The newest drug to help treat opiate addiction is now being sold by drug dealers and abused by addicts in Portland and other Maine communities.

“It seems to be everywhere in Portland,” said Ronni Katz, coordinator of Portland Public Health’s Substance Abuse Prevention Program.

The drug, Suboxone, is prescribed by federally licensed physicians who are trained to treat opiate addiction.

It contains buprenorphine, a synthetic opiate that controls cravings, and naloxone, an opiate blocker that is intended to prevent users from getting high and discourage abuse.

While considered a breakthrough in helping addicts break their dependence on oxycodone and other opiate-based pain medications, Suboxone pills are now turning up alongside crack cocaine and oxycodone in seizures from drug dealers. And Suboxone sublingual tablets, thin strips that dissolve under the tongue, have become the most popular illicit drug in jails and prisons because they are easy to smuggle, in the flaps of manila envelopes and greeting cards.

In Portland, Katz said, many users are dissolving and injecting Suboxone into their veins. They apparently have figured out how to remove the naloxone from the drug and get high, she said. “When you’re an addict, you become a chemist.”

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Chuck Lawson, a recovering addict in Portland, said Suboxone was one in a series of drugs that he got hooked on, after heroin and OxyContin.

“That was the next drug. Everybody was using it,” Lawson said.

Some experts argue that Suboxone users on the street are mostly self-medicating to avoid withdrawal until they can get a more powerful drug or get into a treatment program. The state’s shortage of treatment programs may be contributing to the abuse, they say.

Diversion and abuse of Suboxone is a special concern because the drug is intended to help treat addiction, not contribute to it.

Methadone, another opiate replacement drug that is prescribed for pain, also is widely abused and has been a significant contributor to overdose deaths. Suboxone is considered less of an overdose threat, and some say its street use is less of a problem.

Dealers are bringing some Suboxone into the state along with a variety of other drugs, police say.

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But the drug’s widespread availability on the street in Portland, Bangor, Rockland and other areas indicates that doctors who are treating addicts – just like doctors who are treating pain patients — are prescribing it to some people who are reselling it or giving it away.

Doctors licensed to prescribe Suboxone are supposed to monitor patients closely and require them to get substance abuse counseling as part of their treatment. However, there were about 12,000 buprenorphine patients in Maine in the past year, and the state has records of only about 3,000 getting counseling, said Guy Cousins, director of the Maine Office of Substance Abuse. Cousins and others are urging physicians to tighten up their use of the drug.

Some of the doctors are urging more care, too, because the abuse could lead to tighter restrictions on use of a drug that they say has helped many addicts.

“It has to be carefully and thoughtfully prescribed to minimize diversion. I want to preserve access to this drug,” said Dr. Mark Publicker, an addiction specialist at Mercy Recovery Center in Westbrook.


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