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.
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MAP posted-by: Larry Stevens