The Common Cure For Heroin Addiction Is Also A Magnet For Police Harassment
With heroin addiction skyrocketing, methadone remains the gold standard for narcotics dependence treatment. Yet cops nationwide target heavily regulated methadone clinics to turn vulnerable addicts into informants, with little public outcry, reaffirming the medicine's enduring, deadly stigma.
The first time the team from Manhattan North Narcotics rolled up on Betty, she was about 20 feet from her methadone clinic. The program is in Washington Heights, Betty's neighborhood, and she had just come from getting her daily dose upstairs. She crossed the street to watch her friend's car while he went in to take his medication; he was double-parked, and when you're a methadone patient the last thing you need is to give the police a pretext to question you.
Her friend and his wife came back downstairs, and the three of them talked for a minute when something caught Betty's eye. “There was this black dude who just kept patrolling up and down the block,” she recalls. “And I'm like, 'Something's not right.'” The guy was in plainclothes and he approached the group to ask what they were doing. Betty, who asked me only to use her first name for this story, asked her friend in Spanish if he knew the guy; he didn't. Then, she saw a white guy, also in plainclothes, approaching from the other end of the street. She told her friend to get in the car and leave, but before he could the two officers flashed their badges. The police, presumably, thought they had seen a drug deal go down. Or, perhaps, that's what they wanted to have seen. Either way, they used that pretext to pat her friend and his wife down, and found a bottle of pills Betty said he had a prescription for and were in his name.
As that pat-down was happening, the sergeant pulled Betty aside, across the street from the clinic. He frisked her too, and after pushing her on whether she knew anything about her friend's pills, he made her an offer: Become a criminal informant, or CI. She'd get $25 or so to set someone up. The area, according to Betty and others I interviewed, is crawling with informants.
Betty said no thanks. Her friend got a ticket and said the cops walked off with $60 and a handful of pills. Betty walked away free, but it wouldn't be the last time that team found her in their sights. A few weeks later, the same team stopped her again — mere steps from her program. She didn't have any illegal drugs on her. “Same fucking white guy,” she says, referring to the officer. “He just wants me to work with him.” She was stopped a third time, just a few weeks after that, blocks from the program, and questioned by the same team. She was detained on the street corner for about an hour, in part because she had an extra “take-home” bottle with her since the clinic would be closed the following day, July 4. (The New York Police Department did not respond to repeated requests for comment for this story, nor did the New York City Department of Health and Mental Hygiene.)
Though BuzzFeed News could not independently verify Betty's claims, numerous methadone patients in New York City tell stories of being harassed outside their program, stopped, questioned, frisked, and arguably entrapped into making drug sales they wouldn't have made otherwise — all because police were surveilling their clinic. A 2011 survey conducted by VOCAL-NY, an advocacy group that focuses on poor people and drug users, found that nearly 4 in 10 methadone patients in New York City have been stopped and frisked by police outside their clinic, while 7 in 10 had seen someone else get stopped and frisked.
There has never been a nationwide study into the police practice of surveilling methadone clinics looking for — and sometimes creating — illegal activity, so the scale of the issue remains unknown. In two dozen interviews, however, strong evidence emerges to suggest methadone patients all over the country face stigmatization and risk of profiling by law enforcement to varying degrees. These patients tend to be poor, and the clinics are often ghettoized to low-income neighborhoods. The result is that cops can lurk outside what are essentially specialized doctors’ offices and target people, like Betty, based on the medication they’re taking — to virtually no public outcry or oversight.
Now, as the United States faces epidemic levels of abuse of prescription drugs, and a skyrocketing heroin fatality rate, the use of methadone itself is also on the rise, meaning even more are vulnerable to this potentially deadly police harassment. And as misconceptions about methadone continue to run rampant throughout the criminal justice system, addicts trying to kick their habit can find themselves walking around with a target on their back.
