'BUPE' IS NEW HOPE FOR HEROIN ADDICTS

For the first time in four decades, a new drug to treat people addicted to
heroin and other narcotics is about to be introduced in Canada.

Recently approved by Health Canada, buprenorphine, or "bupe" for short, is
expected to be on the market by the end of the year, following training
sessions for doctors.

Manufactured by Schering Canada, Inc., bupe will be sold under the brand
name Subutex. Until now, methadone has been the only replacement therapy
available in Canada for people hooked on heroin and other opiates.

But methadone carries a certain social stigma as well as a risk of abuse
and overdose.

With bupe, however, there is less chance of an overdose, less stigma and
fewer withdrawal symptoms, says Dr. Anita Srivastava, of the Centre for
Addiction and Mental Health. While it won't replace methadone, which some
patients will prefer, bupe provides another option, she says.

"We're really looking forward to having it on the market," she says. "It's
unfortunate we haven't had it sooner."

Srivastava says buprenorphine is no more effective than methadone. But some
recovering addicts consider it virtually a miracle drug.

Wired magazine did a feature on bupe last month and interviewed a
28-year-old American heroin addict who'd repeatedly been in detox trying to
beat the habit.

When he was in a New York rehab facility last year, he was given bupe
instead of methadone.

"It took away the pain," he told Wired. "It even took away the craving," he
said. "I got clarity when I took that first pill."

Two recovering heroin addicts were quoted in an Associated Press story last
week, describing how bupe has enabled them to lead normal lives for the
first time in years.

Bupe has been available in the U.S. since 2002 but health professionals are
complaining that the strict rules are preventing addicts from getting the drug.

In the U.S., for instance, physicians can treat no more than 30 bupe
patients at a time.

The fear is that doctors will inappropriately prescribe the medication and
the drug will be abused. U.S. doctors are allowed to prescribe take-home
supplies.

But one of the interesting things about bupe is it's pretty hard to
overdose on it. Subutex has a so-called "ceiling effect" - bigger doses are
unlikely to produce a greater high.

The idea is that addicts who misuse bupe by taking increased amounts of the
drug simply plateau instead of overdosing.

Bupe is also sold in the U.S. in another formulation called Suboxone, which
contains an ingredient that thwarts the abuse of bupe. If patients crush
and inject the pills instead of letting them dissolve under their tongues,
they suffer horrible withdrawal symptoms.

For now, in Canada, only Subutex will be available and addicts will only be
prescribed take-home pills on weekends.

To prevent potential misuse, patients will be expected to take a daily dose
supervised by a health-care professional.

A national medical advisory board has been set up to develop an education
program to train physicians who wish to prescribe bupe, says a Health
Canada spokesman.

These little pills could revolutionize the way we treat heroin addicts.
It's estimated there are more than 100,000 people addicted to opiates in
Canada but only 25,000 are in rehab programs.

The social and health costs are enormous. Many addicts steal or prostitute
themselves to get drugs. They also share needles, infecting themselves with
HIV and hepatitis C. Injection drug use is now the main cause of HIV
transmission.

Bupe is at least as good and possibly better than methadone as a
replacement therapy, says University of Alberta pharmacologist Dr. David
Cook. "Plus, addicts seem to like it better," he adds.

Bupe could dramatically curb addiction, reduce crime and stem the spread of
disease.