Wired Magazine has a fascinating story about buprenorphine, a heroin detox drug that offers significant promise for recovering addicts. Unlike methadone, buprenorphine (or “bupe”) doesn’t produce a high or low, and it’s almost impossible to abuse it. As a result, it can be dispersed in large quantities. (Methadone clinics generally only deliver one dose per day, which must be consumed on the spot.) Recovering addicts using bupe don’t have to deal with the sedative quality of methadone, and don’t have to schedule a visit to a clinic every day. Unlike methadone, it doesn’t show up on a urine drug test. All of these factors should significantly ease the reintegration of ex-addicts into the work world.
Despite the improved technology, bupe hasn’t been much of a success. Regulation has been bungled, and the relevant parties simply don’t have the incentives to promote a new, improved treatment. Methadone clinics are afraid that they’d lose money if methadone users got on bupe. GPs are afraid of bringing a new population of ex-addicts into their offices. A set of idiotic regulations prevents clinics from dispersing more than a pill a day, and bans even giant health care providers from taking more than 30 cases. The patent holder isn’t a pharma company, and doesn’t have the interest or expertise to promote the new drug. In fact, the protagonists of the article are a pair of treatment specialists who are promoting the drug freelance.
Well worth reading.
{ 2 comments }
Patrick 04.01.05 at 9:45 pm
Why do so many people fall for these puff pieces on drugs?
If you were to check the Cochrane Collaborative Database, a peer reviewed, evidence based medicine site you might find that their conclusion is:Buprenorphine is an effective intervention for use in the maintenance treatment of heroin dependence, but it is not more effective than methadone at adequate dosages.
Or, using Pubmed you can find studies like A pilot study of buprenorphine-naloxone combination tablet (Suboxone) in treatment of opioid dependence that concludes that only one in ten of the patients treated with buprenorphine by the authors would qualify for unsupervised administration of the drug.
Have you heard about this great drug for arthritis called “Vioxx” …
Andrew 04.03.05 at 1:45 pm
True… studies show that bupe may not be more effective than methadone. But Bupe has many advantages. Main one is that you don’t have to suffer the inconvenience and stigma of a daily clinic visit.
Doctors are allowed to write prescriptions that can be filled at a pharmacy (just like other meds). This means that for the first time since 1914 (Harrison Act) opioid addiction treatment is available with privacy and dignity.
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