Vice Squad
Saturday, December 29, 2007
More Reaction to Sun's Light on Buprenorphine

A few days ago Vice Squad mentioned the Baltimore Sun's investigative reporting on buprenorphine, an opioid commonly used to treat heroin addiction (which is rife in Baltimore). One part of the series concerns France, where buprenorphine is widely prescribed to addicts. This part of the series, like other parts, has attracted critical commentary from the treatment community. Today's letter (scroll down a bit) from two French addiction workers expresses dismay about both the story and the Sun's Public Editor's tepid endorsement. Their letter points out some information that did not appear in the Sun story:

Opioid substitution treatment now covers about 70 percent of drug users in France, and most receive buprenorphine. This change in policy has achieved:

• An 80 percent reduction in heroin overdose deaths (from 500 to 100 per

• A 75 percent reduction in HIV prevalence among drug users (from 40
percent in 1995 to 11 percent in 2004).

• A 75 percent reduction in drug-related crimes.

Causality is always tricky, but it does seem that buprenorphine has been a very successful treatment for heroin addicts in France. Incidentally, much of the Sun's concern about buprenorphine "abuse" draws upon heroin addicts who purchase street bupe to stave off withdrawal when they cannot afford or access heroin. This use may not be undertaken under a physician's care, but it is far from clear that it constitutes "abuse" in the usual sense. (Though in the drug policy world, the abuse of "abuse" is common.)

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