Methadone: Not Just for Junkies Anymore 

As the drug moves beyond methadone clinics and into everyday use as a painkiller, overdoses related to its slow-onset effect are growing increasingly common. The very traits that help heroin addicts can kill other drug users.

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That summer, at the tail end of an internship at Diablo magazine, Simon spilled a gin and tonic on a hauntingly beautiful, hollow-eyed woman at a bar. Frances Duff, 24, worked the register at Trader Joe's in Castro Valley, took classes at Chabot, and shared custody of her curly-haired two-year-old son. The attraction was immediate, and intense. On their third or fourth date, she told me recently, Simon caught her off-guard by declining a drink refill. "I don't need one," he said. "I loaded up on morphine at home."

Frances didn't miss a beat. "I asked him why he hadn't brought some for me," she recalled. On their next date, he did. She said she almost overdosed.

Classes started up again. Simon seemed preoccupied, but I chalked it up to his new job as a graduate student instructor, which required him to teach several sections of an undergrad communications class. It was a prestigious position that came with a $1,500 monthly paycheck, a hefty tuition reduction, and a massive workload. Then one day midway through the semester he showed up to school with his eyes glazed and his mind dazed in a way I'd never witnessed. When I asked, he insisted he was fine.

"He'd blow his entire paycheck on drugs," Frances recalled. "He'd come home from teaching, flop on the bed, wake up an hour later, and crush pills." But he'd also help her with her schoolwork and gladly watch her son while she was in class. "He was always telling me how intelligent I was," she said. They hadn't been dating long when Simon occasionally began adding heroin to the mix, showing her how to drop a pearl-sized ball of tar into an uncapped Visine bottle, add water, and drip it into her nose.

"As long as he didn't put anything in his veins, he thought he'd be fine," Frances said. "I didn't tell him otherwise. I was right there with him."

She was no novice, either. She'd been popping a medley of prescription pills since her junior year in high school. He'd taken up the habit at the wise old age of 23 or 24. OxyContin was his mood-booster of choice, but he experimented with other meds, and invested in a copy of the Physicians' Desk Reference to figure out "what shit would fuck him up the best" — as Aaron Tyree, Simon's friend and former roommate in Ohio, put it recently.

"He could never find that plateau that was enough for him," Tyree said. "He burned as brightly as he could, and was constantly seeking out fuel. Sometimes he'd look at himself and think, 'I don't want to be a junkie.' But then his ego would come into play and he'd say, 'I'm not. I do this for fun.'"

Whatever Simon was up to didn't look fun. His long fingers trembled all the time, and he'd pretty much abandoned the guitar. Frances remembers making their bed in the morning and brushing off the skin that had flaked off his dehydrated body during the night. But we'd drifted apart, and I didn't offer to help. Director of admissions Michele Rabin tried to. She called Simon into her office, explained that friends and professors had expressed concern, and gave him a list of substance-abuse support groups and a referral to a counselor at the student health center. "I have no idea if he ever followed up on any of these things," she said.

Simon flew home for Christmas, but stayed just two weeks instead of four. "I'd been worried about him for a while, but when he visited for the holidays I thought, 'God, he really doesn't look that good,'" recalled his lifelong friend Nathan Singer. Growing up, Simon didn't do anything that 90 percent of young people don't do, Singer said. In earlier years they'd often mused about how their full-throttle lifestyles would put them underground before they hit thirty. "It was one of those things that a lot of young men talk about," he explained. "It wasn't a scared thing. We just shared this feeling of having to get a lot done in a very short period of time, because we really didn't know if we'd live very long."

Tyree remembered that Christmas as the one time Simon spoke about his addiction: "I could see he was scared. There we were, in the middle of a strip club at a bachelor party, and he's telling me, 'I have a serious drug problem.' But that was all he said. He knew the only thing that was going to stop him from doing it was himself. I told him I'd take him to rehab, right then and there, or he could stay in Cincinnati with me. He said, 'I'll be okay. Let's get another drink.'"

In February 2003, The New York Times published a story on the spike in methadone deaths, calling it a "killer drug." But experts agree that, when used correctly, methadone is no more dangerous than any other narcotic analgesic. The key, they say, is that doctors need to know how to dose it, and patients need to carefully follow their instructions. This coming year, the federal Center for Substance Abuse Treatment plans to roll out a California pilot program for doctors treating patients with methadone. "We think education will make a big difference," director Robert Lubran said.

Methadone's double-edged sword is its half-life, which is longer than that of any other prescription opiate. As a result, it can take hours to feel, far from the instant relief that pain patients may expect — or the insta-bliss recreational users count on. And half the dose remains in the body from one to four days. Thus, people who use other drugs or down a few drinks within that time frame are playing with fire.

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