New Options for Addicts Wanting to Kick the Habit
And for each patient, one drug may indeed be a better choice than others, says John Renner, MD, an associate professor of psychiatry at Boston University School of Medicine who was not involved in the study. This study was not designed to help determine which treatment is best for whom, he says, "but there is some indication that Orlaam and buprenorphine are better for very stable and motivated patients, while methadone seems to be the better choice for [long-term addicts who are] brand new to treatment."
There is widespread concern about sending "those who are very shaky and not in control to a private doctor's office," says Renner. For that population, methadone is probably best. But it may be equally unwise to send less-experienced users "to a methadone clinic, where they'll come into contact with hard-core [addicts] on a daily basis. Buprenorphine may be a better option for those people," he says,
According to Bigelow, Congress has just recently enacted legislation that is expected to allow buprenorphine, which is under review by the FDA, to be dispensed by doctors outside specialized narcotic treatment programs. This could mean that individuals leery of visiting a methadone clinic may be able to seek help directly from their family doctor. For now, however, it's unclear whether the new regulations will allow addicts to begin treatment with buprenorphine, or if a preliminary period of abstinence with the help of methadone will be required before they can "graduate" to the new medication.