OFFICE-BASED CARE CAN AID MORE ADDICTS

In his column "Few argue about need for drug treatment -- but many argue
about where" (April 14), Michael Olesker identified one of the critical
issues in drug treatment: We need more, but under current policies we are
hard-pressed to expand treatment.

The outdated Harrison Narcotics Act prevents physicians from prescribing
Schedule II narcotics for the treatment of addiction. As a consequence, the
few physicians with experience treating these patients are those who work
in the regulated specialty clinics.

But as Mr. Olesker stated: "If we believe in treatment of addicts, then
treat them in a doctor's office."

Indeed, this approach is being researched and showing success. Experiments
with office-based treatment show drug addicts can be treated successfully
by physicians who take the time to learn how to do so.

And two years ago, Congress and the president saw that private physicians
can help solve the treatment shortage and passed the Drug Addiction
Treatment Act of 2000.

This law allows physicians in private practice to prescribe narcotics that
have less potential for abuse than such Schedule II drugs as morphine or
Demerol and are approved for the treatment of heroin addicts by the Food
and Drug Administration.

Thousands of physicians have completed the continuing education courses
required under the law and are waiting for the FDA to approve the first
drug for this purpose.

The tens of thousands of narcotics addicts in our state live, work, see
doctors and have prescriptions filled with the rest of us. They become a
source of contention when they are corralled into treatment programs.

Let's instead recognize that they are part of the community of patients,
and encourage our health policy planners to embrace the concept of
office-based drug treatment.

Tony Tommasello

Baltimore

The writer is a professor at the University of Maryland School of Pharmacy.