Pubdate: Wed, 16 Oct 2002
Source: New Jersey Herald (NJ)
Copyright: 2002, Quincy Newspapers, Inc
Contact:  http://www.njherald.com/news/
Details: http://www.mapinc.org/media/2162
Author: John Brand

NEW DRUG TREATMENT HELPS HEROIN ADDICTS

Heroin addicts going through withdrawal experience intense physical pain 
which weakens their desire to quit the habit.

"Opiate addicts' threshold to pain is essentially zero; the wind blows past 
their nose and (the pain) is perceived as excruciating," said Greg Benson, 
the chief clinical officer at the Sunrise House Foundation in Lafayette. 
"Heroin is the only thing that stops them from hurting."

But new drugs approved last week by the Food and Drug Administration will 
reduce the pain, making the detoxification process more comfortable and 
tolerable. The drugs should also enable drug treatment centers an 
opportunity to retain patients for extended periods of time, which is 
essential in treating addiction.

"This is an aide," Benson said. "This will help reduce the fear (of 
detoxification pain) and allow people to seek out treatment. And it helps 
us to retain them for treatment and address their needs beyond the physical 
because we know addiction isn't only physical." The drugs, 
buprenorphine/naloxene and buprenorphine, are painkillers. The synthetic 
drugs, which will be sold as Suboxone and Subutex, are manufactured by 
Reckitt Benchiser, a British Company.

The drugs, which are placed under the tongue to dissolve, are said to be 
more beneficial than methadone, which is currently used and often abused by 
recovering addicts.

"(Buprenorphine) is a more effective pain suppressant than methadone and 
methadone is highly addictive," said Dr. Phillip Horowitz, chief executive 
officer of the Sunrise House.

The naloxene mixed with the buprenorphine will lessen the euphoric effect 
of the painkiller, therefore negating its street value and addictive 
qualities, Benson said.

A contended issue about the recently approved drugs is that, for the first 
time ever, heroin addicts could get them from general practitioners in the 
privacy of the doctor's office. The doctors must be educated on the drugs 
and have American Society of Addictive Medicines certification, Horowitz said.

"The major benefit of Subutex/Suboxone is that qualified physicians in the 
U.S. will now be able to treat patients with products in the privacy of the 
doctor's office rather than only from the limited number of existing drug 
treatment programs," Reckitt Benchiser spokesman Tom Corran said last week.

This issue causes some concern for those who specialize in treating opiate 
addicts. Opiate addiction is so profound that detoxification is only one 
small step toward recovery. Long-term, intensive treatment, therapy and an 
understanding of the multi-faceted manifestations of addiction are essential.

"Addicts are very desperate. If you give them something without 
supervision, we know it will be used incorrectly," said Horowitz. "We would 
prescribe it and give it here, but patients would have to be involved with 
the treatment program. We wouldn't become a dispensing clinic. (These 
drugs) are for pain management, not treatment of addiction."

Heroin has had a complete makeover during the past 10 to 15 years. Drug 
cartels from South America and Asia have increased the potency of the 
opiate and remarketed it as a snortable drug. In the 1980s, it was weaker 
and a good "high" was attained only by injecting the drug intravenously.

With drugs like Ecstasy, cocaine, ketamine and Ritalin being snorted by 
recreational drug users, snorting heroin is not limited to junkies only -- 
it is being abused by county teen-agers and adults.

Heroin can be addictive after two or three uses, Horowitz said. It is 
readily, available, cheap and very painful to turn away from. "You can buy 
heroin for less than it costs to buy a can of beer and a can of beer won't 
get you addicted," Horowitz said.
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MAP posted-by: Beth