HEROIN ADDICTION BATTLE CAN MOVE OUT OF CLINIC

Doctors Can Prescribe Treatment In Office

A new weapon against addiction to heroin and painkillers increases the
chances for success because doctors can prescribe it in their own offices
without having to send patients to drug clinics, substance-abuse experts
told local doctors and counselors Monday.

The drug is buprenorphine, a small pill that dissolves under the tongue and
can deliver the equivalent of a high dose of methadone, said Dr. Kenison
Roy III, a longtime local specialist in substance abuse. The federal Food
and Drug Administration approved it in October.

Both methadone and buprenorphine keep narcotics from getting to the brain
by locking onto the same receptors that they seek out. Once that attachment
is made, buprenorphine blocks the craving for drugs such as heroin without
creating a high. To prescribe buprenorphine, doctors must take an
eight-hour training course. Once they have been approved, they can
prescribe buprenorphine from their offices, and their patients no longer
have to drive to methadone clinics and wait in line to receive doses.
Methadone is dispensed from clinics to prevent abuse.

Monday's forum at Ochsner Clinic Foundation was sponsored by the federal
Substance Abuse and Mental Health Services Administration to make doctors
and counselors aware of buprenorphine as an alternative to methadone, not a
replacement.

Buprenorphine, made by Reckitt Benckiser Pharmaceuticals Inc., probably
will be a boon to rural doctors and their patients because it will
eliminate long drives to methadone clinics in cities, said Vernon Shorty,
executive director of the Desire Narcotics Rehabilitation Center in New
Orleans.

But Dr. Rochelle Head-Dunham, regional medical director for the state
Office of Addictive Disorders, said it isn't meant to be the only weapon
against addiction. She said it must be used in combination with psychiatric
treatment and counseling, as well as treatment for other substances that
patients may be abusing.

So far, about 1,500 doctors, including 18 in Louisiana, have applied for
training to use the drug, said Robert Lubran, director of the division of
pharmacologic therapies in the federal Center for Substance Abuse Treatment.

Buprenorphine and methadone cost about $10 per day. Neither is covered by
Medicaid, the government insurance program for low-income people, said
Jerry Phillips, a deputy director of the state Department of Health and
Hospitals.