Pubdate: Tue, 01 Apr 2003 Source: Times-Picayune, The (LA) Copyright: 2003 The Times-Picayune Contact: http://www.nola.com/t-p/ Details: http://www.mapinc.org/media/848 Author: John Pope HEROIN ADDICTION BATTLE CAN MOVE OUT OF CLINIC Doctors Can Prescribe Treatment In Office A new weapon against addiction to heroin and painkillers increases the chances for success because doctors can prescribe it in their own offices without having to send patients to drug clinics, substance-abuse experts told local doctors and counselors Monday. The drug is buprenorphine, a small pill that dissolves under the tongue and can deliver the equivalent of a high dose of methadone, said Dr. Kenison Roy III, a longtime local specialist in substance abuse. The federal Food and Drug Administration approved it in October. Both methadone and buprenorphine keep narcotics from getting to the brain by locking onto the same receptors that they seek out. Once that attachment is made, buprenorphine blocks the craving for drugs such as heroin without creating a high. To prescribe buprenorphine, doctors must take an eight-hour training course. Once they have been approved, they can prescribe buprenorphine from their offices, and their patients no longer have to drive to methadone clinics and wait in line to receive doses. Methadone is dispensed from clinics to prevent abuse. Monday's forum at Ochsner Clinic Foundation was sponsored by the federal Substance Abuse and Mental Health Services Administration to make doctors and counselors aware of buprenorphine as an alternative to methadone, not a replacement. Buprenorphine, made by Reckitt Benckiser Pharmaceuticals Inc., probably will be a boon to rural doctors and their patients because it will eliminate long drives to methadone clinics in cities, said Vernon Shorty, executive director of the Desire Narcotics Rehabilitation Center in New Orleans. But Dr. Rochelle Head-Dunham, regional medical director for the state Office of Addictive Disorders, said it isn't meant to be the only weapon against addiction. She said it must be used in combination with psychiatric treatment and counseling, as well as treatment for other substances that patients may be abusing. So far, about 1,500 doctors, including 18 in Louisiana, have applied for training to use the drug, said Robert Lubran, director of the division of pharmacologic therapies in the federal Center for Substance Abuse Treatment. Buprenorphine and methadone cost about $10 per day. Neither is covered by Medicaid, the government insurance program for low-income people, said Jerry Phillips, a deputy director of the state Department of Health and Hospitals. - --- MAP posted-by: Larry Stevens