Pubdate: Wed, 12 Dec 2007 Source: Edmonton Sun (CN AB) Copyright: 2007 Canoe Limited Partnership. Contact: http://www.edmontonsun.com Details: http://www.mapinc.org/media/135 Author: Mindelle Jacobs Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/find?136 (Methadone) 'BUPE' BRINGS ADDICTS HOPE More than two years after it was approved by Health Canada, a little orange pill that helps heroin junkies kick the habit has finally hit the market. Buprenorphine, or "bupe," has an advantage over methadone because the risk of overdosing is dramatically reduced and addicts can't get high on it. It has a so-called "ceiling effect" - larger doses don't mean a bigger hit. The hexagonal pill is being marketed by Schering-Plough Canada Inc. under the brand name Suboxone. It helps manage the cravings of withdrawal from heroin and opioid-based prescription pain medications. Another benefit is an added component in the pill that reduces the potential for misuse. If addicts crush it up and inject it, they go into immediate withdrawal. "That generally will convince them that it's probably not the best way to try and use the drug," says Dr. Mat Rose, a physician at the Boyle McCauley Health Centre who treats addicts. "Methadone works very well for a lot of people. There are some people that it's not working so well for and buprenorphine might work better," he says. There's some evidence that it's easier for addicts to taper off bupe than methadone, Rose adds. "It could mean the difference between feeling trapped on methadone and actually being completely abstinent." But he cautions that it's not a miracle drug, noting that bupe will work for some people but not others. Addiction is primarily about counselling and lifestyle changes, he points out. "We'll see. The occasional person might benefit from it," he says. "But I'm not going to rush out and switch all my methadone patients over to buprenorphine." One stumbling block is that bupe isn't covered by Alberta Blue Cross yet, so patients who want it will have to pay for it, says Rose. He figures it could cost addicts - many of whom are on welfare - $10 to $20 a day. Dissolves Another possible problem is Suboxone, a tablet that slowly dissolves under the tongue, is meant to be taken daily, typically at a pharmacy. But that can take 10 or 15 minutes and the likelihood that an addict will stick around for that length of time is small, Rose says. "So they can just scamper out of the pharmacy, spit it out, give it to their friends or do whatever with it. That's certainly a possibility." He estimates there are at least 7,000 opiate addicts in Edmonton - and only about 1,000 of them are on methadone maintenance. There are more than 100,000 Canadians addicted to opiates but three-quarters of them aren't getting treatment, according to experts. This is the first time in decades that a new drug has been introduced for people hooked on opiates. "We now have a new treatment option that will help our patients manage their symptoms," says Dr. David Marsh, past-president of the Canadian Society of Addiction Medicine. "It's important to have a new choice, and arming physicians with another weapon to fight opioid dependence will only serve to help patients to manage this disease." Bupe was approved for use in the U.S. in 2002. In Canada, Schering-Plough Canada is offering an online education program about the drug for health-care professionals. The vast majority of opioids that people are addicted to in Western Canada and the Atlantic provinces come from physician prescriptions, notes Rose. "(Bupe) is another option. It has a better safety profile but there's no 100% safe drug." - --- MAP posted-by: Richard Lake