for heroin. It is not intoxicating.
“To say that methadone is a magnet that will attract people that will
become addicts is simply not a fact. It is a fear.”
Leddy spent his career in substance abuse treatment and has been tireless in
pushing the methadone treatment option. Dean, in a radio program earlier this
month, suggested that Leddy was “grandstanding” on the issue.
That only emboldened senators to insist on the new rules for methadone
treatment, a position that could draw a gubernatorial veto.
From the Rutland Herald
Senate, Dean at
odds over methadone
February 15, 2001
By ROSS SNEYD The Associated Press
MONTPELIER – Senators are poised to rescue the governor’s money to fight
heroin at the local level, but they’re on a collision course with him over
treating heroin addicts.
The Senate Appropriations Committee supports Gov. Howard Dean’s request to
send $230,000 from the state budget surplus to local law enforcement agencies to
combat the spread of illegal drugs. The House voted against that proposal last
week.
But the budget adjustment act now pending in the Senate could face a veto
over how to treat heroin addicts.
The Senate committee wants to re-craft some of the regulations governing
clinics that dispense methadone for heroin treatment, allowing addicts to take
doses of methadone home with them for perhaps a week at a time.
That infuriates Dean.
“I will not allow, to the best of my ability, methadone to enter our
communities,” Dean said, his face reddening in anger at a news conference.
Methadone is addictive, just as heroin is. But it is prescribed to replace
the addiction to heroin, a drug that is debilitating and illegal. Clinics
typically require addicts to visit every day early in their treatment regimen to
be sure the doses of methadone are taken as prescribed and aren’t sold on the
street to pay for more heroin.
But as the addict increasingly becomes weaned from the effects of heroin, and
gets away from the culture of illegal drug use, clinics typically send them home
with a dose lasting them a week or more.
Dean argues that those multi-day doses are just going to become another habit
for addicts who will seek to sell them illegally, thereby creating a new
problem.
Sen. James Leddy, D-Chittenden, who has a background in substance abuse
treatment, disputes that contention and has led the drive to treat addicts with
methadone.
“How long are we just going to punish people?” Leddy said.
Under a compromise reached last year, methadone treatment clinics will be
permitted only at hospitals. The budget adjustment bill calls for $168,000 to
let two clinics open before the end of the budget year on June 30. The House
went along with that and the Senate is ready to, as well, but it insists that
Dean administration rules preventing take-home doses of methadone be overturned.
“We can’t expect and shouldn’t require people every single day to have
to travel for medication,” Leddy said. “It’s counterproductive
therapeutically.”
Dean believes allowing methadone into the community, despite controls,
threatens to help spread drug abuse into areas of the state where it does not
currently exist. “My job is to balance the good and evil in every
program,” he said.
People who take doses of methadone home with them have to undergo urine
testing and other monitoring to ensure that they are taking the doses. If
they’re not, they no longer get to undergo at-home treatment.
“The testimony we received is people who are on take-home are closely
monitored and clinics; doctors and technicians know when people are diverting
(their doses),” said Sen. John Bloomer, R-Rutland.
While the Senate Appropriations Committee and Dean feuded over methadone
treatment, the administration unveiled a blueprint for reducing substance abuse,
particularly among youth.
“Kids who start drinking early are five times more likely to become
alcohol dependent as someone who begins drinking at age 21,” said Health
Commissioner Jan Carney. “They are also more likely to move into harder
drugs, including heroin.”
The plan seeks in the next decade to end alcohol drinking among youngsters 13
years old or younger; reduce the percentage of older teenagers who have binges
of drinking and drive drunk; and eliminate marijuana use among teenagers.
A good compromise
April 28, 2000
The compromise emerging in Montpelier on the legalization of methadone is a
good example of how our unwieldy system of checks and balances can be made to
work in a positive fashion.
The checks and balances that frequently frustrate action in the American
system are based on the premise that no one has a monopoly on wisdom and so no
one should have a monopoly on power. It is a difficult system in which to
achieve results. But the methadone compromise shows it can be done.
