Pubdate: Thu, 28 Feb 2008 Source: San Diego City Beat (CA) Copyright: 2008 San Diego City Beat Contact: http://www.sdcitybeat.com/ Details: http://www.mapinc.org/media/2764 Referenced: http://www.mapinc.org/drugnews/v08/n108/a06.html Author: Percy Menzies GIVE THEM CHOICES I read the article on the politics of addiction ["Cover Story," Jan. 30] that was devoted primarily to the controversy surrounding the use or lack of use of methadone in San Diego. Heroin and similar drugs, collectively called "opioids," are the second most extensively studied drugs after alcohol. Unlike alcohol or drugs like cocaine and methamphetamines, opioids selectively bind with specific neurons in the brain called the "opiate receptors" and cause both beneficial effects like pain relief and also addiction. Thanks to this knowledge, we have three distinct medications to treat opioid addictions--more than any other addictive drug except alcohol. The first and the most extensively used medication, and also the most controversial, is methadone, which binds with the opiate receptors, causing complete activation, but not to the same extent as heroin, thus breaking the cycle of withdrawal and cravings. The second medication is buprenorphine, better known by the trade name Suboxone. Buprenorphine binds with the opiate receptors, causing only partial activation. The third is naltrexone, which binds with the opiate receptor and prevents any activation. Buprenorphine can be prescribed by physicians who have received the required training. Naltrexone, being a non-narcotic, can be prescribed by any licensed physician. Successful treatment demands giving patients' choices. Not all patients are going to benefit from just one drug, be it methadone, buprenorphine or naltrexone. Most opioid patients are not aware that they have treatment choices, and the methadone clinics don't offer patients any choices. They offer just one drug--methadone. It's like a diabetes clinic offering patients insulin as the only treatment. Advancement in the understanding of addictions has led to a quiet revolution. Addicting and potentially harmful drugs are being replaced by non-addicting and safer medication. Not too long ago, benzodiazepines like Librium and Valium were considered the "gold standard" for the treatment of alcoholism. We now have medications like acamprosate and naltrexone. The "gold standard" is offering patients treatment choices. Percy Menzies, Assisted Recovery Centers of America St. Louis, Mo. - --- MAP posted-by: Richard Lake