Pubdate: Fri, 30 Jun 2006
Source: Times, The  (Munster IN)
Copyright: 2006 The Munster Times
Contact:  http://www.nwitimes.com/
Details: http://www.mapinc.org/media/832
Author: Jerry Davich
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

COUNTERACTING HEROIN TAKES MANY FORMS

Latest Treatment Shows Promise

Methadone, a synthetic opiate, is still largely considered the gold 
standard for treating heroin addiction. It's a liquid dose of legal 
relief that suppresses narcotic withdrawal for 24 to 36 hours.

"It's been more widely researched than the atom bomb," said Carmen 
Arlt, director of chemical dependency and addiction for Porter-Starke 
Services Inc. But a newer treatment option -- buprenorphine, 
prescribed by doctors as Subutex and Suboxone -- has experts, field 
workers, and even methadone patients excited about its possibilities.

"The advent of buprenorphine was truly a gift. Without a doubt it is 
the biggest advance in treating opiate dependence since methadone," 
said Dr. S. Alex Stalcup, a national expert on heroin addiction and treatment.

Buprenorphine is the first medication treatment available through a 
primary care physician. Since its launch in 2003, an estimated 
200,000 Americans have taken it, including hundreds of local patients 
through specially trained doctors.

The drug, sold by Reckitt Benckiser, is a generic term for Subutex, 
given the first few days of treatment. Suboxone then combines 
buprenorphine and naloxone, prescribed for treatment maintenance.

Arlt, who boasts three decades of experience in this field, said 
buprenorphine is aimed at short-term opiate users, not longtime heroin addicts.

Timothy Lepak, cofounder of the National Alliance of Advocates for 
Buprenorphine Treatment, said replacement therapies such as methadone 
may save lives by keeping patients off more dangerous drugs. But 
buprenorphine allows patients to "step out" of an addiction and avoid 
a relapse.

Dr. Frank Vocci, director of the pharmacotherapies division for the 
National Institute of Health, said being away from heroin for a year 
or two does not decrease the craving for more.

"The desire for opiates can last for years," he said.

Although rapid detoxification and infamous "cold turkey" withdrawal 
methods have poor success rates, buprenorphine allows users to slowly 
and gradually taper their dose allowing the brain to adapt to a 
drug-free status, Lepak said.

Stalcup, medical director of New Leaf Treatment Center in Contra 
Costa County, Calif., began prescribing buprenorphine as early as 
1992, "somewhat illegally," he said, adding he used it to treat pain, 
referring to the pain of opiate withdrawal.

"It was a great relief when it became legal," he said.

"It is hard to get high on, and it is hard to overdose on."

These days, he travels the country training health professionals and 
lecturing to communities with heroin-related issues, including Porter 
County, which he visited in April.

During that visit, he told local health professionals that it takes a 
users' brain chemistry about 40 years to return to normalcy from the 
ultimate feel-good high of heroin addiction.

Whether users try methadone or buprenorphine to kick heroin, most 
experts agree the best results include long-term counseling and 
community residential programs for three to six months.

Dr. Sarz Maxwell, medical director of the Chicago Recovery Alliance, 
said society is taught to only think of heroin addiction in moral or 
legal terms.

"It's a big leap to think of it as a medical condition first," she said.

[Sidebar]

What Is Methadone?

Methadone first was introduced in 1947 as a pain-killing synthetic 
opiate. In recent decades, it's been used to treat heroin addiction. 
Also called methadose, it comes in small, premeasured, sealed plastic 
cups. Some clients get 5 milligrams of the dark-colored, 
smooth-tasting tonic, others get 160 mg. It all depends what they 
need to get by until the next sunrise.

Sweet-N-Low Pack To Get High

It takes only 2 to 5 milligrams of heroin to get high. To get an idea 
of how much this is, a single pack of Sweet-n-Low or Equal is 1 full 
gram, according to Dr. Frank Vocci, director of the pharmacotherapies 
division, National Institute of Health. Feedback Form Questions, 
comments, concerns? E-mail us! Your e-mail address: Your comment/question:
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MAP posted-by: Beth Wehrman