Pubdate: Sun, 05 Mar 2006
Source: Boston Herald (MA)
Contact:  http://news.bostonherald.com/
Address: PO BOX 2096, Boston MA 02106-2096
Fax: 617-542-1315
Copyright: 2006 The Boston Herald, Inc Author: Laura  Crimaldi
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

MASS. DOCS TOUT HABIT BUSTER: DRUG AIDS OPIOID USERS

As the Bay State faces an explosion in OxyContin and heroin abuse, 
Massachusetts doctors are outpacing much of the country with their 
interest in Suboxone, the new "addiction-busting" drug for opioid abusers.

Of the 7,500  doctors authorized to prescribe Suboxone nationally, 
413 are from the Bay State,  making Massachusetts one of the top 10 
hubs for the drug nationally, said Nick  Reuter, senior public health 
analyst for the federal Substance Abuse and Mental Services Administration.

"There is more  use of these products in New England than in any 
other part of the country,"  said Reuter. New York and California 
have the highest numbers of physicians authorized to prescribe the 
drug, he said.

Suboxone, which  is manufactured by the British company Reckitt 
Benckiser Pharmaceuticals Inc.,  is a combination of buprenorphine 
and naloxone. Buprenorphine is a partial  opioid agonist. It curbs 
cravings for heroin or narcotic painkillers by binding  to the same 
opioid receptors those drugs target in the brain.

"I think it's a  good drug. It's not a panacea, but it helps them get 
into treatment," said Dr.  Ronald Pike, medical director at 
Worcester-based AdCare Hospital.

Suboxone users  may suffer from heroin, prescription painkiller 
addiction or both. Some patients  are able to detox completely on 
Suboxone, but most end up using it as a  maintenance drug, doctors 
said. Many clinicians also require their patients to  be in therapy 
while on the drug.

"The success  rate, based on the literature and my experience, is 50 
percent sober in six  months. which is far better than anything else 
that's around," said Dr. Ira  Mintzer, director of continuing medical 
education at Cambridge Health Alliance.

Doctors must  complete eight hours of training to get a waiver to 
prescribe the drug. Reckitt  Benckiser funds the training, but it 
does not have control over the content,  said company spokeswoman 
Harriet Ullman. The trainings are administered by four  medical 
societies, including the American Society of Addiction Medicine.

Federal  regulations prohibit physicians from having more than 30 
patients on the drug at  a time.

Suboxone has its  critics. Dr. P.S. Kishore, founder of the National 
Library of Addictions in  Brookline, only prescribes the drug for 
patients undergoing detox in a clinic.  Last year, six to eight 
percent of his new patients tested positive for  Suboxone, he said. 
Kishore believes they got the drug on the street. "The problem  with 
outpatient maintenance is that it's very hard to get them off. Once 
you  give them the candy, they don't want to give it up," Kishore said.
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MAP posted-by: Beth Wehrman