TREATMENT FOR PAINKILLER ADDICTION GETS MORE ATTENTION

The chance to fight an addiction to narcotic painkillers using a medication
prescribed in medical offices generates frequent waiting lists at Regional
Psychiatry.

It is the only clinic in Spartanburg with doctors authorized to prescribe
buprenorphine-containing medication to treat opiate addiction.

Patients undergoing treatment with medicines called Suboxone or Subutex may
only need to meet with their doctor once or twice a week, whereas other
treatment such as programs at methadone clinics typically require daily visits.

Thirty-five physicians are authorized to prescribe buprenorphine in South
Carolina. Two are in Spartanburg at Regional Psychiatry -- Dr. Rupert
McCormac and Dr. Amishi Y. Shah.

The Drug Addiction Treatment Act of 2000 limits a medical practice to only
prescribe the drug to up to 30 patients at a time.

More than 13 percent of people age 12 and older in the United States have
used pain relievers for nonmedical uses at some time in their lives,
according to statistics from the Substance Abuse Mental Health Services
Administration 2003 study.

If a person addicted to a drug stops taking the substance suddenly, he can
experience withdrawal symptoms such as nausea, cramping or sweating.

"This is not a pull-you-up-by-the-bootstraps-type of illness," McCormac
said. "This is a real, biological illness."

Suboxone contains an opiate that has a weaker effect than opiates in
painkillers typically abused. As a result, it helps reduce withdrawal
symptoms and cravings.

The benefits are:

. Suboxonet interacts in the body without mixing with other drugs to
increase a sensation of being high; rather it will displace drugs such as
heroin. Plus, its "ceiling effect" means taking Suboxone beyond a certain
amount does not increase its effect.

. Suboxone also contains naloxone to discourage misuse. If the tablet is
injected instead of dissolved under the tongue as directed, the user tends
to experience withdrawal symptoms.

Patients take the medicine every day in doses up to 32 mg. The cost is
about $1 per mg, McCormac said. Patients taper off to quit using Suboxone
altogether.

Treatment usually lasts three to six months as patients stabilize and get
support to deal with the issues in their lives that may have contributed to
drug abuse initially, McCormac said.

"Medication-assisted treatment is more effective," he said. "It's actually
an essential component, in my opinion, if you want to give yourself a
long-term chance of recovery."

A 43-year-old woman who asked to be identified only as "Denise" said her
addiction to painkillers began while working in an orthopedics unit at a
medical facility that is not in the Spartanburg area.

"Narcotics flow through that particular unit like it's water," said Denise,
whose reliance on medication for pain escalated into addiction.

At first, she couldn't see it.

"How could they be bad?" she asked. "They were prescription medicines."

But her addiction cost her not only her job but also her nursing license.
She ultimately spent time in prison.

She recently was treated with Suboxone over a four-month period, and said
it was effective. She's quick to say, though, that's one piece of recovery.
There's also a need for therapy and ongoing support.

"It's a lifestyle change," Denise said, "who you hang around with and how
you look at the world."