AN EASIER FIX IN WORKS FOR HEROIN ADDICTS

Recovering heroin addicts soon will be able to get their fix at local
pharmacies, rather than traveling daily to one of the few methadone clinics
in the region, thanks to the federal government's approval of the first
prescription pill for opiate dependence.

The pill, which will be sold under the brand names Subutex and Suboxone,
was approved last week by the Food and Drug Administration as an
alternative to methadone treatment for opiate addictions.

Any doctor who completes an eight-hour course can prescribe it, and it can
be taken in the privacy of one's home.

Addiction doctors said Tuesday the new pill desperately is needed to keep
up with the burgeoning demand of heroin addicts in the region.

Opiate addictions in the region have tripled in the past two years, said
Dr. James Manlandro, who operates methadone clinics in the Rio Grande
section of Middle Township, Cape May County, and Somers Point in Atlantic
County.

About three-fourths of his patients hold steady jobs, he added.

"It's incredible how bad it's gotten," Manlandro said. "It's terrible."

Many people now are getting hooked on the narcotic Percocet, progressing to
the powerful painkiller OxyContin and then graduating to a full-fledged
heroin addiction, he said.

Manlandro said that like most clinics, his maintains a long waiting list.

Dr. William Vilensky, a Margate addictions specialist who served on federal
panels that helped shepherd the new treatment to market, said there are
nearly 1 million heroin addicts in the country, but only 18 percent are
getting treatment.

Some choose not to get treatment to avoid the stigma of standing in line at
a methadone clinic each morning. Most, however, simply have no methadone
clinic reasonably nearby.

Cape May County, for instance, had no methadone clinic until July 1999.
That forced recovering addicts in isolated places such as Wildwood to
travel four hours roundtrip by bus, until Manlandro opened his facility.

Subutex and Suboxone are expected to remove many existing barriers to
treatment.

"The whole idea is to get more addicted patients into treatment," Vilensky
said.

Any doctor can take the required course that allows him or her to write
prescriptions for the new treatment, exponentially expanding the potential
number of places an addict can get help.

And unlike methadone, which is dispensed at clinics in single doses to
prevent abuse, patients can take home up to a one-month supply.

The basis of the new treatment is buprenorphine, which acts much like
methadone in suppressing symptoms of opiate withdrawal, but it is less
addictive, according to the FDA.

Subutex is prescribed to start treatment, while Suboxone is for maintenance
treatment. The latter contains an added ingredient intended to guard
against intravenous drug abuse. Both pills are dissolved under the tongue
daily.

Suboxone is expected to far outsell Subutex, as many recovering addicts may
take it the remainder of their lives.

In that way, drug addiction is no different from people with high blood
pressure, diabetes or asthma who must always take medicine to manage their
disease, Vilensky said.

The new treatment also should prevent the kind of relapses that result when
a methadone patient misses a dose, because daily trips to the clinic won't
be necessary for Suboxone, Manlandro said.

The new treatment also produces "a more steady state" with no significant
withdrawal symptoms, he said.

Not everyone is jumping on the bandwagon.

The Institute for Human Development, an Atlantic City methadone clinic that
has about 300 patients, doesn't plan to offer buprenorphine, Executive
Director Millicent Tate said.

"We have absolutely no plans to change our protocols at the given time,"
Tate said. "We find there is always a need for what we do."

Vilensky noted that it was the Drug Addiction Treatment Act of 2000 that
cleared the way for buprenorphine to be prescribed in an office setting.
But doctors certified through the eight-hour course are limited to 30
buprenorphine patients at a time, to prevent any one doctor from becoming a
de facto center for drug addictions.

Pharmacies should be stocked with the new pills in eight to 12 weeks.