If heroin is the most stigmatized illegal drug, methadone is the most stigmatized drug treatment. Bob Newman knows this well. Newman is considered a methadone guru because of the role he played in establishing treatment programs in the early 1970s. He says police harassment of this nature is nothing new. “We used to be plagued by this in the early to mid-'70s,” he says. “For over 40 years that has been a problem facing methadone programs and methadone patients.” Though Newman acknowledges the problem has actually improved over time, he still says police harassment is “very, very frequent.”
The problem, he and others contend, remains ignorance on the part of police — and society at large. “In general there is a very strong antipathy toward methadone patients, toward methadone treatment, toward methadone providers, based on the totally incorrect assumption that methadone maintenance, for addiction, is given and used in order to get high,” says Newman. Myths about methadone are rampant even in drug-using communities: It makes your teeth fall out, weakens your bones, gives you a hunchback. Some people think methadone is a conspiracy to keep former users under government control.
The truth about methadone is far duller. When administered in the correct way, it — along with buprenorphine — is the most effective known treatment for opiate addiction, including addiction to heroin and prescription pain pills. Though some studies show that buprenorphine, which is combined with naloxone to make the drug called Suboxone, may one day eclipse methadone as the preferred medicine, methadone remains “the gold standard,” says Bill Piper, the director of national affairs at Drug Policy Alliance. It is one of the most clinically studied drugs in the world, yet remains one of the most misunderstood.
It makes some sense that misinformation reigns; to need methadone isn't something people are necessarily proud of. As Dan Bigg, director and co-founder of the Chicago Recovery Alliance, puts it, "Even people who work in methadone treatment are in a sense ashamed that people take methadone. They're desperately hoping they can get people off methadone. That's their goal."
Methadone, when it is prescribed to heroin users, is one of the most tightly regulated legal drugs in the United States. It can only be dispensed from specially certified treatment centers, often only in daily doses for the first three months of treatment. Many advocates feel the tight regulatory regime places undue burdens on people who want to kick heroin. Bigg says such restrictions are “more burdensome than any other treatment in medicine." As he sees it, "They're worried about having the tightest control possible on this medicine.”
Police surveillance outside methadone clinics isn't the only way in which authorities can prevent or deter addicts from obtaining this potentially life-saving medicine. Patients are overwhelmingly denied methadone treatment while incarcerated, a practice some courts have found constitutes cruel and unusual punishment, according to a report from the Legal Action Center. The same report found that drug courts in the U.S. regularly mandate that patients begin detoxing from methadone, sometimes due to “a lack of understanding of the nature of addiction and MAT (medication-assisted treatment), including the belief that MAT is ‘substituting one addiction for another.’” A separate study focusing specifically on New York state drug courts found judges and other court officials “often don’t know enough about addiction treatment to escape the same prejudices that affect other people, and they demand abstinence-only approaches even when better alternatives exist.”
Orlando Chavez, a former methadone patient and activist in Oakland, echoes a complaint heard over and over again from proponents of methadone therapy: Cops don't have enough education about the drug to properly understand how it works. “They can't really tell the difference between someone that's taken their dose and legally medicated, and someone who's not,” says Chavez. “So, from their perspective, everybody is under the influence. They don't really grasp the concept of methadone maintenance very well.”
“The police do tend to accost people when they're leaving the clinic,” he tells me. “Run warrant checks on them, search them. I've seen years of it.” He also says that he's personally aware of several people who have been ensnared by undercovers or informants into selling their take-home bottle, and guesses that there are many, many more instances he isn't aware of. Like the other patients I spoke with, he suspects some of the harassment is due to cops feeling pressure to make quotas. “We're easy targets,” he says.
Neill Franklin, a retired former undercover narcotics cop and executive director of Law Enforcement Against Prohibition (LEAP), says if this is happening, it makes sense to him: “When we go to a place where we think the hunting is going to be good, we refer to it as a duck pond,” he says. “We know that some [methadone patients] do sell and engage in other drug activity. You stop enough people … and you know what, you're going to be able to make some arrests. It's just that simple.”
