INDEX
» Struggle to fight heroin a reality in Lodi, county
» Heroin trail: From Mexico’s mountains to veins of Lodi addicts
» Lodians talk about their dangerous dance with the needle
» Methadone treatment more than heroin replacement
» Acupuncture helps heroin-hooked moms, babies
» Lodi police officer journeys into nether world of heroin
» The ancient origins, different forms of heroin
» From the beginning: The chronology of heroin use
Methadone treatment more than heroin replacement
By Jennifer Pearson Bonnett
News-Sentinel staff writer
Freda is one of hundreds who line up in front of a county-owned building for a daily drug fix.
But this fix is legal.
The San Joaquin County Alternatives Treatment Services office in French Camp goes through 10 10,000-milligram bottles — or 10 large shampoo bottles — per day as it provides methadone to approximately 600 heroin addicts per day.
“There are people literally dying to get on this program,” said Judy Anselmi, program director.
 |
 |
| Judy Anselmi | |
|
|
Methadone is a long-acting opium-based medication, effective as a legal substitute for heroin or other narcotics.
The substance, which has been used in treatment programs since the mid-1960s, is believed to help stabilize the lives of heroin-dependent individuals and reduce the harm associated with drug use.
Freda, a longtime drug user who lives in Lodi, said she started using heroin and cocaine when she worked as a nurse. Today, she takes daily doses of methadone with the hopes it will wean her from the illegal substances.
“I used heroin to make me feel like doing things I wasn’t normally able to. It let me be someone I wasn’t,” said Freda, who requested her last name not be used. “I’m usually shy, and I like the way it makes me feel. It made me strong with lots of courage.”She stopped using for several years in the mid-1990s but after a difficult surgery and lots of pain, she went back. “When the prescription ran out, the pain started. So I ran to the nearest thing I knew would help the pain,” she added.
But after nearly 15 years of addiction and failed treatment, Freda finally was recently enrolled in a free county program through the methadone clinic. She is currently homeless and takes a bus daily to French Camp for what she terms, “her juice.”Under Proposition 36, a statewide initiative approved by voters in 2000 to help first-time drug offenders, addicts receive 16 months of free methadone maintenance. Without the sentence, it would cost $160 to $500 per month, depending on income and the number of dependents.
The clinic, located at San Joaquin General Hospital in a pentagon-shaped building that used to be the county’s mental hospital, also offers free methadone-related care and counseling for up to six months to those who are homeless. But there are other rules the client must adhere to, including enrolling in a job training program and continued negative tests for illegal substances.
The methadone clinic is a county-run program whose 42 staff members include 18 maintenance counselors, six nurses, four detox counselors and two medical doctors.
Each patient must undergo stringent physicals and drug testing before even being accepted into the program.
“We want them to be as healthy as possible” Anselmi said. Those who don’t pass the tests are referred to other similar programs.
Once the necessary paperwork is filled out, a survey is done of other medications the client is on. Some can drastically affect the methadone and even send a patient into withdrawal.
Methadone services are contracted with AEGIS Medical System, Inc., based in San Diego.
Group and one-on-one counseling sessions are mandatory.
The clients are randomly tested at least once a month to see if they’re still using illegal substances.
“But in this business you don’t need a test,” Anselmi said, adding that those slipping back into addiction stop paying their bills, attending daily dosing appointments and let their hygiene go.
The clinic doesn’t only offer maintenance for former heroin addicts; methadone successfully treats those addicted to codeine and Vicodin, for example.
For those, there is a 21-day detox treatment program similar to methadone maintenance, but on a faster track.
Each morning, Freda checks in, then stands in a long line to ingest 60 milligrams of methadone with hopes of weaning herself off heroin. (The average user requires 40 milligrams to help take the desire away from using the illegal drug.)A nurse punches her number into a computer that automatically measures the dose into a Dixie cup. Once the medication is ingested, the nurse has to make the patient speak to insure he or she has swallowed the liquid.
“They might not take it because they want to give it to a friend who might be really sick, or sell it, or they want a fix,” Anselmi said.
The drug in liquid-syrup form is pink, mixed with water and tastes like cherries.
Methadone is a synthetic opiate, first synthesized by German scientists during World War II and made commercially available in the United States in 1947. It was originally developed for use as an pain killer.
While Anselmi admits methadone can be just as addictive as heroin, she said it is better because its dispersing is done under a doctor’s care. “With the heroin, you’re out there using needles and that equals disease,” she said. “And, you’re not doing sexual favors to get (methadone).”In addition, clients are going to be weaned off the illegal drug, be educated and counseled.
Anselmi said they can still get addicted, but in this program a doctor is always watching.
