The Quick Fix.(opiate abuse)

Byline: editor: Abigail Walch

A sore back. A sprained ankle. Everyday mishaps can lead to a prescription for painkillers--and to abuse. Judith Newman investigates a controversial treatment that claims to kick cravings in days.

When did Valerie Black know she was in trouble? Was it when her doctor increased her fentanyl patch--the powerful opiate that blunted the pain of Crohn's disease and debilitating menstrual cramps--from 25 micrograms to 50? Or 75? Or 100? Was it when she began going through one patch a day, instead of one every three days? No. It had to have been when she and her husband, a prominent California attorney, decided to spend time at their home in Canada and she accidentally left the country one patch short.

"That night, I lay on the ground, screaming," recalls Black (her last name has been changed), a 45-year-old PTA president who, for the past three years, had gotten her fix not from the corner drug dealer but from a pharmacist. "I was crawling out of my skin." Frantic, she rushed to the emergency room of the local hospital and got another patch; it was hardly the first time the ER had seen the fallout from opiate abuse--however unintentional.

When she next saw her regular physician and told him how serious she felt her need for the drug was, he seemed puzzled. She had genuine pain; he had offered her a solution. Would a diabetic not take insulin because she didn't like feeling "dependent"?

But to Valerie, this was not like being a diabetic; it was like being a junkie, except she had never even smoked a joint in her life. And she wanted out. She had heard about a four-day program in Orange County that uses anesthesia-assisted detox: Patients are knocked out and then receive a medication that flushes the opiates from their system and blocks cravings. The treatment condenses withdrawal--which typically means ten unbearable days of sweating, shaking, nausea, and cramping--into about two hours. "I didn't think I could get off the fentanyl by myself," she says. "This treatment sounded like my only hope."

Valerie, a birdlike blonde dressed in jeans and a vintage T-shirt, still trembles (a symptom of the last remnants of the opiates' leaving her system) as she tells me her story. A couple of days ago, she started the Waismann Method, perhaps the country's premier program for rapid detox. Since it launched in 1997, more than 3,000 patients have successfully completed the treatment.