Doctor helps addicts 'sleep away' habits Treatment: For $2,800, a New Jersey doctor will put a heroin addict to sleep and painlessly rid his addiction in four hours. But his method is much criticized.

December 26, 1997|By Jonathan Bor | Jonathan Bor,SUN STAFF

MERCHANTVILLE, N.J. -- When Dr. Lance Gooberman set out to market "rapid heroin detoxification" to middle-class addicts along the East Coast, he came up with an ingenious strategy. He posted billboards along roads leading out of town.

His strategy worked. In just two years, he has treated 1,000 addicts, many of them suburbanites who saw the signs after completing deals in the drug markets of Baltimore, Philadelphia, and Camden and Newark, N.J.

"We're targeting suburbanites," said Gooberman, who operates a full-time "detox" practice in this crusty small town just miles from the drug markets of Camden and Philadelphia. "People are coming out of the city saying, 'Oh ----, I did it again."

Nobody disputes the success of his pitch, which holds out the possibility of a less painful withdrawal to people who can pay $2,800 up front. How well this works is a matter of intense debate.

In simplest terms, the addicts who flock to his office begin their recovery in a deep, anesthetized sleep that lasts four hours.

Surrounded by heart monitors and oxygen equipment, they lie on beds where they are given naltrexone, a drug that compresses into a few hours a physical withdrawal that would normally take days to accomplish. As they sleep, they remain oblivious to the nausea, stomach cramps and irritability that would grip them if they were awake.

Patients also receive a naltrexone implant, a time-release tablet that robs heroin of its satisfying buzz for about a month. When the pill wears off, they can invest $475 in a new one, take daily pills for less or attempt abstinence on their own.

Gooberman says he is giving patients a comfortable start to recovery, the crutch some people need to even contemplate getting clean. Critics allege that he is holding out the false hope that recovery comes painlessly and without a lifetime of work.

"The only thing that detox accomplishes is it wipes out the physical dependence," said Tony Tommesello, director of substance abuse studies at the University of Maryland School of Pharmacy. "But the hard part is the psychological drive that compels people to seek drugs. That's what therapy is about."

None of this has diminished Gooberman's belief that he is onto something. He sees the day when doctors all over the region, even the world, will refer addicts to him, when his practice will be regarded as a "center of excellence" for heroin withdrawal.

Although his billboards might create the impression of a "quick fix," Gooberman maintains that he is only giving addicts a palatable way to clear the hurdle of withdrawal. After that, patients must cope with a psychological craving that might last weeks, years or perhaps the rest of their lives.

For this, he recommends the 12-step recovery programs offered by Alcoholics Anonymous or Narcotics Anonymous. He has no idea how many attend meetings on a regular basis or, for that matter, whether rapid detox leads to long-term sobriety. He says many of his patients have remained clean for months, but acknowledges that others slip back into heroin use.

"I'm not holding this out as a cure," said Gooberman, a stocky redhead with a bouncy demeanor. "What we're doing is breaking down the barriers to getting clean. And the first big barrier is this horrendous sickness that I want them to sleep through."

One recent morning, before the town's main street came to life, Karen Alexander pulled up to the plain office building that houses Gooberman's clinic. She had driven from Bloomington, Ill., with her 24-year-old son, Bradley, a heroin addict for two years.

A few weeks earlier, Bradley checked himself out of an Illinois rehabilitation center, declaring that he hated the tough rules, the stark room that lacked so much as a television set, and the certainty that he would suffer through several days of agony.

Time to act

Around the same time, his mother happened to see Gooberman on the "Montel Williams" television show. She thought his program sounded more humane, and she liked the doctor's enthusiasm. Shown a videotape, Bradley agreed.

"It was just time to do something about it," said Bradley, who had dark circles under his eyes and heavy lids that were barely open. "I'd tried to kick a couple times but I'd last about three days. You get so you can't take it. You get chills, you throw up, you can't sleep. It's just kind of hard to explain."

His grandparents paid the bill.

Bradley describes his family as comfortably middle-class. His mother works for an elected official. His father is a farmer, and moonlights as a forklift operator at a Nestle plant. Bradley once did pretty well himself. He worked construction, lived on his own and surrounded himself with material possessions: two motorcycles, gold jewelry and purebred dogs.

All this fell apart when he accepted a friend's offer of heroin. Before long, he had spent his savings, lost his job and sold everything but his dogs.

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