Pubdate: Sat, 11 May 2002
Source: Baltimore Sun (MD)
Copyright: 2002 The Baltimore Sun, a Times Mirror Newspaper.
Author: Tony Tommasello


In his column "Few argue about need for drug treatment -- but many argue 
about where" (April 14), Michael Olesker identified one of the critical 
issues in drug treatment: We need more, but under current policies we are 
hard-pressed to expand treatment.

The outdated Harrison Narcotics Act prevents physicians from prescribing 
Schedule II narcotics for the treatment of addiction. As a consequence, the 
few physicians with experience treating these patients are those who work 
in the regulated specialty clinics.

But as Mr. Olesker stated: "If we believe in treatment of addicts, then 
treat them in a doctor's office."

Indeed, this approach is being researched and showing success. Experiments 
with office-based treatment show drug addicts can be treated successfully 
by physicians who take the time to learn how to do so.

And two years ago, Congress and the president saw that private physicians 
can help solve the treatment shortage and passed the Drug Addiction 
Treatment Act of 2000.

This law allows physicians in private practice to prescribe narcotics that 
have less potential for abuse than such Schedule II drugs as morphine or 
Demerol and are approved for the treatment of heroin addicts by the Food 
and Drug Administration.

Thousands of physicians have completed the continuing education courses 
required under the law and are waiting for the FDA to approve the first 
drug for this purpose.

The tens of thousands of narcotics addicts in our state live, work, see 
doctors and have prescriptions filled with the rest of us. They become a 
source of contention when they are corralled into treatment programs.

Let's instead recognize that they are part of the community of patients, 
and encourage our health policy planners to embrace the concept of 
office-based drug treatment.

Tony Tommasello


The writer is a professor at the University of Maryland School of Pharmacy.
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