EFFECTIVE HEROIN TREATMENT

'Bup' Offers Great Potential in the Fight Against the Deadly Drug

Heroin abuse plagues many of our communities, bringing drug-related
crime and violence and tearing families apart. Roughly 1 million
people in the United States are addicted to heroin, according to the
Office of National Drug Control Policy.

There are no easy or quick solutions to this epidemic, but effective
treatment programs can and must play an integral role as we fight
back. In recent years, a new anti-addiction medicine called
buprenorphine has revolutionized the way we treat heroin addiction,
and Congress recently acted to make it more widely available.

One of the difficulties in the fight against drug abuse has been a
lack of effective treatments. This was especially true for recovering
heroin users, who for many years depended on methadone, itself an
addictive drug that was dispensed only in centralized clinics often
located far from those seeking treatment.

However, in the early 1990s I learned of buprenorphine, widely known
as "bup," which drastically improves the way we treat heroin
addiction. Bup functions as a drug "blocker," suppressing the craving
for heroin and other opiate drugs, including prescription
painkillers. To learn more, I visited drug treatment centers and
research labs and worked to foster a national dialogue on addiction
and treatment.

In 2000, the bipartisan Drug Addiction Treatment Act, which I
sponsored with a Republican colleague, Sen. Orrin Hatch of Utah,
authorized physicians to prescribe and dispense bup in their private
offices pending approval by the U.S. Food and Drug Administration,
which came in 2002.

DATA permitted physicians to dispense bup if they had received the
specialized training required under DATA, were able to refer patients
to counseling and other related services, and agreed to treat no more
than 30 patients at a time.

This year, I hosted a symposium with Hatch that brought together
physicians, health policy experts and patients to review the results
of the first three years of office-based bup treatment.

Overwhelmingly, experts agreed that bup has successfully helped many
people rehabilitate their lives. A survey required by DATA and
completed by the Department of Health and Human Services found that
bup has been effective and well-received among patients, shown
minimal adverse effects and increased the availability of
medication-assisted treatment programs.

Some of the most dramatic portions of the symposium came during the
testimony from patients whose lives have turned around since being
introduced to bup.

One of these patients was a college student in Boston who spent more
than three years in the grips of heroin addiction. During that time,
she underwent methadone detox 10 times- 10!- before bup helped her to
feel "normal for the first time in three and a half years." She
returned to school a short time later, has been on the dean's list
ever since and is on track to graduate this spring.

The Senate symposium also highlighted a troublesome limitation on the
use of bup. Too many physicians have been forced to deny treatment to
potential patients because they are already at the 30-patient limit.

This was a tragic and arbitrary limitation for thousands of Americans
who could benefit from bup, so Congress recently passed an amendment
I authored with Senator Hatch to increase the limit to 100 patients
per physician. The president is expected to sign it into law this year.

With this important change, which will more than triple the number of
patients with access to bup in their physicians' offices, we are
closer to fully realizing the lifesaving, family-saving and
community-saving potential of bup.