PILL TO TREAT PAINKILLER ABUSE SELDOM USED IN E. KENTUCKY

Some Didn't Know They Could Prescribe It

WHITESBURG - A new drug designed to treat prescription painkiller
addiction is seeing only limited use in Eastern Kentucky despite the
region's historic problems with pill abuse, a newspaper reported.

The medication, itself a federally regulated painkiller, was approved
by the Food and Drug Administration in late 2002 for use in a fashion
similar to methadone to wean addicts off heroin and other narcotics
under controlled conditions.

But it is less prone to abuse and is intended for office use by
trained primary care doctors, potentially expanding such help in areas
underserved by specialized treatment facilities.

Methadone is dispensed only at licensed centers. Illegal use is an
increasing problem in many areas.

However, the new medication -- tablets called Suboxone or Subutex --
is getting scant attention from Eastern Kentucky hospitals, clinics
and primary-care doctors, The Mountain Eagle of Whitesburg reported
Wednesday.

Lois A. Baker, chief executive officer at Mountain Comprehensive
Health Corp. in Whitesburg, said family doctors at the company's
Whitesburg Medical Clinic were under the impression the drugs were for
use only in drug detoxification centers and residential treatment
facilities.

"However, if it is something that can be used in a primary care
facility, then I certainly would be interested in taking a closer look
at it," Baker said.

Donnie Fields, administrator with the Whitesburg Appalachian Regional
Hospital, also was unfamiliar with the drug treatment but said it
sounded like something the ARH chain of hospitals would want to look
into.

An official with Unlawful Narcotics Investigation, Treatment and
Education in Somerset said that organization has no immediate plan to
encourage prescribing of the drugs. "So far we're not an advocate for
that type treatment," said Cathy Stout, UNITE's director of treatment
and education.

UNITE, founded by U.S. Rep. Hal Rogers, R-London, focuses on
local-level drug enforcement, education and treatment in the region.

According to Stout, if a person calls UNITE seeking treatment, he or
she is referred to a "treatment referral coordinator" who provides the
telephone number of a program that the coordinator feels suits the
patient.

Suboxone and Subutex went on the market in January 2003. Their primary
ingredient is buprenorphine, a well-known narcotic.

The newspaper said a Kentucky research center discovered the drug was
effective in treating heroin addiction more than 25 years ago.
However, doctors couldn't legally prescribe it for that purpose until
a federal law was passed in 2000.

Nationally, 4,000 doctors had completed required certification on
buprenorphine use by late April, according to the federal Substance
Abuse and Mental Health Services Administration.

Only 12 provide the treatment in Kentucky -- including two in Hazard
and two in Lexington -- according to the agency's Internet site.

In addition to eight hours of training, doctors must obtain
prescribing authority from the Drug Enforcement Administration and
submit to controls to fight abuse. Each doctor is limited to just 30
patients.

SAMHSA has reported that the special requirements, plus the difficulty
of working with some addicts and uncertainties about payment
discourage some doctors from getting involved.

"Buprenorphine alone is not a silver bullet for opioid addiction, but
it can open the door to recovery and provide the opportunity to regain
lost lives," SAMHSA Administrator Charles Curie said in an April report.