Addicts’ angel

Kim Smith

Monday, Feb. 28, 2000 | 11:10 a.m.

Her friends say she is addicted to addictions. Her husband says she's an angel. Her patients say she's a godsend.

If you ask Miriam Adelson why she has opened a new nonprofit heroin clinic, she'll give you a more practical answer.

"I'm a physician."

Today marks the official grand opening of the Adelson Clinic for Drug Abuse Treatment and Research. The clinic at 3661 S. Maryland Parkway is the twin of one opened by Miriam Adelson and her husband, Venetian hotel-casino owner Sheldon Adelson, in Tel Aviv, Israel, seven years ago.

The couple are hoping to repeat or improve the success they've had in Israel. Adelson said 83 percent of her patients stay in treatment for one year and 70 percent are heroin-free by the time they've spent 18 months in her program.

Patients are provided the synthetic drug methadone to ease their craving for heroin and are given the opportunity to attend therapy sessions, seminars, health classes and 12-step meetings.

Patients pay what they can afford, Adelson said. The clinic, which actually opened three weeks ago, is open from 5 a.m. until 2 p.m. daily.

Adelson's interest in heroin addiction goes back several years. She received her bachelor of science degree in microbiology and genetics from Hebrew University in Jerusalem and then attended medical school at the Sackler Medical School at Tel Aviv University, where she graduated magna cum laude. Later she specialized in internal medicine at the Tel Aviv Medical Center and became an associate physician at Rockefeller University in New York, where she studied addictive diseases.

Adelson saw close-up the results of heroin addiction while working in the emergency room in the Tel Aviv Medical Center.

"I would have the prostitutes come in with overdoses, and I felt a lot of compassion for them," Adelson said. "They were forced to go out to work, to sell their bodies because of the heroin, and they couldn't stop, though they wanted to."

While she was in New York in the late 1980s, Adelson learned that 60 percent of the people being treated for heroin addiction were HIV-positive. She also discovered that the addicts being treated with methadone were less likely to contract AIDS.

"It (methadone) protected them from the streets. They got the methadone and they didn't need heroin and they didn't share needles," Adelson said. "Sharing needles and behaving in irresponsible ways can cause the spread of infectious diseases."

Because Israel had yet to see a significant number of AIDS-related cases, Adelson felt it imperative she share her knowledge with her colleagues and the public back home. Once there, she convinced the director general of the hospital, Dan Michaeli, to allow her to open the first Adelson clinic.

There was a huge stigma attached to heroin addiction and methadone in Israel back then, Adelson said. Few understood that heroin addiction is a disease and methadone its treatment. No one had yet made the comparison between methadone as a treatment for heroin and insulin as a treatment for diabetes.

"At that time in Israel, they would treat (heroin addicts) in a way I didn't approve," Adelson said. "They would have a trailer outside the city next to a garbage place. I told them they (addicts) are not bad people. They are normal people who have a disease."

While heroin is better understood nowadays here and in Israel, the debate over methadone continues. Some physicians believe that heroin addicts are simply trading one addiction for another when they switch from heroin to methadone.

Adelson could not disagree more.

Studies have shown that 80 percent of heroin addicts will relapse and use heroin again if they are not kept on a lifelong methadone program, Adelson said. Rather than risk relapses, most addicts are better off staying on methadone.

"Of course it would be great to be clean, to be drug free, but in this case you have to balance, to weigh," Adelson said. "What is better? To be drug free (relapse and later) contract AIDS, conduct criminal activity, contract hepatitis, beat your wife, be homeless and waste all of your money, or start work, stop criminal activity, don't get AIDS, don't get hepatitis and be a normal human being?"

Brad, 44, and Connie, 41, are among the 30 or so patients who have already found their way to the Las Vegas clinic. The couple, who asked that their last names not be used, have been battling their heroin addiction for more than 20 years.

The staff at the Adelson clinic has made them feel welcome, Connie said. They haven't been threatened with expulsion because they can't consistently pay on a certain date or because they have relapsed.

"The people at the other clinics I've been to have made me feel uneasy," Connie said. "I've met some rude, obnoxious people and I always felt like they were looking down on me."

"We've said that it's a miracle for us," Brad added. "I feel like God's guided us to this place."

Adelson said she doesn't know why some clinics have turned away patients for using heroin.

"I cannot understand. If I am a diabetic and I am eating sugar, would a doctor stop treating me?" Adelson asked.

The only patients she will turn away are those who become violent and those who try to deal drugs inside her clinic, Adelson said.

She wants everyone to feel welcome. That is why there is a shower available for the homeless, and patients are treated to free coffee and Danish pastry, Adelson said.

Gary Pfifer, a certified drug and alcohol counselor and the clinic's program director, said he agreed to work for Adelson specifically because of her views.

"She views our patients as people, and they don't need to be treated in a way that makes them feel worse than they already feel," Pfifer said. "We are going to place a major emphasis on the counseling aspect. We're going to tell our patients not to worry and to take their time. We want them to know that it doesn't matter if they get off methadone or not. We want them to look at the type of life they are living."

Pfifer said he is also impressed with the Adelsons' vow to keep to a 1-to-30 staff-to-patient ratio. He has worked at other clinics where the ratio was 1 to 80.

Adelson said she hopes to treat up to 200 patients at the Las Vegas clinic, but if necessary, a second or a third clinic isn't out of the question. She also plans to conduct some research in the hopes of finding out what role genetics play in heroin addiction, if addictive personalities can be predicted and why some addicts seem doomed to relapse again and again.

"I am a physician. It is who I am," Adelson said. "I want to help."

Kim Smith covers courts for the Sun. She can be reached at (702) 259-2321 or by e-mail at kimberly@lasvegassun.com.