Keeping bupe off the streets

Our view: More safeguards needed for a promising treatment

April 20, 2008

Buprenorphine - the drug that is being more widely distributed to treat heroin addiction - is showing up with troubling frequency in illegal street sales. Police seizures of bupe in Baltimore and Baltimore County last year were at least twice as high as the year before, while methadone seizures decreased 45 percent. Efforts to control diversion of bupe need to be redoubled. But the drug is still part of the treatment solution to heroin addiction.

The extent to which bupe is becoming a black-market product is important as the drug is increasingly being recommended as a treatment option. Last year, it was seized 182 times by Baltimore police, compared with 58 times in 2006. In Baltimore County, it was seized 65 times in 2007, compared with 32 times in 2006. Those increases are disturbing, but some may have involved people who had the drug legally. The larger problem is that city police had almost 9,500 seizures of heroin and 12,670 of cocaine when making arrests last year. As long as heroin is in such abundance, bupe and other antidotes need to be even more available. But safeguards are essential.

City health protocols for bupe include requiring addicts to start using it in approved treatment programs before switching to a private doctor who can maintain treatment. And federal treatment guidelines suggest monthly check-ins for stable bupe users so that even if a 30-day prescription allows refills, someone is keeping track of the pills.

Closer monitoring may be needed, but illegal sales shouldn't undermine bupe's promise.

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