"That is not the type of diversion that is a public health crisis," Sharfstein said. "It doesn't mean I support it."
Sharfstein told the committee that The Sun's series did not adequately address buprenorphine's benefits and did not credit the city's program for the measures it has taken to prevent misuse.
"I'm not happy about any diversion," he said. "There's a big difference between a pill being sold on the street that's used by people to avoid withdrawal ... and a pill that is injected and used for euphoria."
An addict named Charlene who accompanied Sharfstein credited the drug with saving her life, calling it her miracle pill. She also said she first tried it on the street, as others have, to avoid the painful withdrawal symptoms that set in when addicts cannot get heroin.
In parts of the country where buprenorphine is most readily available, such as Maine, Vermont and Massachusetts, people have misused it, and several have died after mixing it with other substances, The Sun reported.
Del. Eric M. Bromwell, a Baltimore County Democrat, elicited laughter by criticizing The Sun's reporting of buprenorphine being in the deadly mix rather than blaming the other substances.
Sharfstein also had complained that The Sun's series overstated the drug's danger, but he quickly acknowledged that "if we're not serious about the risks" of buprenorphine abuse, that could jeopardize the treatment's benefits.
Sharfstein said the city has taken 14 precautions to prevent illegal use, including pill counts, tests for buprenorphine's presence in patients' urine and asking them if they have used the drug on the street.
But his initiative, which is costing $3 million and has treated nearly 700 people, does not systematically track how many patients have tried it on the street first and how many clients have failed urine tests to determine whether they are taking the drug.
Sharfstein said after the hearing that the six treatment centers in his initiative all have different standards for how to handle patients when they fail pill counts or if their urine screens show they are not taking their pills.
Dr. Peter Luongo, director of the state Alcohol and Drug Abuse Administration, told lawmakers that buprenorphine testing is "a key and crucial element" that the state plans to require. He also said results would be tracked through its computer system.
