MASS. DOCS TOUT HABIT BUSTER: DRUG AIDS OPIOID USERS

As the Bay State faces an explosion in OxyContin and heroin abuse,
Massachusetts doctors are outpacing much of the country with their
interest in Suboxone, the new "addiction-busting" drug for opioid abusers.

Of the 7,500 doctors authorized to prescribe Suboxone nationally,
413 are from the Bay State, making Massachusetts one of the top 10
hubs for the drug nationally, said Nick Reuter, senior public health
analyst for the federal Substance Abuse and Mental Services Administration.

"There is more use of these products in New England than in any
other part of the country," said Reuter. New York and California
have the highest numbers of physicians authorized to prescribe the
drug, he said.

Suboxone, which is manufactured by the British company Reckitt
Benckiser Pharmaceuticals Inc., is a combination of buprenorphine
and naloxone. Buprenorphine is a partial opioid agonist. It curbs
cravings for heroin or narcotic painkillers by binding to the same
opioid receptors those drugs target in the brain.

"I think it's a good drug. It's not a panacea, but it helps them get
into treatment," said Dr. Ronald Pike, medical director at
Worcester-based AdCare Hospital.

Suboxone users may suffer from heroin, prescription painkiller
addiction or both. Some patients are able to detox completely on
Suboxone, but most end up using it as a maintenance drug, doctors
said. Many clinicians also require their patients to be in therapy
while on the drug.

"The success rate, based on the literature and my experience, is 50
percent sober in six months. which is far better than anything else
that's around," said Dr. Ira Mintzer, director of continuing medical
education at Cambridge Health Alliance.

Doctors must complete eight hours of training to get a waiver to
prescribe the drug. Reckitt Benckiser funds the training, but it
does not have control over the content, said company spokeswoman
Harriet Ullman. The trainings are administered by four medical
societies, including the American Society of Addiction Medicine.

Federal regulations prohibit physicians from having more than 30
patients on the drug at a time.

Suboxone has its critics. Dr. P.S. Kishore, founder of the National
Library of Addictions in Brookline, only prescribes the drug for
patients undergoing detox in a clinic. Last year, six to eight
percent of his new patients tested positive for Suboxone, he said.
Kishore believes they got the drug on the street. "The problem with
outpatient maintenance is that it's very hard to get them off. Once
you give them the candy, they don't want to give it up," Kishore said.