When bupe was introduced in Europe and Australia many years earlier, it reduced overdose deaths dramatically (by over 80 percent in France). In 2002 in NYC, on average, every day, three people were dying of narcotic overdoses, which made this drug what NYC needed at the time. Dr. Sederer writes that it was his job, as NYC mental health commissioner at the time, to set about trying to introduce bupe to the City.

Dr. Sederer talks about one of his patients, Stuart, a white, suburban, middle class teenager who played sports, with an intact family, who grew up to become a college student, drinking and experimenting with pot and club drugs like ecstasy and ketamine. Before long he is addicted to Vicodin™, Percodan™, OxyContin™ and finally to heroin -- first sniffing then shooting. With a cost of up to $200/day his life collapsed about him.

Stuart now has marked over three years without any drugs, unless you count buprenorphine ("bupe") which he takes every day. He is back working, earning good money and rebuilding relationships that were battered by drug abuse.

Buprenorphine works differently and is distributed differently than methadone, or heroin. As a person takes more methadone (or heroin or narcotic pain pills), his breathing is increasingly slowed until eventually it stops altogether. This is how death occurs in these types of overdoses. With bupe, there is a "ceiling" effect, that taking more drug does not get the person higher, nor does it slow the breathing. This means buprenorphine is far less likely to be abused and cause preventable fatalities.

Buprenorphine is distributed differently than Methadone. Methadone is only distributed at "Methadone Maintenance Programs (MMPs)' where a person must go every day to swallow the usually red-pink colored liquid under the observation of the staff. MMPs often become crime zones in communities as drugs and stolen goods are bartered in the blocks that surround the site. Bupe is picked up at a pharmacy with a doctor's prescription. Buprenorphine tends not to produce the nodding that methadone produces; which allows the addict to function with more clear mind and work more productively.

Buprenorphine use in US has not caught on like Europe yet. Federal rules require that doctors take an eight-hour course and pass a test before they are allowed to prescribe it -- the only medication in this country with that requirement; additionally many doctors are biased against addiction, not wanting "addicts" in their office.

The fact that methadone providers make more money from MMPs than they would from providing bupe perhaps has not helped its widespread use either.

The consequence of not providing this treatment is existence of more crime to support habits by drug addicts, greater incidence of HIV/AIDS, hepatitis, and havoc in the lives of those affected. All this despite of existing treatment that can enable people to work, rejoin their families and rebuild their lives.

Source: Huffington Post - Dr. Sederer – Posted: June 7, 2010

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