Randy Kovach, 31, who goes to a methadone clinic in Pittsburgh, says that Port Authority police there harass patients all the time. Like Betty, Kovach has observed Port Authority cops camped out down the street from the clinic he goes to, watching patients enter and exit. “What do you do, call the cops?” says Kovach. “He is the cops.”
Kovach was arrested in 2013 by Pittsburgh Port Authority police and charged with possession of a controlled substance and intent to deliver. He says he was waiting for a bus outside his program, and the arresting officer, William Luffey, pulled him out of the powered wheelchair he regularly uses. “I was new to the whole methadone thing,” Kovach tells me over the phone, so when Luffey asked Kovach if he could search him, Kovach said it was fine. “They found my medication, Xanax, and arrested me. They said because I was on methadone I must've been selling my Xanax.” Kovach, who has prior convictions, later took a plea and got 18 months probation.
His ex-boyfriend, William Ura, says the officer who arrested Kovach has a history of targeting methadone patients. “He goes pretty much after anyone he knows is either in the methadone clinic or that is on any kind of prescription drugs,” Ura tells me. He says Luffey continued to stop Kovach repeatedly over the course of a month following the arrest. “But it was like every time he saw him he was constantly harassing him, stopping him, searching him,” says Ura. “He'd even search me also because I was with him.”
Kovach says the Port Authority police in Pittsburgh offered him a deal if he'd work with them but Kovach turned them down. Ura says that kind of thing happens a lot, and the targets are often the drug users deepest in the hole of addiction. “I know this one kid I used to be friends with that's actually a CI for Port Authority,” says Ura. “And they picked him to work for them because they know that everybody knows that he buys pills off of everybody.”
Both Kovach and Ura also say that Pittsburgh Port Authority police keep books full of photographs of patients who attend clinics, a charge the Port Authority denies. The two of them say they saw the book for one of the clinics after responding to a bulletin Port Authority released following an assault on a bus driver. They recognized the suspect from their methadone program, and went to the Port Authority police station to make a statement.
“We knew what clinic [the suspect] went to, so they gave us the book for that clinic and had us look through the book and point the guy out to them,” Ura tells me. Both Ura and Kovach independently described the book they were shown as not only containing mugshots from arrests, but also photographs of patients simply walking around town. “They know what clinic they go to and the whole nine yards,” says Ura. “It encourages the officers to harass anybody that's on methadone, because they think we're doing stuff we shouldn't be doing and not trying to get our life together and not trying to better ourselves.”
In a letter denying an open records request filed by BuzzFeed News, a Port Authority official offered a different explanation. Bryan Campbell, assistant general counsel at the Port Authority of Allegheny County, wrote, “The book of photographs referenced in your request is actually an array of arrest photographs of several individuals that was utilized in the past for investigative and identification purposes.” Campbell later clarified that by “arrest photographs,” he meant only mugshots, contrary to Ura and Kovach's allegations.
“Port Authority police do not maintain the type of photo book that you’ve described,” says Jim Richie, a Port Authority spokesperson. “With regard to your question about where Port Authority police conduct surveillance or patrol, the Authority would not disclose that type of specific information as it potentially could jeopardize the safety of our officers and/or the outcome of potential investigations.” (The head of security for the clinic Kovach and Ura attend, who is a former Pittsburgh police officer, was denied permission by clinic management to discuss the allegations.)
Authorities aren’t wrong to be worried about methadone ending up in the illegal market. In addition to its use as a treatment for narcotic addiction, it can also be used as a pain medication. Paradoxically, when prescribed for pain, methadone is subject to significantly fewer restrictions than when it’s used as a treatment for narcotic addiction. Any physician can apply for a schedule II license from the DEA to prescribe methadone for pain, and since it is a generic, and therefore cheap, option, many insurance plans list it as a preferred medication. Over the last decade, prescriptions for methadone for pain skyrocketed — and with them, so did overdoses. One reason for that is methadone's unique chemical makeup, and the fact that it can build up in a person's body over time. As a result, a person can overdose on a consistently taken amount of medicine if the initial dosage is too high.
