RESEARCHERS, PATIENTS ALIKE SEE ADVANTAGES OF 'BUPE'

One recent Tuesday morning, Lorenzo Cleveland Lawson sat in an office
of the Phoenix House drug treatment facility, tucked behind the
Ravenswood housing development in Long Island City.

Lawson, 42, a heroin addict for 14 years, was entering his seventh
day of withdrawal. But he was calm and smiled easily as he spoke of
his plan to get clean and to repair his fractured relationships with
his wife and 10-year-old daughter.

"I don't feel high," said Lawson, who credits the drug buprenorphine
with easing his cravings for heroin. He wasn't successful in an
earlier effort to beat the habit, dropping out of a methadone
detoxification program.

"I feel strong enough to be around people. My mind is sharp enough
and my body feels good," Lawson said. "I am not high and I have the
incentive now to get better so I can help myself."

The program is one of the first in the country to use buprenorphine
to detoxify addicts before transferring them to a drug-free
residential rehabilitation program, said Dr. Terry Horton, medical
director of the city's Phoenix House operation.

Historically, opiate addicts have had difficulty in successfully
crossing the bridge from detoxification to participation in a
drug-free residential setting, Horton said.

"Our initial goal was to open the door wider for a group of people to
get to rehabilitation who could never get through detox," Horton
said. "The key is, the longer they stay in treatment, the better they
do overall."

Currently, there are 12 patients undergoing buprenorphine detox at
the Long Island City facility at a daily cost of $134 each, Horton
said. Most of the treatment is covered under private insurance or Medicaid.

The time it takes for detoxification using buprenorphine averages
about 14 days, though it varies with the individual, he said.

Columbia University researchers, in a recently completed outcome
study of the Phoenix House program, showed that buprenorphine users
had a 90 percent completion rate in detox - with 76 percent of the
detoxed patients later entering drug-free residential rehabilitation.

"The old model of one-size-fits-all does not work," Horton said,
referring to existing detox methods, most of which rely on the
also-addictive drug methadone. "It has been a useless revolving door
and costs a lot of money, with less than half of those treated going
back to get rehabilitation treatment after they are discharged from
detox. And when they do go to rehabilitation treatment, they are
still in withdrawal."

From day one with "bupe," as it has come to be called, patients seem
to have a clear mind and are able to function better, which helps
them immediately proceed with counseling, Horton said.

Javier Rosario, 37, was in his 18th day of trying to kick a
seven-bag-a-day heroin addiction - for which, at $10 a bag, he was
shelling out about $500 a week. He said buprenorphine helped him both
physically and mentally to prepare for the drug-free rehabilitation
phase of his recovery.

Seated in a circle during a counseling session, Rosario told a group
of fellow addicts how he began using drugs as a teenager to escape a
childhood during which he was molested by an older relative and
physically abused by his grandfather.

"I feel good, but at the same time I feel scared," Rosario said
later. "On methadone, when you came off of it, my body didn't feel
good. They told me to go to rehabilitation, but my body wasn't up to
it. I was anxious and I didn't feel the same when I was off.

"With bupe, I had some cravings, but I don't have the withdrawal
symptoms that I had before. This drug helps you come down a lot
better," he said. "I feel like I am myself for the first time in years."