FDA approves heroin treatment, researched at UVM

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(Host) The Food and Drug Administration has approved the use of a drug that officials say should dramatically improve treatment for heroin addiction in Vermont. The approval comes after years of clinical trials at the University of Vermont School of Medicine.

VPR’s Steve Zind reports.

(Zind) This week, the FDA approved the use of the drug buprenorphine for both the short-term effects of heroin withdrawal and the ongoing treatment of heroin addiction. Physicians, state officials and recovery advocates agree the approval is a milestone in the treatment of heroin addiction. Until now, methadone has been the most effective drug treatment available for heroin addiction.

Dr. Warren Bickel led the clinical trials for buprenorphine at UVM. Bickel says the drug is especially effective in treating young people who haven’t been addicted for a long time. He says buprenorphine doesn’t have the drawbacks of methadone. Unlike methadone, beyond a certain point the affects of buprenorphine drug don’t increase with dosage. That means there’s no risk of an overdose.

Bickel says UVM researchers also discovered that unlike most medications, increasing the dosage of buprenorphine prolongs the effects of the drug. That means a person can take several days’ dosage at one time.

Methadone has to be taken every day. While some methadone clinics have take home programs, this has raised community concerns about the drug being abused or sold on the street. Bickel says buprenorphine offers the advantages of a take home program, without the drug leaving the clinic.

(Bickel) “We can give people multiples of their daily dose that they can ingest at one time and skip coming to the clinic. So that allows us to essentially provide take homes without the risk of diversion.”

(Zind) Vermont currently has no methadone clinics. People seeking the treatment have to go out of state. The first clinic is set to open this fall in Burlington. In other communities, there’s been resistance to establishing clinics. Governor Howard Dean says the FDA’s approval of buprenorphine should help break down that resistance.

(Dean) “This drug is not the same problem as methadone, so this should calm community fears considerably because buprenorphine has a much lower abuse potential than methadone.”

(Zind) Dean says buprenorphine could also be used at treatment centers in Vermont where methadone isn’t permitted. Dean says he expects buprenorphine will replace methadone as the primary drug used for heroin addiction. Alice Doreo of the Vermont Harm Reduction Coalition agrees approval of the drug is good news for Vermonters seeking treatment.

(Doreo) “I think it’s going to give access to a lot of people that don’t have access now.”

(Zind) Doreo says one downside is the cost of buprenorphine. A week’s worth of methadone costs about $5. Warren Bickel says at the outset, buprenorphine might cost more than ten times that.

There’s likely to be controversy over one aspect of the government’s approval of buprenorphine. Doctors will be able to write buprenorphine prescriptions that can be filled at local pharmacies. Dean says he’s reluctant to see that happen. He feels the drug is best confined to a clinic. Doreo says giving doctors access to buprenorphine will make it more available to people who need it.

For Vermont Public Radio, I’m Steve Zind.

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