The abuse of methadone prescribed as a pain medication is increasing at an alarming pace. A Centers for Disease Control and Prevention study from 2012 found that “six times as many people died of methadone overdoses in 2009 than a decade before.” The same study found that about 5,000 people a year die of “overdoses related to methadone,” and that “methadone contributed to nearly 1 in 3 prescription painkiller deaths in 2009.” This is due in part to methadone bought and sold illegally.
Crucially, evidence suggests that illegal methadone isn't coming from maintenance clinics. Bradford Stone, a spokesperson for the Substance Abuse and Mental Health Services Administration, says diversion of methadone is a serious public health concern. “SAMHSA has conducted three national assessments of methadone-related mortality and in each case concluded that federally certified opioid addiction treatment programs is not a major source of diverted methadone,” says Stone.
And yet the rise in pain-prescribed methadone overdoses has almost certainly negatively impacted methadone patients looking to stay off heroin, creating a need for stricter policies. “I believe, firmly, that the prescribing of methadone in such a wide quantity for such a long period, over a decade, for pain management, has done great damage to the perception and integrity of how methadone is used in treating opiate addiction,” says Mark Parrino, the president of the American Association for the Treatment of Opioid Dependence. “And no one wants to take responsibility for that.”
“Yes, I sold my methadone, but I thought I was selling it to someone who looked very sickly,” Anita Jenkins tells me. Jenkins is an activist with VOCAL-NY and attends a methadone clinic in Brooklyn. A criminal informant had approached her with an empty water bottle she could pour some of her medicine into, which in retrospect she says should have raised some alarm bells. “How convenient for him to have a water bottle,” she says. (This isn't the first time, she says, she's been targeted: On a single day in 2013 she was harassed twice by different sets of detectives within two blocks of her program.)
A defense attorney who has represented at least two methadone patients recently in criminal proceedings in New York City says the trap Anita fell into is all too common. One of the lawyer's clients sold methadone to an informant who also provided his own empty bottle. The client later told the lawyer that he would've just given it away because the guy looked so sick, and he remembered what that felt like. “They're preying on the good nature of people,” says the lawyer, who spoke anonymously because his employer forbids talking with the media.
“I know for a fact that undercovers are involved in this stuff on a routine basis,” says Zachary Johnson, a former Manhattan assistant district attorney. “Just like they're involved in a buy-and-bust for cocaine and heroin deals.” Johnson currently practices law as a civil rights defense attorney, but says that for the 13 years he's been a lawyer the practice of observing patients leaving clinics has been a part of the larger narcotics strategy the NYPD has deployed. “A cynical person might say that person [leaving a methadone clinic] is low-hanging fruit. A cynical person. I'm not saying that I'm saying that.” Johnson hadn't heard of any examples of informants trying to buy take-home bottles, but says if it is happening, that could be a big problem. “If they're just waiting outside clinics and asking to buy bottles, it's borderline entrapment.”
Bob Gangi, director of the Police Reform Organizing Project, goes even farther. “It's an even darker aspect of broken windows policing than some of the arrests and tickets that the cops engage in, because it's actually a form of entrapment.”
Sometimes the harassment methadone patients face comes from aggressive detectives looking to develop a pool of informants, as was allegedly the case for Betty and Randy. But other times the harassment is much more mundane, and comes at the hands of ordinary patrol officers. One such case happened in a small town in Georgia, and was told to me by the sponsor of the clinic. Samantha — a pseudonym — spoke to me on the condition of anonymity out of fear of retaliation by police against her or her patients.