Methadone is the heroin substitute that is administered in all but eight
states to heroin addicts to help them quit their habit or at least to keep it
manageable. With heroin abuse on the rise in Vermont, Sen. James Leddy, a
Chittenden County Democrat, has spearheaded the legislative effort to establish
methadone clinics in Vermont. Earlier this session the Senate approved a
methadone bill by a vote of 26-4.
As executive director of the Howard Center for Human Services and a mental
health professional, Leddy brought his professional experience to the issue. He
was an ardent and articulate advocate for methadone as a medical treatment.
But a lopsided vote in one legislative chamber is not enough for the passage
of a law. One of the principal checks on the legislative branch is the
executive, and the executive in this case was Gov. Howard Dean, a physician with
a different view of methadone.
Dean had seen methadone treatment abused at clinics in the Bronx, and he was
worried that clinics in Vermont would attract addicts, worsen crime, and create
a black market in methadone. Dean, who has a hard-nosed attitude toward drug and
alcohol abuse, also does not like treating addiction to one drug through
dependence on another. He promised he would veto a methadone bill.
Supporters of the bill thought Dean’s opposition was the sign of a stubborn
and arrogant executive who believed he always knew best. Dean, in turn, was
exasperated by Leddy, who he believed was trying to ram the bill through without
looking at all sides of the issue.
So the checks and balances were working fine. But action on heroin addiction
was on the verge of being thwarted. Two things can happen in such a case. The
two sides can dig in their heels and seek to score political points. Or the two
sides can listen to each other.
The two sides decided to listen. As the House Health and Welfare Committee
took up the bill, someone came up with the idea of siting methadone clinics in
hospitals. That way management could be well controlled, and illicit traffic in
the drug could be prevented more easily.
The House version of the bill also called for an assessment of the potential
use of buprenorphine, a new anti-heroin drug favored by Dean that is being
tested at the University of Vermont.
By listening to Dean, the House committee has modified the bill in a positive
way. After listening to the Legislature, Dean has allowed that action to treat
heroin is necessary and that, properly managed, methadone could have positive
results.
The war on drugs in America has failed on many fronts. The front that has not
received sufficient emphasis is medical treatment. Methadone as a medical
treatment combined with other therapies has the potential for curbing the use of
heroin and cutting back the crime that is its inevitable result. The compromise
in Montpelier could help the state get a grip on the worsening problem of heroin
in Vermont.
Friday,
February 16, 2001 – 09:07 AM ET
(WCAX) Efforts
to stamp out heroin in Vermont may hit a dead end because Vermont hospitals
continue to shy away from opening methadone clinics.
Legislation
bringing methadone to Vermont was passed last year requiring only hospitals run
treatment centers. Some hospitals hoped for an alternative, clinics run by
hospitals but off campus. Vermont medical centers were reluctant then to open
clinics. Now newly drafted rules regarding treatment have not persuaded pivotal
hospitals to come on board.
So far just Fletcher Allen Health Care in Burlington and the Brattleboro Retreat
have stepped forward to potentially open methadone clinics. Both facilities
already have substance abuse programs in place. However, with the heroin problem
spreading across Vermont, hospitals in Rutland, Central Vermont and St Johnsbury
have also shown some interest but no commitment says Norm Wright of the Vermont
Hospital Association. �These are services that are going to take some
expertise and some time which hospitals do not have.�
Concerns about drug addicts mixing with other patients at hospitals have fueled
debates within communities and new health department rules regarding operation
of methadone clinics have not changed any minds. �It is very rigid. The
rigidity for us is simply we have no other option other than to operate these
clinics within the confines of existing facilities. That’s as much of a problem
in mixing our clinical needs with our psychiatric needs as when we attempt to
combine psychiatric facility and medical-surgical units.�
A spokesperson for Governor Howard Dean says the agreement last year was for
hospital based clinics. It’s an effort to make sure addicts have 24-hour access
to methadone so as not to take methadone home.
The rules still need to be approved by the legislature. Currently, there is no
money earmarked to help hospitals set up these clinics. There are funds proposed
to pay for treatment at Burlington and Brattleboro immediately and more money is
proposed to expand treatment at other hospitals next budget year
