Pubdate: Sun, 07 May 2006
Source: Janesville Gazette (WI)
Copyright: 2006 Bliss Communications, Inc
Contact: http://www.gazetteextra.com/contactus/lettertoeditor.asp
Website: http://www.gazetteextra.com/
Details: http://www.mapinc.org/media/1356
Author: Marcia Nelesen, Gazette Staff
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

DOCTOR SEES STRONG RESULTS WITH BUPRENORPHINE

JANESVILLE -- Vicodin. OxyContin, Percocet. Morphine. Heroine.

Health officials say abuse of these opiate painkillers is increasing.

In the past, people seeking treatment for opiate addiction had few  
options.

Now, a new drug takes away the craving for the opiate. And it reduces  
or even eliminates withdrawal symptoms.

Dr. Adedapo Oduwole, who specializes in addiction psychiatry at Mercy  
Options, said buprenorphine is performing miracles.

People have to want to stop using opiates for buprenorphine to work,  
Oduwole said. But those who do have rebuilt their lives.

About 900,000 people in the United States are dependent on an opiate,  
Oduwole said. Of those, 460,000 are receiving treatment.

Opiates are dangerous because they change a user's brain, Oduwole  
said. Once addicted, the opiate receptor needs to be "occupied'' so a  
person can function.

In the past, addicts could go cold turkey and get counseling. Or they  
could report daily to a clinic for a dose of methadone, which is a  
substitute narcotic drug.

Less than 10 percent of those who choose the first route kick their  
dependency, Oduwole said.

About 65 percent of those who take methadone put their lives back in  
order. But methadone is highly regulated because it is a narcotic and  
has value on the street. Patients must make daily trips to clinics  
and risk the associated stigma. The closest methadone clinics are in  
Rockford and Madison, so many people don't have access to the drug.

With methadone, patients essentially trade one narcotic for another,  
Oduwole said. They go through withdrawal if the supply is interrupted.

But buprenorphine squashes the opiate craving in a person's brain.  
And it blocks the effects of other opiates if they are taken at the  
same time.

Buprenorphine also suppresses symptoms of withdrawal, which is a  
major plus.

"Withdrawal from opiates is terrible,'' Oduwole said. "You wish you  
were dead, but you never die.''

Many people go back on drugs because they cannot get through the  
withdrawal or the craving.

Unlike with methadone, buprenorphine's narcotic effects are limited.  
Patients can receive the drug a month at a time and take it in their  
own homes.

Oduwole has prescribed the drug here since 2003, with a success rate  
of greater than 90 percent. Before moving to Janesville, Oduwole  
headed a pilot program for Suboxone, a brand name for the drug, in  
New York.

Oduwole is also on an advocate panel for Suboxone through Reckitt- 
Benckiser, the manufacturer.

Buprenorphine does not give a person the same euphoria as an opiate,  
Oduwole said. Still, it occupies the opiate receptor for a long time.

People can overdose on methadone. But no death has been documented  
when people take buprenorphine alone. The most common side effects  
are cold or flu-like symptoms; headaches; sweating; sleeping  
problems; nausea and mood swings.

Some patients can eventually be weaned off buprenorphine. Others will  
be on it as long as they live.

The federal government has in the past restricted the numbers of  
patients that a doctor could treat with buprenorphine. Oduwole had a  
patient who drove here monthly from Minnesota because Oduwole was the  
closest doctor prescribing the medicine.

Recently, the Federal Drug Administration loosened patient restrictions.

Any doctor can dispense the drug, but the doctor must be certified  
after taking a class and must be able to refer the patient to  
addiction counseling.

Oduwole warned that anyone who takes opiates for long periods of time  
will become addicted.

Opiates are fine for short-term use, Oduwole said. But patients build  
up tolerance when opiates are taken for chronic pain. If you take an  
opiate to get relief from pain but crawl into bed to sleep, you're  
becoming an addict, he said.

When a doctor won't prescribe increased dosages and you turn to the  
street, you are an addict, he said.

"If you have pain and you're not able to walk, and you take  
OxyContin, you'd better be running a marathon.''

Oduwole said counseling is an important aspect of recovery, even when  
taking buprenorphine.

First, a person must want to get off drugs. Oduwole has had patients  
who go on and off buprenorphine to take opiates and get high. Oduwole  
removes them from his program. Methadone is the treatment for those  
who still want to take opiates, Oduwole said.

As people recover, they must also face the damage they have done to  
relationships during their addict years.

And addicts recovering from one substance often turn to another, such  
as alcohol.

Oduwole predicts the crime rate will decrease as buprenorphine is  
prescribed more extensively.
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MAP posted-by: Jackl