Methadone: Controlled doses sold for cash on the streets

By 19, after suffering two injuries for which he was prescribed narcotic painkillers such as Lortab and Oxycontin, Hermantown High School graduate Daniel Stanius was addicted to opiates.

“I started graduating to stronger ones,” he said. “By 23, I was a real heavy user.”

By 26, Stanius was serving a nine-month sentence at the Northeast Regional Corrections Center for illegally possessing methadone, which, he told the News Tribune, had become “my drug of choice.”

And his favorite type of methadone: the liquid form provided at methadone clinics, including at the clinic in Duluth, the Lake Superior Treatment Center.

“It gets you very, very high. I think it’s stronger than (Oxycontin),” he said. “With pot, you get a little bit of a head buzz. With methadone, it was throughout your whole body. You’d get a warm glow, a sense of well-being.”

Under federal law, if patients prove their trustworthiness at methadone clinics, they can get up to a month’s worth of take-home doses of the drug. It’s intended to be a reward for patients, who start their treatment by having to go to a clinic each day, six to seven days a week to take their dose. Getting take-home doses is standard practice at methadone clinics around the country and is fully legal.

But the pressure to sell those doses can be extremely high, as they go for about $1 a milligram on the streets, with doses ranging from 50 to 300 milligrams, according to local law enforcement experts and current and former users of the drug.

Stanius never enrolled as a patient at the treatment center, but he said he never had a problem getting the liquid form of the drug.

“I just bought it from (patients) at the center. There was a lot of trading and selling of methadone and other pills, and drugs in general,” he said. “You’d go there in the morning, and everybody would be waiting there; everybody is talking: ‘What are you going to do with yours?’”

Three registered confidential police informants who worked extensively with area law enforcement on major narcotics cases over the past year told the News Tribune that dealing take-home doses is common.

Still working undercover and fearing for their lives if they were identified, they asked that their names not be used for this article.

Often, the informants said, the dealing takes place near the treatment center, and patients will lie to treatment counselors about suffering withdrawal symptoms to get higher doses of the drug.

Two informants said that, together, they know about 30 patients at the clinic.

They said they don’t believe any of the 30 are using the drug for its intended purpose.

“They’re not taking it to get help; they’re taking it to get high,” an informant said.

Asked how quickly a liquid dose of methadone could be obtained, an informant responded, “Give me the money … and I’ll find some within the hour.”

Liquid methadone is a thick liquid and requires a veterinary needle to shoot up. As a result, many stores that sell those kinds of needles have seen them stolen or used in overdoses. L&M Fleet supply in Cloquet has taken to locking up the store’s veterinary needles, requiring an ID proving the buyer is 18 or older. Store manager Larry Tisdell said L&M took those steps after police told them a young student overdosed using a veterinary needle that appeared to have come from L&M.

“Now we’re tracking who buys them,” he said.

The director of the Lake Superior Treatment Center did not return repeated phone calls for comment.

A representative for Colonial Management Group, which owns the Lake Superior Treatment Center along with more than 50 other clinics across the country, told the News Tribune from Florida that the company does not speak to the media.

However, Dr. Tom Payte, a corporate medical director for Colonial Management Group did speak with the News Tribune. He said diversion will happen but that his company has policies in place at all clinics to limit it as much as possible.

He also said that crimes associated with drug abuse would be far worse if methadone weren’t offered.

“Addiction is an incurable, progressive, often fatal disease. It’s not curable, but it is treatable,” Payte said. “Our purpose is to improve the quality of life, and eliminate the crime and all the other negative aspects of the addict lifestyle.”

‘Abused and … diverted’

Dr. Bruce Goldberger, a Florida coroner who was one of the first to raise the alarm on methadone deaths in the early part of the 2000s, has been part of numerous studies looking at deaths associated with the drug. He said laws pertaining to take-home doses should change.

Before being contacted by the News Tribune, he said he had never heard of more than a weekend’s worth of methadone being provided for patients to take home.

“You’re putting a large amount of methadone out onto the street that can be used, misused and abused and — even worse — diverted,” he said.

Records requested by the News Tribune of state and federal agencies show that the Lake Superior Treatment Center has never been cited for its patients selling their take-home doses.

However, earlier this year the Minnesota Department of Human Services, which licenses and oversees methadone clinics, cited the treatment center for violating regulations aimed at controlling the take-home doses. Among those violations: The treatment center wasn’t doing bottle checks — selecting patients at random to bring their take-home doses back to the clinic to prove they were taking the prescribed dosage.

The ability to prescribe take-home doses is regulated by the federal Substance Abuse and Mental Health Services Administration. Nick Reuter, a senior public health analyst with the federal agency, which is charged with licensing and accrediting methadone clinics, acknowledged the trust can be abused, and doses can be diverted.

