Drug is helping addicts recover

A drug that has been on the market for 4-1/2 years and is proven to be very effective in treating pain pill addicts remains hard to find in southeastern Kentucky. However, a recovery center in Perry County has been prescribing the drug for more than six months and is pleased with the results so far.

“We’ve had a real good success rate with Suboxone,” said Lesa Chaney, president and chief executive officer of the Addiction Help

in Hazard. The clinic also drug Naltrexone.

Suboxone, which contains a combination of the mild narcotic buprenorphine and Naloxone, another opiate blocker, has been on the market since January 2003, three months after it was approved by the U.S. Food and Drug Adminstration (FDA) for the treatment of addiction to painkillers ranging from OxyContin to Lortab. The drug, said by many patients to make withdrawal symptoms disappear, is much more effective and nowhere near as dangerous as methadone.

Although Suboxone can be prescribed by family doctors and is available at pharmacies, the federal Substance Abuse & Mental Health Services Administration (SAMHSA) reports that only 51 physicians in Kentucky have taken the eight hours of training necessary to be able to prescribe the drug. Among those physicians is Lesa Chaney’s husband, Dr. James A. “Ace” Chaney. None are in Letcher County.

The Addiction Help Center is located adjacent to the Ace Clinique in Hazard. While relief is only a short drive away for Letcher County residents who want to kick their pill addiction, Mrs. Chaney said patients are required to do more than just show up at the doctor’s office and get a prescription.

“Dr. Chaney doesn’t believe in it as a maintenance drug,” she said. “He tries to use it as a detox drug only. Patients must attend two Narcotics Anonymous meetings a week or counseling sessions with documentation brought back to us. We also do random drug screens.”

Addiction to narcotic painkillers is defined as a long-term brain disease by the World Health Organization (WHO) and the National Institute on Drug Abuse (NIDA). It is a treatable medical condition that is caused by changes in the chemistry of the brain. Opioid dependence can start with the use of pain medication that a doctor appropriately prescribes for pain but that a person continues to use after the medical need for pain relief has passed. Or it may begin as recreational drug use that spins out of control.

“Millions of everyday Americans from all walks of life are burdened with dependence on such prescription painkillers as oxycodone, fentanyl (and) morphine,” said Edwin A. Salsitz, MD, of Beth Israel Medical Center in New York City. “This chronic brain disease often has devastating consequences for individuals, their families, and their communities. Opioid dependence and addiction is a national public health crisis, and giving more patients access to an FDAapproved medical treatment that can be prescribed in the privacy of a doctor’s office, just as treatment for other serious diseases is offered, is a tremendously positive step forward.”

“Physicians should be armed with as many medical options as possible as they tailor treatment plans to the needs of individual patients,” Salsitz adds. “Officebased treatment with Suboxone is one option in the physician’s arsenal.”

Naltrexone is the other drug available in Dr. Chaney’s “arsenal.” The drug, which blocks the effect of all opiates, is available by implants that last up to three months, by injection, and in pill form.

If someone tries to use any kind of opiate while they are receiving treatment, they will feel no effect from the painkiller because the opiate receptors in their brain are already completely blocked with Naltrexone. Therapy with Naltrexone usually lasts for one year.

Late last year, President Bush signed into law an amendment to the Controlled Substances Act which raised from 30 to 100 the number of patients physicians such as Dr. Chaney can treat with Suboxone.

“We’ve got plenty of spots open,” Lesa Chaney said.

Suboxone users often credit the drug with allowing them to “feel normal” again.

“The patients like it, but who likes it even more is the patients’ families,” said Mrs. Chaney. “They can’t believe the change in their sons and daughters, or in their wives or husbands. Many of the patients who come to talk to us about Suboxone come in real skinny and pale and sicklooking. By the end of the first week there’s a big change. By the end of two weeks the change is unreal.”

Mrs. Chaney said the clinic treats addicts from all walks of life, including professionals, but that “some who come in are unemployed and don’t have a place to live. After a month or so of treatment they’re out searching for a job.”

In addition to treating addiction to pain pills, Suboxone is also very effective in treating heroin addiction. The treatment is so effective the New York City Health and Mental Hygiene Department has set a goal to have 100,000 opiate addicts taking the drug by 2010.

Health officials caution that while Suboxone is the best drug for treating narcotics addiction, it is not a miracle drug and not without danger. Because the drug contains buprenorphine, it can cause respiratory depression or death it taken intravenously in combination with benzodiazepines. However, because Suboxone also contains Naloxone, persons who do try to divert and abuse the drug intravenously are often thrown into rapid withdrawal, says the National Drug Intelligence Center (NDIC).

Individuals who need more information about opioid dependence and its treatment, either for themselves or someone they are concerned about, have several options. Free educational resource kits on the topic can be obtained from turntohelp.com or by calling 1-866-455-TURN. Information is also available at buprenorphine.samhsa.gov.

The Addiction Help Center is located at 207 Roy Campbell Drive in Hazard. The center may be reached by telephone at 1- 606-439-0606 or 1-606-438- 0594.