New hope for heroin addicts

Brooklyn center uses drug that could revolutionize treatment

March 14, 2001|By Gerard Shields | Gerard Shields,SUN STAFF

Behind an ordinary storefront in Brooklyn, a potentially revolutionary heroin addiction treatment is being administered.

The former shop at 110 E. Patapsco Ave., near Hanover Street, houses the Recovery Center of Brooklyn, a 20-patient-a-week drug treatment facility.

What makes the treatment center different is its physician director Dr. Richard W. Carpenter, who dishes out a promising new heroin rehabilitation drug, buprenorphine.

The drug comes in tablets that supporters hope the federal government will eventually allow to be dispensed by more doctors, who could then treat addiction much they way they treat other ailments.

In a city that the U.S. Drug Enforcement Administration recently called the nation's per capita heroin capital, health officials see the treatment as a possible way to radically change the healing of addicts.

"It's the coming thing," said Dr. Peter L. Beilenson, the city health commissioner. "And it's a good thing."

For 30 years, cities such as Baltimore have relied on methadone clinics, where addicts come daily to receive a substitute narcotic in a syrupy form. That method has regularly been opposed by neighborhood groups, who dislike the lingering platoons of addicts.

The new drug - which some supporters believe could eventually be taken at home like other prescriptions - would eliminate the stigma of having to go to methadone clinics.

"It's going to make treatment more socially acceptable," said Ann T. Ciekot, director of the Maryland chapter of the National Council on Alcoholism and Drug Dependence.

With its narrow, cream-colored blinds, the Brooklyn center draws little attention. The blue-collar southern Baltimore enclave has seen its share of economic despair, and some view the drug rehabilitation center as a new, necessary avenue of service, much like a shoe store of old.

"We needed a treatment center here," said Jim Martsoukis, owner of the Holiday Restaurant across the street. "There are a lot of drugs all over the place."

The Brooklyn center is the brainchild of Carpenter, a doctor of 40 years who specializes in addiction medicine. A Tennessee native, Carpenter moved to Baltimore eight years ago.

An alcoholic with 20 years of sobriety, he listened to a former assistant from Brooklyn who urged him to provide drug treatment in her neighborhood.

Carpenter sees the need firsthand some nights when he walks to his car and is solicited by prostitutes or dealers.

"It's sad," he said. "People told me that this was a place where addicts needed help."

Carpenter, who has been administering buprenorphine for one year, is seeing four in 10 patients stay clean, a slightly higher success rate than the one in three with other methods.

"That's a good figure in this business," Carpenter said. "Not good enough, but good."

In October, then-President Bill Clinton signed a law allowing doctors to use the prescription, although the Food and Drug Administration has yet to regulate it.

That means that physicians trained in addiction medicine, such as Carpenter, are limited to giving out the treatment three times until new regulations come out. That gives the drug a somewhat renegade reputation. The drug also being used at several Baltimore-area hospital treatment programs and a few clinics.

Carpenter administers the three treatments in person through lozenges over five to seven days to help addicts get the heroin toxins out of their system, he said. Addicts are then referred to an outpatient program for counseling. Because of the drug's newness, it is strictly regulated. The pharmacy requires Carpenter to document how many patients he is treating with the medicine, which is manufactured in Nevada.

The average addict takes about two years to become clean, with up to five stops and starts, Carpenter said. Buprenorphine helps accelerate the process because it is nonaddictive, removing the need for doctors to use another narcotic, such as methadone.

Patients trying to end their drug habit under Carpenter's program pay $175 for the first visit and $25 for each visit thereafter. In the long haul, the costs can be lower than those of methadone, which costs about $100 for the first treatment and $11 with each daily visit, Carpenter said.

U.S. officials estimate that the nation has up to 1 million addicts. City officials estimate that 41,000 residents are addicted to heroin.

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