Recently, a few officers in town decided — seemingly on their own — to target patients leaving Samantha's clinic. They'd park in a lot adjacent to the clinic, and when patients pulled out the police would follow them, pull them over for a minor traffic violation, and often charge them with DUIs. “Mostly it was taillight, or you didn't use your blinker coming out of the parking lot, or failing to stop at a stop sign,” says Samantha. “But it was harassment.” As a result, three patients told Samantha they wanted to begin tapering as fast as possible so they could stop coming to the clinic to avoid any possible interactions with the police.
“And of course the thing about our patients is you can't get into methadone treatment without doing something illegal,” Samantha adds. “And so people are paranoid. Legitimately so. That lingers; it takes a long time to get past that.”
She eventually went to the office of the chief of police and told him what was going on. By that time, she estimates that 30 or 40 of her patients had been pulled over. Samantha says the police chief was unaware that any of his officers were engaged in the practice, and when she brought it to his attention he was stunned. He threw a well-worn pocket Constitution down on his desk, said what his officers were doing was profiling, and promised to make sure it stopped. In the two months between that meeting and when I spoke with Samantha, she hadn't had any problems. (I did not attempt to verify Samantha's story with the police chief, as it would have violated my agreement to protect her identity.)
In other cases, an officer might pull someone over not knowing they're a methadone patient, only to have a routine traffic stop escalate once they find that out. Zachary Talbott is the director of the Tennessee branch of the National Alliance for Medication Assisted Recovery, as well as an administrator for what he says is the largest online community for methadone patients and their family, currently with about 3,500 members. Through that closed Facebook group, he's able to get a good sense of how patients throughout the country are dealing with law enforcement and other issues. “That really gives me kind of a pulse. On a daily basis I go in and monitor threads, and I'll see stories across the country of police targeting and profiling methadone patients,” Talbott tells me.
Just a week before I interviewed Talbott last fall, he had gotten a call from a patient who lives in rural Tennessee and drives over an hour each way to the closest clinic, which is in Knoxville, several times a week. When this patient returned back to his home county, he got pulled over for an ordinary traffic stop. The patient had two days' worth of take-homes with him so he wouldn't have to make the trip again the following day. “He happened to have his medication bottles — totally legal — with the lid on them, all the medication still in there,” Talbott tells me. The cops saw the bottles and the patient told them it was methadone. Then, Talbott says, “things went crazy.”
“They pulled him out of the car, they search his car, they throw him in handcuffs,” Talbott says. The cops gave him a field sobriety test, and even though he passed it they arrested him anyway, on a charge of driving under the influence, ostensibly a violation of the Americans With Disabilities Act, which protects opiate addiction as a medical disorder. He adds: “We've got a mound of medical evidence and research showing that maintenance, daily doses of methadone do not cause sedation; they don't impact the ability to operate heavy machinery.”
The cops also impounded his car, so after he posted bond he had to get a ride to the clinic or borrow a car from a friend — all from a traffic stop. “And because he's a methadone patient, he's targeted, he's thrown in jail, and given an unlawful DUI, all sorts of stuff,” Talbott says. “And most patients simply don't have the money to fight it.”
"You're doing what the federal government, the CDC, the National Institute[s] [of] Health, the medical community, and the authorities say is the best treatment you can do," Talbott says. "The most effective. Gives you the best shot at beatin' it ... You're trying to do the best by yourself, your family, your kids, trying to get back on track.” But the stigma attached to methadone endures. “Then you leave the treatment program and you're harassed and targeted by the police and treated like you just left a crack house."
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Sources for Methadone Treatment by the Numbers: SAMHSA, "National Survey of Drug Use and Health," 2013; SAMHSA, "National Survey of Substance Abuse Treatment Services," 2012; CDC National Vital Statistics System, Mortality; CDC, "Increases in Heroin Overdose Deaths," 2014; Scherbaum N, Specka M, et.al., Does maintenance treatment reduce the mortality rate of opioid addicts? Fortschr Neurol Psychiatr, 2002; 2012; VOCAL-NY, "Beyond Methadone: Improving Health and Empowering Patients in Opioid Treatment Programs," 2011.