Pubdate: Sat, 07 May 2005 Source: Edmonton Sun (CN AB) Copyright: 2005, Canoe Limited Partnership. Contact: http://www.canoe.com/NewsStand/EdmontonSun/ Details: http://www.mapinc.org/media/135 Author: Mindelle Jacobs Bookmark: http://www.mapinc.org/find?143 (Hepatitis) Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/find?136 (Methadone) 'BUPE' IS NEW HOPE FOR HEROIN ADDICTS For the first time in four decades, a new drug to treat people addicted to heroin and other narcotics is about to be introduced in Canada. Recently approved by Health Canada, buprenorphine, or "bupe" for short, is expected to be on the market by the end of the year, following training sessions for doctors. Manufactured by Schering Canada, Inc., bupe will be sold under the brand name Subutex. Until now, methadone has been the only replacement therapy available in Canada for people hooked on heroin and other opiates. But methadone carries a certain social stigma as well as a risk of abuse and overdose. With bupe, however, there is less chance of an overdose, less stigma and fewer withdrawal symptoms, says Dr. Anita Srivastava, of the Centre for Addiction and Mental Health. While it won't replace methadone, which some patients will prefer, bupe provides another option, she says. "We're really looking forward to having it on the market," she says. "It's unfortunate we haven't had it sooner." Srivastava says buprenorphine is no more effective than methadone. But some recovering addicts consider it virtually a miracle drug. Wired magazine did a feature on bupe last month and interviewed a 28-year-old American heroin addict who'd repeatedly been in detox trying to beat the habit. When he was in a New York rehab facility last year, he was given bupe instead of methadone. "It took away the pain," he told Wired. "It even took away the craving," he said. "I got clarity when I took that first pill." Two recovering heroin addicts were quoted in an Associated Press story last week, describing how bupe has enabled them to lead normal lives for the first time in years. Bupe has been available in the U.S. since 2002 but health professionals are complaining that the strict rules are preventing addicts from getting the drug. In the U.S., for instance, physicians can treat no more than 30 bupe patients at a time. The fear is that doctors will inappropriately prescribe the medication and the drug will be abused. U.S. doctors are allowed to prescribe take-home supplies. But one of the interesting things about bupe is it's pretty hard to overdose on it. Subutex has a so-called "ceiling effect" - bigger doses are unlikely to produce a greater high. The idea is that addicts who misuse bupe by taking increased amounts of the drug simply plateau instead of overdosing. Bupe is also sold in the U.S. in another formulation called Suboxone, which contains an ingredient that thwarts the abuse of bupe. If patients crush and inject the pills instead of letting them dissolve under their tongues, they suffer horrible withdrawal symptoms. For now, in Canada, only Subutex will be available and addicts will only be prescribed take-home pills on weekends. To prevent potential misuse, patients will be expected to take a daily dose supervised by a health-care professional. A national medical advisory board has been set up to develop an education program to train physicians who wish to prescribe bupe, says a Health Canada spokesman. These little pills could revolutionize the way we treat heroin addicts. It's estimated there are more than 100,000 people addicted to opiates in Canada but only 25,000 are in rehab programs. The social and health costs are enormous. Many addicts steal or prostitute themselves to get drugs. They also share needles, infecting themselves with HIV and hepatitis C. Injection drug use is now the main cause of HIV transmission. Bupe is at least as good and possibly better than methadone as a replacement therapy, says University of Alberta pharmacologist Dr. David Cook. "Plus, addicts seem to like it better," he adds. Bupe could dramatically curb addiction, reduce crime and stem the spread of disease. - --- MAP posted-by: Elizabeth Wehrman