Pubdate: Sat, 04 Nov 2000 Source: Bangor Daily News (ME) Copyright: 2000, Bangor Daily News Inc. Contact: http://www.bangornews.com/ 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. TREATING ADDICTION WITHOUT METHADONE 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. - --- MAP posted-by: Larry Stevens