“He knows these people have addictive personalities, so the doctor monitors what they’re doing, their behaviors,” she added.
“It’s not just the medication, it’s the whole gamut. We stress counseling.” Freda said, for now, the methadone is holding her. “I’ve done (other) programs. All they do is talk about drugs, and it makes you want them. So the first thing is you go get it.”For those who earn the trust of their counselor, patients are allowed to put a week’s worth of their medication in a locked container and take it home to ingest. But he or she must be drug-free for three months.
Freda, who has started working part-time, will start tapering off her dosage in the next two months. When asked if it’s helping, she said, “Yes, because I’ve got money in my pocket. You have to want to clean up.”Anselmi agreed.
She knows because she was a heroin user for 18 years.
What started out as recreational use less than once a month turned into an addiction that forced her to find any way possible to get money to buy drugs.
She remembers seeing people who had lost feeling in their hands let cigarettes burn down to the bone between their fingers.
Her husband was murdered. She contemplated suicide just to get rid of the sickness she felt from using heroin.
“It wasn’t worth it. It was a real rude awakening. I got way in over my head,” Anselmi said of her addiction, adding that she came from a “normal” middle-class family.
“You think you’re just going to have fun. When the party’s over and you’re hooked, the reality sets in.” But she wanted to get clean because she was already enrolled in college. “I was sick and tired of being sick and tired, so I got off (the heroin).”Today, Anselmi sits among certificates and diplomas in her colorful office filled with live Pothos plants and M&M candy dishes discussing what she refers to as her “trip to hell and back.” She jokes that her arms are worth millions from the amount of heroin pushed into her veins.
“I could be rich right now.”For Freda, she is trying to get clean by working small jobs and steering clear from prostitution, a practice the 44-year-old once used to earn money for drugs. She wants to have money to spend on her grandchildren.
Freda, who has three grandchildren, also came from a middle-class family. “I’ve lived the good life. I’ve had the husband, the house, the family and drugs make you lose it all.”Anselmi said heroin addicts not only act different, they smell different. “Your heartbeat is different. You even forget to breath,” she added.
For some in recovery, alcohol has become a replacement for the drug abuse. Since alcohol intensifies the effect of methadone, Anselmi said many clients undergo daily breathalyzer tests before receiving their dosage.
At the French Camp facility, the patients range in age. The youngest ever was 15, and the oldest in their 80s.
Approximately 64 percent are female, and patients are broken into 38 percent white, 34 percent Hispanic, 15 percent black, 11 percent Asian-Pacific Islander, 1 percent American Indian and 1 percent Filipino.
Some have jobs, from McDonald’s cashiers to high-up administrators, Anselmi said.
The average length of treatment is between one day and 30 years; some in the program have been attending since 1985.
“Some people feel, once they’re on this program they have to be their whole life,” Anselmi said, adding that addiction is like a disease. “If it works for them, that’s fine.”She was on methadone treatment for seven years.
Freda, who contracted Hepatitis C from drug use, admits she still dabbles in heroin. “When you start using you get sick. Then you have to have it,” she added. “If I can stop one child from doing drugs. ...These kids need to see what we go through.”Anselmi said about 75 percent of the clients have Hepatitis C because their livers are damaged. Plus, she said, many addicts share needles and pass the highly contagious disease onto others.
And, they have put dirty needles in their arms without using rubbing alcohol to sterilize them.
“A lot of our clients have a lot of pain from either their livers being shot, or their heart,” Anselmi said.
Many are in emotional pain, too, and are referred to grief therapy.
“Then they don’t have to use,” Anselmi said. “Instead they have found a legal way to get out all their frustrations.”In-house counselors deal more with the behavior that comes with drug use than the actual addiction, Martie Gallego said. This can include withdrawal and sometimes abusive relationships.
She is a recovering addict who benefited from the county program. “Methadone is a wonderful, wonderful drug if it’s used correctly,” Gallego said.
The clinic also provides regular group counseling for those in the program, including some in their own native languages.
In October, the clinic received a $500,000 grant to expand intensive outpatient methadone maintenance treatment services by 60 slots per year for Southeast Asian adults. Anselmi said the staff is taught to love and nurture instead of being punitive.“Our clients already hate themselves. We hold them lovingly accountable for their actions,” she said.
“I’m really proud to say I survived it. You have to act on wanting to make a change, and you alone have to make that decision.”
The clinic is open from 5:30 a.m. to 2:30 p.m. Monday through Friday, and from 6:30 to 10 a.m. on Saturdays, Sundays and holidays. It is located behind San Joaquin General Hospital, 500 W. Hospital Road, in French Camp.
For more information, call 468-6848.