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. - --- MAP posted-by: Beth Wehrman