If scientists at the forefront of federal research on drug treatment have their way, methadone and other drugs used to treat heroin addicts will move out of clinics and into doctor's offices and pharmacies. It's possible that buprenorphine, the latest drug for treatment of addiction to heroin and other opiates, will be in pharmacies by this summer, according to one leading researcher.

"Office-based methadone treatment would represent an enormous step forward in treating heroin addiction," says Alan Leshner, director of the National Institute on Drug Abuse (NIDA), in response to a new report in the Journal of Urban Health: Bulletin of the New York Academy of Medicine. "This study shows that practitioners understand that their addicted patients are suffering from a treatable disease, and they are willing to provide that treatment."

Sharon Hall, a researcher at the University of California at San Francisco whose study on methadone treatment appears in the Journal of the American Medical Association, concurs: "My feeling is anything that moves drug addiction treatment from clinics to physician's offices and pharmacies is a major step. It takes it from a moral issue to a medical issue."

The past five years have seen a 25 percent increase in heroin use. There are now an estimated 800,000 heroin addicts in the United States, and only 180,000 of them are being treated with methadone. Drug treatment specialists have been trying for many years to loosen strict federal and state regulations that require methadone to be administered at public clinics. They argue that many more people would undergo treatment for their addictions if it wasn't provided only at clinics. The stigma of going to such clinics often keeps addicts away, as does the requirement to come to the clinic every day to get a methadone dose. "There's a group of addicts who refuse to go to clinics," says Frank Vocci, director of treatment research and development at the NIDA.

Even the National Academy of Sciences and the National Institutes of Health have recommended integrating methadone treatment into general medical practice as a way to increase the number of individuals receiving treatment.

One of the reasons there is strong support for moving heroin treatment out of clinics and into mainstream medicine is the increased use of potent, cheap heroin by middle-class suburbanites and teenagers in small towns across the country -- from high-class suburbs outside Chicago to bucolic towns in Vermont. They start by snorting and smoking heroin and wind up with habits they cannot break, drug enforcement officials say.

"Many of the users are lulled into a false sense of security, believing that because they inhale heroin, they are less likely to become addicted to it," said Drug Enforcement Administration agent William Nelson in testimony before a congressional committee last year. "As a result, we're seeing a rise in first-time heroin users."

The phenomenon of middle-class heroin use is so new that officials are just starting to compile statistics. By one measure, emergency room visits for heroin rose from 33,000 in 1990 to 70,000 in 1997. And the number of teens seeking emergency treatment for heroin showed a "dramatic increase," Nelson testified. In the Philadelphia region and other metropolitan and suburban areas, heroin is on its way to eclipsing crack cocaine as the drug of choice.

"More 20-something professionals are showing up as heroin addicts," says Jeremiah Daley, head of the Philadelphia Police Department's narcotics unit. "They aren't all doctors and lawyers, but enough people working important jobs are using dope. We locked up a school-bus driver the other day. It's frightening. Young, white suburban housewives are becoming as common as middle-aged African-Americans."