DOCTORS, ADDICTS TO RALLY FOR BETTER ACCESS TO TREATMENT DRUG

Say Federal Rules Hurt Those Who Could Be Helped

With heroin and OxyContin abuse at epidemic levels, Massachusetts
doctors say they are increasingly frustrated by tight federal
restrictions that force them to put addicts on a waiting list for the
most promising treatment for opiate addiction in decades.

Suboxone is the first treatment for addiction to heroin and narcotic
pain relievers that doctors can prescribe rather than sending
patients to a methadone clinic, making it more attractive for younger
addicts and addicts who hold jobs and other responsibilities.
Suboxone can be taken at home, and , unlike methadone, it doesn't
make patients groggy and there is little risk of a fatal overdose.

But Congress allows doctors to treat no more than 30 addicts at a
time with the somewhat addictive drug, and only after they've
completed an eight-hour course. In Massachusetts, 425 doctors are
approved by the US Drug Enforcement Administration to prescribe
Suboxone, barely enough physicians to prescribe the drug to all the
heroin addicts in the Boston area alone. Doctors in other states have
reported waiting lists for the drug of up to 300 addicts, while some
Massachusetts doctors say they have stopped counting how many
patients they turn away.

"This medication has the potential to wipe out at least 50 percent of
the national demand for heroin," said Dr. Claude Curran , a Fall
River psychiatrist who defied the federal limit last year. Curran
prescribed Suboxone to 800 patients before the DEA forced him to
dramatically scale back by transferring patients to other doctors or
terminating their treatment.

Curran plans to lead a protest at the JFK Federal Building in Boston
this afternoon , bringing together addicts, their families, and
treatment providers to rally support for a measure just introduced in
the US Senate to allow at least some doctors to treat far more than
the current limit.

However, state officials caution that relaxing limits on
prescriptions of Suboxone could cause problems. While Suboxone is
less dangerous than methadone -- implicated in more than 1,100 deaths
since 1970 -- it is also less effective for hardcore addicts. And,
just three years after it went on the market, the US Justice
Department reports a black market for the drug, which is potent
enough to get non-opioid addicts high.

"We've got to be careful that this is done in a thoughtful manner,"
said Michael Botticelli , the assistant public health commissioner of
the state Bureau of Substance Abuse Services. "It's important that
this not become a pill factory [or] a cash cow for physicians who
want to make money" from the opiate epidemic.

Up to a million people nationwide are addicted to heroin and 4.4
million people abuse narcotic pain relievers such as OxyContin. Both
drugs are chemically related to opium and can create a powerful
craving for more. Only about 15 percent of addicts who go "cold
turkey" are still drug-free a year after they get out of detox,
according to Dr. Mark Eisenberg of Massachusetts General Hospital.

Since 1973, methadone has been the main long-term treatment for
opiate addicts, giving them a daily high that temporarily eases their
craving for opiates. But the rise of cheap heroin and abuse of pain
relievers created new classes of addicts from experimenting
20-somethings to middle-aged working people who got hooked after
taking pain pills for an injury. These patients didn't want to go to
a clinic for care and they feared methadone's side effects.

Suboxone, also known as buprenorphine , seemed to offer a real
alternative when approved in 2002, and addicts raved that the new
drug controlled their cravings without dulling their minds.

"I said, 'Wow. I want this forever,' " said Barry Andrade , who took
the medicine in the early 1990s as part of a study. "I was
functional. I was working. I was married. I was paying my bills."

When the study ended, he recalls, he went back to heroin and was
jailed repeatedly for drug offenses until he began taking
buprenorphine again recently. Andrade said he searched for years for
a doctor who could prescribe it to him before finding Curran.

Though 9,200 doctors nationwide are now authorized to prescribe
Suboxone, the limit of 30 addicts per doctor makes it virtually
impossible to treat most of the people who need help, said Dr. Karen
Kagey of Medway, who plans to attend the rally. "I turn down eight or
10 people per month at least, sometimes more," she said. "Some of
them say they have called 50 or 60 doctors."