Pubdate: Wed, 9 Oct 2002
Source: Reuters (Wire)
Copyright: 2002 Reuters Limited
Author: Maggie Fox

ADDICTION TREATMENT TO BE AVAILABLE AT DOC'S OFFICE

WASHINGTON (Reuters) - Drug addicts in the United States will soon be able 
to get medical treatment in the privacy of their own doctors' offices, 
thanks to the approval of two new drugs and a new piece of legislation, 
experts and lawmakers said on Wednesday.

Two formulations of the narcotic painkiller buprenorphine were approved by 
the US Food and Drug Administration (news - web sites) Tuesday night, and 
under legislation signed by US President Bill Clinton in 2000 they can be 
prescribed by specially licensed doctors and filled at a pharmacy.

The drugs, called Subutex and Suboxone, are the first two that can be 
prescribed under the legislation, aimed at getting drug addiction patients 
away from poorly attended clinics.

The new rules effectively give heroin and other opiate addicts more control 
over their treatment, and experts hope the combination of a new drug and 
easier availability will mean more addicts will seek help.

"We hope we have made a major impact on the reduction of heroin addiction," 
Sen. Carl Levin, a Michigan Democrat who helped sponsor the legislation, 
said at a news conference.

"Currently the available medications, methadone and ORLAAM (a relative of 
methadone), are extremely useful but ensnared in regulations that grossly 
limit their potential effectiveness," said Charles Schuster, a psychiatry 
professor at Wayne State University.

Fewer than 200,000 of an estimated 1 million opiate addicts in the United 
States are in treatment, added Dr. Harold Kleber, substance abuse director 
at Columbia University's medical school. This is in part because it is so 
difficult to get treatment at clinics, which tend to be in urban 
neighborhoods and often in crime-ridden districts.

At least half of those offered methadone treatment turn it down, according 
to the National Institute on Drug Abuse. Patients often dislike the 
atmosphere at clinics and want more of a say in their treatment than 
clinics offer.

NEW DRUGS

The new drugs, made by British pharmaceutical company Reckitt Benckiser 
Pharmaceuticals, not only block the effects of opiate drugs on the brain 
but also are considered less likely to themselves cause dependence and 
addiction.

Like methadone, buprenorphrine is related to morphine. It can be abused and 
it can kill if taken in an overdose.

Buprenorphine alone is sold under the brand name Subutex, while a second 
newly approved pill, Suboxone, also contains naloxone--another drug that 
interferes with the effects of opioids on the brain.

"Subutex and Suboxone are the first narcotic drugs available for the 
treatment of opiate dependence that can be prescribed in an office setting 
under the Drug Addiction Treatment Act (DATA) of 2000," the FDA said in a 
statement.

"Until recently, opiate dependence treatments...like methadone could be 
dispensed in a very limited number of clinics that specialize in addiction 
treatment. As a consequence, there have not been enough addiction treatment 
centers to accommodate all patients desiring therapy."

"I hope that FDA approval will help spur the private sector to redouble its 
efforts to find new cures for drug addiction," said Utah Sen. Orrin Hatch, 
a Republican who helped sponsor the legislation.

Hatch and others stressed that drug use should remain illegal, but said 
they hoped addicts would someday be treated as patients and not as criminals.

"Opioid dependence, as with other addictions, is a chronic relapsing 
disorder, not a character flaw, failure of will or lack of self-control. 
These drugs change our brains," Kleber said.
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