Suboxone Saving Lives in Baltimore

Health advocates and doctors say a little pink pill called buprenorphine (brand name Suboxone), a relatively new drug for treating heroin addiction, has decreased overdose deaths and taken many addicts off the street, reducing crime and even preventing homicide.

“It’s absolutely the best thing that ever happened to this city in terms of treating heroin addiction, and I think it’s safe to say it has been a factor in reducing violence,” said Dr. Michael Hayes, chief physician at the Center for Addiction Medicine at Maryland General Hospital.

Buprenorphine is a mild analgesic that acts as a “blocker,” preventing withdrawal symptoms and cravings in people addicted to heroin. Made available for treating addiction nationally in 2005, buprenorphine –unlike methadone, a more established treatment for heroin addiction—is not nearly as potent, and doesn’t cause feelings of euphoria associated with more powerful opiates.

The apparent effectiveness of buprenorphine has prompted a greater push by Baltimore officials to expand the availability of the drug, which currently gets only a small percentage of the city’s $47 million drug treatment budget. “Every week I get calls from doctors or clinics seeking funding to be able to provide buprenorphine to people who need it,” said Greg Warren, CEO of the Baltimore Substance Abuse Systems.

Baltimore’s buprenorphine program was given a “Model Practice Award” by the National Association of City and County Health Officials last week in recognition of the efficacy of its buprenorphine initiative. “In 2008, 84 fatal drug overdoses did not occur, and in my book that is 84 people whose lives were saved. This award is well earned and deserved,” said Mayor Sheila Dixon, referring to the 2008 reduction in overdose deaths from the previous year, which Warren also attributes to the wider availability of the drug.

Despite the drug’s success, the DEA wants to closely monitor the doctors prescribing the drug because it can be misused by addicts who obtain it illegally. Warren said that buprenorphine is still much safer than treatments like methadone.

“I do not believe that buprenorphine is being misused, even when it’s being bought on the street because you can’t really get high on it,” said Warren , noting that Suboxone contains an additive called Naxolone, a drug that blocks the effects of other opiates, making buprenorphine less attractive to people using other narcotics.

“It almost impossible to overdose on buprenorphine unless you are taking another substance,” Hayes added. “In general, we still don’t see deaths, but we do with methadone, burprenorphine is a much, much safer drug,’

Last year, a Baltimore grand jury investigated buprenorphine’s efficacy for treatment of heroin addiction. After a four-month probe that included interviews with health officials, drug treatment professionals, and even addicts, the jurors concluded that the drug is both “safe” and “effective” for treating heroin addiction, and recommended that the city expand availability of the drug.

Still, the FDA has yet to lift restrictions that limit each approved doctor to prescribing the drug to more than 30 patients; restrictions initially limited an entire practice to 30 patients being treated with buprenorphine.

But Hayes said that in a city where heroin addiction fuels a violent drug trade and criminal behavior, the more buprenorphine available the better.