HEROIN ADDICTS STRUGGLE TO FIND NEW DOCTOR

The suspension of Dr. Alfredo Gonzalez's license left 100 patients
searching for a new physician to fill their prescriptions for
Suboxone, a relatively new treatment for opioid addiction.

The problem is that fewer than a dozen Cape doctors are authorized by
the federal government to prescribe Suboxone, and several of them
already carry the maximum patient loads allowed by the government.

One heroin addict who did not want to give his full name said he and
his wife are struggling to hold their family together while they find
a new doctor.

"We're in active withdrawal here," he said.

He said High Point Treatment Center in Plymouth, where two physicians
prescribe Suboxone, told him they can't accept any more patients.

Julie Lizotte, director of marketing and development for High Point
Treatment Center, said the facility is referring callers to Falmouth
Hospital and Bourne Medical Internists, where Gonzalez worked before
his arrest earlier this month for possession of marijuana.

Gonzalez also had been director of inpatient services at High Point
since February, Lizotte said. He is not practicing medicine currently,
having voluntarily suspended his license, according to the state Board
of Registration in Medicine.

David Reilly, spokesperson for Cape Cod Healthcare Inc., which
employed Gonzalez at Bourne Internal Medicine and is the parent
company of Falmouth Hospital, suggested that patients consult a
government directory of Suboxone prescribers.

"You can always come to the ER for care," he said.

According to the federal Substance Abuse & Mental Health Services
Administration, there are nine physicians on the Cape that prescribe
Suboxone.

But those numbers include Gonzalez and Dr. Oscar Glieberman, a
physician formerly associated with Physicians Medical Center in
Hyannis who is now in New Bedford.

The federal government allows individual physicians to prescribe
Suboxone to up to 100 patients after their first year
prescribing.

Unlike methadone, which is dispensed, not prescribed, only from
federally regulated opioid treatment centers, Suboxone can be
prescribed by physicians in private office settings once the physician
has been trained and received a federal waiver.

"The beauty of it is you can take it home," said Dr. Lisa
Zandonella-Huchta of the Duffy Health Center in Hyannis, which runs a
Suboxone program for impoverished people at-risk of
homelessness.

Suboxone is dissolved under the tongue and poses far less of an
overdose risk than methadone, experts say.

Approved by the Federal Drug Administration as a tool for opioid
dependency in October 2002, buprenorphine -- the active ingredient in
Suboxone -- gave the family doctor the tools to fight heroin and other
addictions, Zandonella-Huchta said.

But part of what makes the treatment so appealing -- patients go to a
regular physician instead of a special clinic to obtain the medication
- -- also poses a risk if their doctor leaves the area, or -- as in the
case of Gonzalez -- loses his license.

"People will have withdrawal," said Zandonella-Huchta. The major
symptoms are fatigue and trouble sleeping.

Going off Suboxone cold turkey "is not a good way to stop the
medication," Zandonella-Huchta said.