NEW DRUGS APPROVED FOR ADDICTS

May Be As Effective As Other Treatments

In years to come, drug addiction probably will be treated like
hypertension, diabetes and other chronic, relapsing diseases: with a
variety of medications prescribed in the doctor's office.

This month, the Federal Drug Administration announced the approval of two
prescription drugs for heroin addicts: buprenorphine, a partial opiate that
produces minimal mood alteration, and buprenorphine- naloxone, a
combination with an opiate blocker.

Studies during the past decade suggest these medications may be as
effective as methadone in reducing opiate use and retaining addicts in
treatment programs.

Methadone - the treatment of choice since the 1960s - produces a high when
taken orally, even more so when injected. But buprenorphine- naloxone does
not produce euphoria when taken orally, and if injected it will make an
addict feel sick.

Buprenorphine-naloxone also has a much lower potential for overdose and
withdrawal symptoms than methadone, and it has to be taken less frequently
- - once every two to three days as opposed to daily.

Even more important, buprenorphine-naloxone can be dispensed in the privacy
of a doctor's office, a result of the Drug Addiction Treatment Act of 2000,
which was written in anticipation of this new generation of medications.
The hope is that by allowing addicts to avoid visits to centralized
methadone clinics, the stigma will be removed from seeking treatment and
more patients will seek help in the early stages of addiction.

Some experts say the new era in addiction treatment inevitably will affect
the debate over the decriminalization of drugs. If heroin abuse is just
another treatable condition, is heroin still a dangerous social menace?

"The combination of developing and approving new antiaddiction drugs and
the new law allowing their treatment in a private doctor's office
represents a real sea change," said Alan Leshner, chief executive of the
American Association for the Advancement of Science and the publisher of
Science magazine. "It is a flat-out demonstration that we are viewing
addiction as a bona fide disease."

Methadone remains the gold standard in treating opiate addiction -
especially for heroin users who have longstanding habits and require large
doses.

But medications like buprenorphine-naloxone provide patients with more
choices and may prove especially helpful in the early stages of addiction.