Pubdate: Sat, 04 Nov 2000
Source: Bangor Daily News (ME)
Copyright: 2000, Bangor Daily News Inc.
Author: Robert Q. Dana
Note: Robert Q. Dana of Bangor is a drug-addiction specialist at the 
University of Maine and the chairman of the Treatment Subcommittee of 
Communities against Heroin.


There has been a long and difficult discussion re-garding opiate dependence 
and treatment occurring in Bangor for almost one year. There are 
significant changes in the treatment of drug dependence being reported 
almost every day and today a very important option in the treatment of 
opiate problems has become available.

The Washington Post reported Oct. 19 that heroin addicts will be able to be 
treated for heroin addiction with an exciting and effective new drug in the 
privacy of a doctor's office under a bill signed into law by President 
Clinton late Tuesday. Instead of going to a methadone clinic, opiate 
addicts will be seen by private physicians in their offices and given 
prescriptions for the highly effective, but mild narcotic buprenorphine. An 
effective program of recovery will also include counseling services, job 
training and self-help groups.

The availability of this approach will make treatment much more broadly 
available and because it does not require attendance at a methadone clinic 
it should help reduce the stigma of opiate addiction and encourage more 
people to get help with this type of problem.

Without the problems associated with methadone, buprenorphine prevents 
opiate addicts from painful withdrawal and it also prevents the euphoria 
people experience with heroin and other prescription narcotics. Consistent 
with the recommendations of the Communities Against Heroin Treatment 
Subcommittee, the availability of buprenorphine offers an excellent 
alternative to methadone in that it is longer lasting, less addictive, and, 
because it does not suppress breathing, it is less likely to trigger a 
fatal overdose than methadone or other opiates.

There is also no diversion risk associated with buprenorphine. A critical 
advantage is the fact that buprenorphine can be administered in physicians' 
offices, thus moving addiction treatment away from government-sanctioned 
clinics consequently eliminating the need for these clinics and eliminating 
the current controversy in Bangor of whether to locate a clinic in the city.

This is a compassionate and cutting-edge treatment that will be marketed 
under the names Subutex and Suboxone. The drug will be available in tablet 
form that opiate-dependent patients would simply place under their tongues. 
The treatment is expected to be available for opiate detoxification and 
maintenance as soon as January.

Given this remarkable turn of events it seems reasonable that the state 
Office of Substance Abuse and Acadia Hospital withdraw their plans for a 
methadone clinic in Bangor and instead fully turn their attention to the 
important issues of prevention and to the utilization of this cutting-edge 
and less controversial approach.
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