Pubdate: Thu, 19 Jul 2007
Source: Baltimore Sun (MD)
Copyright: 2007 The Baltimore Sun, a Times Mirror Newspaper.
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?136 (Methadone)

HELPING ADDICTS

The first interim report on Baltimore's efforts to reduce heroin 
addiction through expanded use of a promising drug shows that the 
city's strategy is working relatively well, but that results could be 
even better with broader participation by doctors and hospitals. In a 
city with such abundant medical talent, that should not be an 
impediment to helping eliminate a major scourge.

Baltimore's buprenorphine initiative is a worthy effort, led by the 
city's Health Department, to help addicts by using a synthetic opiate 
that is an effective antidote to heroin. Buprenorphine is not as 
habit-forming as methadone and can be managed more privately under 
medical supervision, through teaching hospitals, community health 
centers and group practices. The state has also been reaching out to 
private physicians and training them in prescribing the drug and 
managing patients who take it.

Beyond physician outreach and training, Baltimore, with a larger and 
more intensely addicted population than elsewhere in the state, has 
effectively beefed up its buprenorphine efforts with two important 
ingredients. For starters, patients first receive the drug while 
enrolled in a treatment program, where the chances of success are 
enhanced by individual counseling, group therapy and other 
therapeutic services. Before leaving the program, a patient is 
assigned a social worker who helps secure health insurance and other 
services. In addition, the social worker connects the patient to a 
doctor trained to help manage the addiction with buprenorphine as 
well as tend to the patient's other medical needs.

In its first nine months, the initiative enrolled 388 patients and 
just about reached its goal of keeping two-thirds of them in drug 
treatment for at least 90 days. Nearly 80 percent of patients were 
able to qualify for health insurance, and almost all are expected to 
secure coverage so that they can receive the drug from a doctor. But 
only 50 Baltimore doctors have completed the training, out of 93 who 
signed up. Those are disappointing numbers for a city with so many 
top-flight medical facilities.

City officials can engage in more-aggressive outreach, but the 
medical establishment should also make this a priority. On top of 
their addiction, those who are hooked on heroin and have other 
untreated medical conditions cost the medical system - and society - 
millions of dollars. More medical professionals stepping up to the 
plate could save money, not to mention lives.
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MAP posted-by: Beth Wehrman