'BUPE' BRINGS ADDICTS HOPE

More than two years after it was approved by Health Canada, a little
orange pill that helps heroin junkies kick the habit has finally hit
the market.

Buprenorphine, or "bupe," has an advantage over methadone because the
risk of overdosing is dramatically reduced and addicts can't get high
on it.

It has a so-called "ceiling effect" - larger doses don't mean a bigger
hit.

The hexagonal pill is being marketed by Schering-Plough Canada Inc.
under the brand name Suboxone. It helps manage the cravings of
withdrawal from heroin and opioid-based prescription pain
medications.

Another benefit is an added component in the pill that reduces the
potential for misuse. If addicts crush it up and inject it, they go
into immediate withdrawal.

"That generally will convince them that it's probably not the best way
to try and use the drug," says Dr. Mat Rose, a physician at the Boyle
McCauley Health Centre who treats addicts.

"Methadone works very well for a lot of people. There are some people
that it's not working so well for and buprenorphine might work
better," he says.

There's some evidence that it's easier for addicts to taper off bupe
than methadone, Rose adds.

"It could mean the difference between feeling trapped on methadone and
actually being completely abstinent."

But he cautions that it's not a miracle drug, noting that bupe will
work for some people but not others. Addiction is primarily about
counselling and lifestyle changes, he points out.

"We'll see. The occasional person might benefit from it," he says.
"But I'm not going to rush out and switch all my methadone patients
over to buprenorphine."

One stumbling block is that bupe isn't covered by Alberta Blue Cross
yet, so patients who want it will have to pay for it, says Rose. He
figures it could cost addicts - many of whom are on welfare - $10 to
$20 a day.

Dissolves

Another possible problem is Suboxone, a tablet that slowly dissolves
under the tongue, is meant to be taken daily, typically at a pharmacy.

But that can take 10 or 15 minutes and the likelihood that an addict
will stick around for that length of time is small, Rose says.

"So they can just scamper out of the pharmacy, spit it out, give it to
their friends or do whatever with it. That's certainly a
possibility."

He estimates there are at least 7,000 opiate addicts in Edmonton - and
only about 1,000 of them are on methadone maintenance.

There are more than 100,000 Canadians addicted to opiates but
three-quarters of them aren't getting treatment, according to experts.

This is the first time in decades that a new drug has been introduced
for people hooked on opiates.

"We now have a new treatment option that will help our patients manage
their symptoms," says Dr. David Marsh, past-president of the Canadian
Society of Addiction Medicine.

"It's important to have a new choice, and arming physicians with
another weapon to fight opioid dependence will only serve to help
patients to manage this disease."

Bupe was approved for use in the U.S. in 2002. In Canada,
Schering-Plough Canada is offering an online education program about
the drug for health-care professionals.

The vast majority of opioids that people are addicted to in Western
Canada and the Atlantic provinces come from physician prescriptions,
notes Rose.

"(Bupe) is another option. It has a better safety profile but there's
no 100% safe drug."