HELP FOR HEROIN ADDICTS

There are essentially two drugs in wide use to help recovering addicts:

Methadone -- The longest-used and perhaps most controversial of
heroin treatments. Methadone is an opioid that acts on the same
receptors in the brain as heroin. Unlike heroin, however, it is
long-acting. So whereas a severe heroin addict needs to use that drug
three or four times a day to avoid withdrawal, methadone can be
administered once a day.

The criticism surrounding methadone is that it replaces one addiction
with another. A user can be on methadone for years. But its
proponents point to studies that show conclusively that it reduces
death and crime and increases job performance in heroin addicts.

Buprenorphine -- The newest treatment for heroin has been falsely
heralded as a panacea, doctors say. While it is not a miracle pill,
it is an effective tool.

The drug is an opioid, but, unlike heroin and methadone, it has a
ceiling: If a user takes two or three times the prescribed dose, they
will feel no pleasurable effects. It works on the same receptors as
heroin, methadone and all other opioids, so it helps the patient
avoid withdrawal and craving. It has the added benefit of being
administered in a doctor's office, not at a special clinic where
addicts mix with other addicts and risk reinforcing bad behaviors.

Buprenorphine, however, is not for everyone. If an addict is using
too much heroin, Buprenorphine will actually force them into
withdrawal. But if patients can reduce drug use on their own to an
acceptable level, Buprenorphine can help.

Buprenorphine often is given in pill form, mixed with Naloxone, which
blocks the effects of opioids. The mixture is designed to prevent
patients from injecting Buprenorphine in search of a more intense
high. When the drug is taken as designed -- dissolved under the
tongue -- the Naloxone will not prevent Buprenorphine from working.

Heroin help is available at the following places:

Brien Center: 24-hour crisis line: (800) 252-0227; www.briencenter.org.

McGee Unit of Berkshire Medical Center: (413) 442-1400.

Massachusetts Bureau of Substance Abuse Services: mass.gov/dph/bsas

Source: Eagle interviews