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Researchers, Patients Alike See Advantages Of 'Bupe'

URL: http://www.mapinc.org/drugnews/v05/n1098/a09.html
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Webpage: http://www.nynewsday.com/news/local/newyork/politics/nyc-phoe0710,0,4799420.story
Pubdate: Sun, 10 Jul 2005
Source: New York City Newsday (NY)
Source: New York City Newsday (NY)
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Copyright: 2005 Newsday, Inc.
Author: Curtis L. Taylor, Staff Writer
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RESEARCHERS, PATIENTS ALIKE SEE ADVANTAGES OF 'BUPE'

One recent Tuesday morning, Lorenzo Cleveland Lawson sat in an office of the Phoenix House drug treatment facility, tucked behind the Ravenswood housing development in Long Island City.

Lawson, 42, a heroin addict for 14 years, was entering his seventh day of withdrawal.  But he was calm and smiled easily as he spoke of his plan to get clean and to repair his fractured relationships with his wife and 10-year-old daughter.

"I don't feel high," said Lawson, who credits the drug buprenorphine with easing his cravings for heroin.  He wasn't successful in an earlier effort to beat the habit, dropping out of a methadone detoxification program.

"I feel strong enough to be around people.  My mind is sharp enough and my body feels good," Lawson said.  "I am not high and I have the incentive now to get better so I can help myself."

The program is one of the first in the country to use buprenorphine to detoxify addicts before transferring them to a drug-free residential rehabilitation program, said Dr.  Terry Horton, medical director of the city's Phoenix House operation.

Historically, opiate addicts have had difficulty in successfully crossing the bridge from detoxification to participation in a drug-free residential setting, Horton said.

"Our initial goal was to open the door wider for a group of people to get to rehabilitation who could never get through detox," Horton said.  "The key is, the longer they stay in treatment, the better they do overall."

Currently, there are 12 patients undergoing buprenorphine detox at the Long Island City facility at a daily cost of $134 each, Horton said.  Most of the treatment is covered under private insurance or Medicaid.

The time it takes for detoxification using buprenorphine averages about 14 days, though it varies with the individual, he said.

Columbia University researchers, in a recently completed outcome study of the Phoenix House program, showed that buprenorphine users had a 90 percent completion rate in detox - with 76 percent of the detoxed patients later entering drug-free residential rehabilitation.

"The old model of one-size-fits-all does not work," Horton said, referring to existing detox methods, most of which rely on the also-addictive drug methadone.  "It has been a useless revolving door and costs a lot of money, with less than half of those treated going back to get rehabilitation treatment after they are discharged from detox.  And when they do go to rehabilitation treatment, they are still in withdrawal."

From day one with "bupe," as it has come to be called, patients seem to have a clear mind and are able to function better, which helps them immediately proceed with counseling, Horton said.

Javier Rosario, 37, was in his 18th day of trying to kick a seven-bag-a-day heroin addiction - for which, at $10 a bag, he was shelling out about $500 a week.  He said buprenorphine helped him both physically and mentally to prepare for the drug-free rehabilitation phase of his recovery.

Seated in a circle during a counseling session, Rosario told a group of fellow addicts how he began using drugs as a teenager to escape a childhood during which he was molested by an older relative and physically abused by his grandfather.

"I feel good, but at the same time I feel scared," Rosario said later.  "On methadone, when you came off of it, my body didn't feel good.  They told me to go to rehabilitation, but my body wasn't up to it.  I was anxious and I didn't feel the same when I was off.

"With bupe, I had some cravings, but I don't have the withdrawal symptoms that I had before.  This drug helps you come down a lot better," he said.  "I feel like I am myself for the first time in years."