A new heroin-addiction treatment that many doctors say is safer than methadone can be prescribed in Canada starting this week.
The drug, sold under the names Subutex and Suboxone, contains buprenorphine, an opiate. Manufactured by Schering-Plough Corp., it was approved by Health Canada in 2005.
Dr. Mark Dubé, a private practitioner in Sudbury, Ont., has been prescribing methadone for years. He started prescribing Subutex and Suboxone in August to one of his methadone patients under a special access permit granted by Health Canada.
Dubé considers the drug safe. He argues the formulations to be sold in Canada contain antidotes that make using high doses unpleasant. But the medication is addictive.
According to Dr. H. Westley Clark, director of Washington, D.C.-based Substance Abuse and Mental Health Services Administration, if a drug can be abused, it will be.
"These are still opioids. It has a very good safety profile, but … they are not sugar pills," he told CBC News.
The U.S. Food and Drug Administration says buprenorphine is not as dangerous as crack cocaine, OxyContin and methamphetamines. But it is in the same category as Vicodin, a commonly abused painkiller.
As for the risk in Canada, each province will have to decide on its own how tightly to control it. "Across the province and at the college we're still trying to figure out what the appropriate supervision is — and it's still a work in progress," said Dubé.
He said he's hoping for flexible regulations, adding that strict rules would make it harder to treat patients.
The Ontario College of Physicians and Surgeons warns doctors on its website that opioid-addicted patients are at a higher risk for drug and alcohol abuse, including inappropriate mixing of alcohol or other drugs with prescribed medication.
"As with any new therapy or treatment, the college expects that all physicians who wish to use buprenorphine to treat opioid-dependent patients will have training/education in this drug, and addiction medicine generally, prior to initiating buprenorphine treatment," it says.
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