Pubdate: Sat, 22 Dec 2007
Source: Baltimore Sun (MD)
Copyright: 2007 The Baltimore Sun Company
Authors: Joshua Sharfstein, and Peter Luongo


Not one person. Despite pages of text arguing that the misuse of 
buprenorphine is a crisis, The Sun interviewed nobody in Maryland 
whose initial or primary problem is abuse of the medication ("The 
'bupe fix,'" Dec. 16-18). Not one good comparison. The Sun provided 
no information to help readers contrast the street market for 
buprenorphine with our major heroin problem or with the diversion of 
more addictive, more lethal and less regulated drugs, such as OxyContin.

Not one stereotype of drug treatment left out.

The Sun perpetuated the myth that addiction therapy must either be 
perfect or a failure.

Instead of accurately describing buprenorphine as a long-term 
medication proved to treat addiction to heroin and other opiates and 
supported by an international medical and public health consensus, 
The Sun suggested that its benefits are "still being assessed."

The newspaper even attributed to unnamed "clinic directors" the 
demonstrably false statement that "people treated with 
[buprenorphine] do no better or worse than addicts on any other type 
of treatment."

Stringing together anecdotes, The Sun branded treatment programs as 
places for hustling, not healing.

Patients "sell a portion of their pills to raise cash or buy drugs" 
and "plead for large quantities of the pills to take at home." A 
French physician is quoted describing himself as a "legal dealer."

The series then cites unnamed "critics" who say buprenorphine 
"doesn't address the underlying problem of opiate dependence."

This is a dangerous deception. The underlying problem is addiction - 
characterized by loss of control, crime, family breakdown, and 
community harm. The underlying problem can be seen in a boarded-up 
block, a pair of siblings forced into foster care, a neighbor dying 
from AIDS. The underlying problem will not be solved until the stigma 
of treatment recedes.

Yes, it is our job to continually improve our monitoring and control 
of buprenorphine diversion. As with any other medication, the 
challenge is to maximize the benefits of buprenorphine while 
minimizing its risks.

But let us move forward without hysteria, imbalance and ignorance. 
Let us respect the doctors, nurses and counselors who use this 
effective medication to help save lives. And let us remember that if 
we can expand access to care that works, more people who are drowning 
in a sea of addiction will reach the shore.

Joshua Sharfstein Peter Luongo Baltimore

The writers are, respectively, Baltimore's health commissioner and 
the director of the state's Alcohol and Drug Abuse Administration.
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MAP posted-by: Jay Bergstrom