Saturday, August 21, 2004
Woman jailed for listening to doctor
The case presents a conflict between law enforcement and the medical needs of recovering addicts.
Caught in the middle, Bucklin sits in the Tazewell County jail. At a hearing Friday, Judge Henry Vanover was asked to reconsider his earlier decision to sentence Bucklin to three years in prison for violating her probation by receiving treatment at a methadone clinic run by the Life Center of Galax.
The case, reopened at the request of the American Civil Liberties Union and drug treatment advocates, presents a conflict between law enforcement's fight against drug abuse and the medical needs of recovering addicts.
"It really, really is a medical decision and not a legal decision," Bucklin's attorney, Tom Scott, said of her need for methadone. Vanover delayed making a decision Friday after hearing testimony in Tazewell County Circuit Court.
Last year, Bucklin was charged with child abuse and possession of OxyContin. Following her arrest, she became a patient at the Life Center's satellite clinic in Tazewell County.
"I would say her response was dramatic, positive and very rapid," said Dr. Robert Newman, director of the Chemical Dependency Institute of Beth Israel Medical Center in New York.
Testifying as an expert witness, Newman said methadone is an effective treatment for addicts of opium-based drugs. Studies have shown that the drug, when properly administered, reduces criminal activity and allows addicts to live normal lives.
But in what Newman called a "terrible conflict," Bucklin was ordered in June 2003 to discontinue all use of methadone within six months as a condition of her probation and a six-year suspended prison sentence.
Against the medical advice of the clinic physician, the 29-year-old began to gradually reduce her daily dose of methadone. But after she suffered cravings and withdrawal symptoms, the clinic restored her to a higher dose and continued her treatment past the six-month deadline.
In February, Bucklin was charged with violating her probation. She has been in the county jail ever since - except for a brief hospital stay shortly after she was locked up, when she was treated for severe methadone withdrawal.
Tazewell County Commonwealth's Attorney Dennis Lee said judges in the area routinely forbid probationers from taking methadone at a clinic. Bucklin is the first person in the county sentenced to prison for violating such an order, he said.
Bucklin's dilemma raises a new question for judges in Southwest Virginia, which had no methadone clinics until the first one opened in Galax several years ago to deal with a rising OxyContin abuse problem. The Life Center has since opened a second clinic in Tazewell County, and the company that owns both facilities is planning a third one in Northwest Roanoke.
It is unusual for methadone patients to be sent to prison for taking a medication that is supposed to keep them out of trouble, according to Mark Parrino, president of the American Association for the Treatment of Opioid Dependence.
"Despite the fact that the federal government has spent millions in research to determine that methadone is the gold standard for treating opioid dependence, you still have what I would call unenlightened and misinformed representatives of the law enforcement community," Parrino said.
Some authorities have questioned the wisdom of methadone treatment, saying that it only replaces one addictive drug with another. Critics also say that methadone from clinics can easily find its way into the wrong hands, generating crime and feeding a prescription drug abuse epidemic that has overtaken much of far Southwest Virginia.
Although Lee declined to comment after the hearing about his personal views on methadone treatment, many of his questions to Newman contained themes often raised by critics.
What incentive would a doctor at a for-profit clinic have to wean a patient off the $11-a-day treatment? he asked. And is it true that many patients remain on methadone for life?
"Many of them do, and many of them should," Newman responded, likening the treatment to insulin for diabetics.
The danger with a judge ordering someone off methadone is that it often prompts the addict to return to the original drug at a time when he or she has a low tolerance because of treatment, creating a danger of a fatal overdose, according to a brief filed by Scott and ACLU attorneys.
Lee may present a different view. He asked Vanover to delay a decision until Lee can prepare his own evidence. Although a second court date has not been scheduled, Scott said it could be October before the case resumes.
Last month, when Vanover sentenced Bucklin to three years in prison for violating her probation, it seemed to come as a shock to then-defense attorney Penny Nimmo, according to the following exchange in a court transcript:
Nimmo: "Your honor, would the court consider suspending a portion of that sentence?
Vanover: "I sure won't. Anything else?"
Nimmo: "Your honor, this is her first probation violation."
Vanover: "She's got three years to serve. Anything else?"
Nimmo: "Thank you."