Methadone may come under closer supervision
ST. PAUL -- Minnesota legislators likely will debate proposals next year to slap tighter supervision on the use of the potent drug methadone, used to treat pain and addictions to illegal drugs such as heroin.
However, key backers of the legislation say the Legislature should leave up to medical experts the controversial question of whether methadone ought to be prescribed.
Two Minnesota House health care committees touched on the topic Thursday, with doctors saying methadone is the best treatment for drugs like heroin and others pointing out problems the drug causes when it leaves patients' hands and ends up for sale on the street.
"It is a controversial therapy," Commissioner Lucinda Jesson of the Minnesota Human Services Department told committee members. "You are using a legal drug to battle an illegal one."
It is more than controversial, said Director Phil Norrgard of the Fond du Lac Band of Lake Superior Chippewa Human Services Department. When the drug gets into the wrong hands, it often is deadly.
"More addicts are fixing and mixing," he said, meaning they get their drug fix by mixing methadone with other substances.
Thursday's discussion will continue in the legislative session due to begin Jan. 8.
Rep. Tom Huntley, DFL-Duluth, and Sen. Tony Lourey, DFL-Kerrick, come from areas affected by methadone problems and they will lead legislative health committees. The two say that legislators have no business delving into the issue about whether methadone is the right treatment, but agreed that the state needs new laws to make sure the drug does not end up falling into the hands of those who would abuse it.
Lawmakers often heard about an in-depth report the Duluth News Tribune printed on methadone in September. Huntley said chief reporter on the series, Brandon Stahl, deserves a Pulitzer Prize for the stories that exposed methadone's danger and problems encountered at a Duluth methadone clinic and elsewhere.
Among facts Stahl uncovered was that at least 392 Minnesotans have died from methadone-involved overdoses since 2001.
Experts at Thursday's hearing indicated the death toll could be far higher. One reason is that medical examiners vary greatly on whether they list methadone as a contributing cause to deaths. Also, some deaths may not be directly attributed to methadone, such as two Carlton County workers who were hit this fall by a vehicle driven by someone authorities believe was using methadone.
Norrgard said he is tired of hearing that drug addiction is a disease like diabetes and high blood pressure.
"High blood pressure and diabetes medications do not have any street value," he said. "They are not dangerous narcotics."
Methadone, on the other hand, "can be easily converted to cash," Norrgard said.
A 30-day methadone supply could be sold for $3,600, he added.
Norrgard said Carlton County, which shares the Fond du Lac reservation with St. Louis County, has the highest rate of methadone deaths in the state.
Investigator Dan Daniels of the Carlton County Sheriff's Department said crimes committed by methadone users "have gone through the room. It is almost epidemic."
Daniels, Norrgard and others asked legislators to pass laws to better supervise methadone use. Jesson said her department will give lawmakers suggestions for bills.
Some Republicans suggested that methadone itself is addictive and people being treated for other addictions should use it only for a short period of time.
"How do we wean them off?" asked Rep. Mary Franson, R-Alexandria.
Dr. Gavin Bart of Hennepin County Medical Center said that patients who quit using methadone have a much greater chance of going back to drug use: "They do not do well."
Bart, who indicated that many patients need to remain on methadone for life, presented evidence showing those who quit methadone treatment often die soon.
"Methadone patients are not addicted to methadone," he said, and it is the best treatment for many drug addicts.
Norrgard rebutted Bart by saying that Fond du Lac is working with the Mayo Clinic on another treatment, not involving methadone, that shows a 95 percent success rate. The program includes behavior modification, which Bart said does not work.
Lourey did not take sides in that controversy, but said: "The drug needs to be used as prescribed."
About 5,000 Minnesotans receive methadone treatments a year, Jerry Kerber of the Human Services Department said. About half are funded by the state, at an $8.5 million annual cost.
Most clinics that supply methadone are in the Twin Cities, but others are in St. Cloud, Rochester, Willmar and Brainerd. The state is trying to close the Duluth clinic for multiple rule violations.
Huntley said that people using methadone are not just a danger to Minnesotans' well-being. "There is a huge cost to the community from those who are out of control.