The New York Times

The Metro Section

Tuesday, July 21, 1998

MAYOR WANTS TO ABOLISH USE OF METHADONE

Drug-Treatment Experts Angered by 4-Year Aim

By Rachel L. Swarns

As Mayor Rudolph W. Giuliani outlined plans to dramatically expand his workfare program to include drug addicts, he veered unexpectedly from his prepared speech yesterday and announced his desire to abolish all methadone treatment programs for heroin addicts in New York City.

Mr. Giuliani, who criticized the programs for substituting a dependency on methadone for a dependency on heroin, conceded that he could not unilaterally take such action. Federal and state officials provide about 92 percent of the financing for methadone treatment in New York, Federal officials say. But Mr. Giuliani said he would still lobby to reduce the role of the programs in the city, which has the largest concentration of recovering heroin addicts in the country.

"Over a period of time, hopefully within the next two, three or four years, we will phase out and do away with methadone maintenance programs in the City of New York," Mr. Giuliani said.

His comments quickly created a furor in the drug-treatment community. Methadone treatment has been embraced by the National Institutes of Health, Gen. Barry R. McCaffrey, the White House's top drug official, and other drug rehabilitation experts who have all called for an expansion of the program, which they describe as the best hope for recovering heroin addicts.

"He said what?" asked Don Des Jarlais, the director of research for the Chemical Dependency Institute of Beth Israel Medical center and an expert on heroin addiction.

"From a public health standpoint, that has to be one of the more ridiculous things for any public official to have said over the past 30 years. It implies that he was either misunderstood or misspoke, or he does not have much of an understanding of drug abuse treatment for heroin addiction," Mr. Des Jarlais said.

Federal drug officials also expressed astonishment. "The Mayor of New York City said that?" said one official, who spoke on condition of anonymity. "Does he realize this is scientifically considered to be the best treatment for heroin?"

The Mayor caught even some of his own city officials by surprise as he strayed from the prepared text of a speech that focused on his plan to require virtually all adults on welfare to work for their benefits by the year 2000.

Under the new policy, only the most severely disabled people will continue to receive cash assistance without working. The rest - currently about 340,000 adults - will be required to participate in workfare or to find private-sector jobs. The initiative, which is modeled after a similar policy in Wisconsin, would create the largest welfare program in the country to have a universal work requirement.

But Mr. Giuliani, who has been promising to enforce a universal work requirement for months, received the most sustained applause from supporters and welfare officials when he announced his plain to end the methadone treatment program. He described drug addiction as the most serious stumbling block on the road to putting most people on welfare to work, but he emphasized that drug addicts should learn to recover the hard way, without the help of medication.

"What we should be teaching in drug-treatment programs is the more difficult, but the much more loving and caring, attempt to try to reintegrate into a person the ability to take care of their own life," Mr. Giuliani said.

Mr. Giuliani, who revolutionized the city's welfare system by creating a workfare program that has sharply reduced the welfare rolls, has already pushed hundreds of the disabled and the drug-addicted into worfare. Additionally, welfare officials have begun to discourage the poor from applying for welfare, urging them to rely on relatives, charity and work. And this year, the number of people on public assistance plunged to its lowest point since 1967.

But putting the universal work requirement into practice will be a much more daunting feat, and the problems posed by welfare recipients suffering from drug addiction is only one of many obstacles ahead.

Only about 22 percent of adult welfare recipients are working, and city officials must now confront the task of moving about 260,000 people into workfare or private-sector jobs over the next 18 months.

Some workfare caseworkers, union officials and advocates for the poor doubt the city can develop enough workfare positions, private-sector jobs or child care slots to support such a transition. A similar plan announced in 1996, in which Mr. Giuliani promised to create a workfare force of 100,000 over two years, never materialized. Today, about 36,000 people participate in workfare, and city officials say that number is expected to increase by only about 4,000 over the next year.

But Mr. Giuliani dismissed doubts about his plan yesterday, saying he was confident that New York City's strong economy and workfare program could easily absorb thousands of welfare recipients.

"We're going to end welfare by the end of this century completely," Mr. Giuliani said during a news conference in Manhattan. "Everybody in this city will work, with the possible exception of people who are truly disable or, for some short period of time, are unable to work.

About 30,000 people on public assistance have been excused from working, he said, because they were participating in drug-treatment programs. Under the new plan, he said, drug addicts will work and receive treatment. Since March of this year, 1,139 drug addicts have been assigned to worfare slots, city officials said. They did not have estimates for the number expected to be working in the next 12 months. [...]