NEW MEDICATION MAY AID OPIATE ADDICTS

Heroin is cheap and plentiful on the streets of Utah's most populous cities.
The use of such opiate-based prescription drugs as OxyContin and Vicodin is
on the upswing.

Until recently, opiate addicts wanting to recover were steered mainly in the
direction of the state's six methadone clinics, clustered along the Wasatch
Front.

Now they have another treatment choice -- buprenorphine, which blocks the
cravings for the drugs.

Buprenorphine was approved by the U.S. Food and Drug Administration in
October 2002 to treat opiate addiction. It became available in Utah in
February.

Federal and state substance abuse officials held a symposium in Salt Lake
City on Monday to spread the word about buprenorphine and to persuade more
doctors to become certified to prescribe the medication.

Unlike methadone, which is strictly regulated by the government at clinics
and unavailable by prescription, buprenorphine can be prescribed by private
physicians -- an advantage experts say cuts down on the stigma of going to
a methadone clinic.

"At a methadone clinic, you're standing in line with other drug addicts,
some of whom aren't interested in recovery," said Michael Crookston, a
chemical dependency specialist at LDS Hospital in Salt Lake City. "It's hard
to convince people to go to a methadone clinic. With buprenorphine, you have
that privacy, and it's a lot easier for patients."

Crookston is one of only seven doctors statewide who is certified to
prescribe buprenorphine. He has treated about 30 addicts with the
medication, with a high success rate, he said.

"So far, the only problem I've seen with this drug is there aren't enough
people to prescribe it," Crookston said.

The federal Substance Abuse and Mental Health Services Administration, the
Utah Medical Association and the state's Division of Substance Abuse and
Mental Health are all pushing to get more doctors on board.

Physicians are required to take an eight-hour training session before they
can receive a special identification number from the U.S. Drug Enforcement
Agency allowing them to prescribe buprenorphine.

According to Randall Bachman, the director of the state's Division of
Substance Abuse and Mental Health, there are 5,000 Utahns hooked on opiates.
Of those, 1,000 are on methadone.

To broaden access for treatment and educate doctors, a buprenorphine
training session will be held in Utah in the next few months, most likely in
September. Doctors also can take a course via the Internet or CD-ROM.

Salt Lake City was targeted for the buprenorphine program along with 14
other cities because of the number of drug-abuse related deaths here and in
Davis County.

In 2001, there were 86 mentions of narcotic pain medications or heroin
associated with deaths.

H. Westley Clark, the director of the federal Center for Substance Abuse
Treatment, acknowledges that buprenorphine is not a panacea. However,
compared with methadone, it is less addictive and has fewer side effects, he
said.

"We don't view buprenorphine as a wonder drug," Clark said Monday. "We don't
see it as a replacement for methadone. We see it as expanding options for
treatment."

Being able to prescribe buprenorphine in an office setting is also helpful
for addicts who live in rural areas without access to methadone clinics,
Clark said.

A week's supply of buprenorphine costs about $70 -- nearly the same price
as methadone treatment, Crookston said. Some health plans cover part of the
doctor's office visit and prescription cost.

Buprenorphine and methadone are administered orally, taken in daily doses
during the detoxification process. After that, patients typically receive
lower doses until they are weaned off the drugs.