“If diversion is an issue, we do take steps to immediately seek compliance,” Reuter said. “But abuse does happen. You’re giving a medication with abuse potential — methadone — to people who have had substance abuse issues in the past, including diverting the substances. You can reduce and have all the things in place to reduce the risk of that happening, and take actions when you identify it happening, including kicking the patients out of programs. But we can’t eliminate it 100 percent.”

Several area overdoses

The number of take-home doses methadone patients can get and when they can get them are governed by federal laws, which states can make stricter but can’t weaken.

In Minnesota, which adheres to the minimum federal rules, after 90 days of good behavior, patients can get two take-home doses; at six months, patients can get three take-homes; at nine months, patients can get up to a week’s worth; after a year, patients can get up to two weeks’ worth; and after two years, they can get up to a month’s worth of take-home doses.

Patients generally have to show that they’re not abusing the drug or any other narcotics, which methadone clinics test through urine screens.

“Those are not the (patients) most likely to abuse their privileges,” said Jane Maxwell, a senior research scientist with the University of Texas School of Social Work who has done extensive study on methadone-related deaths.

But 15 current and former patients of the Duluth center who spoke to the News Tribune, along with addicts like Stanius, said the safeguards put in place to limit the abuse of take-home doses can be easily circumvented.

“People would fail (urine screens), and they would say, ‘Well I’m still going through withdrawals because this isn’t enough,’” Stanius said.

In response to finding other drugs in the patients’ urine, the clinic “would raise up their methadone,” he said. “The best way I can think of it is: You’re adding gasoline to a fire.”

Methadone proponents say patients who do test positive for other drugs sometimes should have their methadone dosage increased to help them with the cravings for illicit drugs.

In some cases, overdosing on the liquid methadone has led to deaths in the area.

Of the 38 methadone-involved deaths in St. Louis and Carlton counties identified by the News Tribune, at least seven were from ingesting liquid methadone. The rest either could not be readily identified from records or were from the pill version of the drug.

Records show criminal charges were filed in only one of the overdose deaths from liquid methadone, but those charges were dropped for lack of evidence.

The Minnesota Department of Human Services, which licenses and monitors methadone clinics, said they are looking at strengthening rules and enforcement of take-home methadone dosing.

“The diversion-control procedures are in the federal regulations; they’re not in the state regulations. We don’t have the direct authority to enforce the federal requirements,” said Jerry Kerber, the inspector general for the DHS.

‘A wicked drug’

The take-home doses have also been misused — even when not sold on the streets, records show.

In three cases in Duluth, for example, young children have gotten hold of their parents’ liquid methadone and overdosed. The children, all younger than 5, survived. In two of the cases, charges weren’t pressed because police investigators felt there wasn’t enough evidence to prove neglect; in the other, Duluth police are investigating whether neglect occurred.

At least three deaths from liquid methadone have occurred on the Fond Du Lac Reservation.

Daven Martineau of Cloquet died in November 2011 when he was at the reservation home of friend Tony Barney, who was then a patient of the Lake Superior Treatment Center.

Barney told the News Tribune that he informed police he had his take-home doses stored in a lockbox and that it appeared as if Martineau stole his lock-box key and injected the methadone. Police reports in the case said they found hypodermic needles filled with methadone in Barney’s home, but Barney “was adamant that he never used those needles to inject himself or anybody else.”

Methadone patients drink the drug; injecting it with a needle, the favored method of abusers, is said to give a quicker, more intense high, according to addicts interviewed for this report.

“The county attorney looked at it and did not file charges,” Cloquet Police Detective Darren Berg said of the methadone death. “The key was in Martineau’s possession.”

Barney told the News Tribune that his methadone treatment was subsidized through state health insurance and that he was discharged from the Treatment Center after Martineau’s death.

Barney’s brother, Randy, died from overdosing on liquid methadone in 2008 after years of drug abuse. Randy’s father, Randy Barney Sr., said his son started abusing drugs at age 11 or 12 and became a patient at the Lake Superior Treatment Center at about age 17.

In 2007, Barney’s father said, his son quit methadone treatment but would still drink and abuse other drugs. Then he took liquid methadone at the same dosage he was on before leaving the clinic, his father said, and died at the age of 23. He was survived by a daughter who was 3.

“It’s such a wicked drug,” Barney said. “It’s an epidemic up here.”

In this series

Sunday
The drug: The costs associated with methadone treatment continue to rise in Minnesota.

Today
Abuse: Some addicts say methadone is their preferred drug of choice.

Tuesday
Costs: About half of methadone patients in the state get their treatment free.

Sept. 23
Completion: Only about 5 percent of methadone patients in Minnesota finish treatment.

Sept. 24
Profits: More than half of the country’s methadone clinics are for-profit.

Sept. 25
The clinic: Former staff members of the methadone clinic in Duluth speak out.

Tags: news, health, crime, investigations, methadone