Alarmism distorts the value of 'bupe'
There are two separate conversations occurring in Baltimore on buprenorphine, a highly effective medication for heroin addiction.
In one conversation, The Sun's news pages are expressing alarm about illegal sales of buprenorphine. This reporting has lacked context and balance.
The Sun's most recent story, for example, highlights several concerns from a 70-page report on buprenorphine diversion prepared for the manufacturer by an expert consultant ("Misuse of 'bupe' is found to be on rise," Feb. 3).
Yet the article did not include comparative evidence from the same report showing that buprenorphine poses much less risk than more-addictive, more-lethal and less-regulated drugs.
The Sun also left out the report's conclusion that "the extent of abuse and diversion does not come close to approaching that of methadone or Oxycontin."
In the other conversation, state and city public health officials are listening to addiction medicine experts, drug counselors, legislators, physicians, patients and community members about how to best use buprenorphine to save lives in Maryland.
At a recent forum, participants spoke passionately about how buprenorphine treatment can help people overcome addiction to heroin and other opiates.
We also discussed the importance of continually improving the quality of care and working to reduce the risk of diversion.
There is no magical potion to end the scourge of drug addiction in Baltimore.
But, as essentially every expert agency and organization in the field recognizes, buprenorphine passes the real-world test of whether its benefits outweigh its risks.
That is why responsibly expanding access to this treatment remains a top priority.
Dr. Joshua M. Sharfstein Peter Luongo Baltimore
The writers are, respectively, Baltimore's health commissioner and the director of Maryland's Alcohol and Drug Abuse Administration.
Replacement drugs can't cure addiction
Recently, I was giving a lecture on the disease of addiction at the homeless shelter where I work. One of the clients said, "I wish they had a pill that could cure addiction."
I replied, "If they had a cure, addicts would abuse it." The classroom laughed.
My predecessors in the field of addiction treatment fought long and hard to have addiction classified as a disease. The only problem is that when something is considered a disease, people want a cure.
There is no real cure for addiction.
Medication is great, but it is useless without therapy and positive support.
I was not surprised at all to read of the misuse of buprenorphine in this country, especially in Baltimore ("Misuse of 'bupe' is found to be on rise," Feb. 3).
When will the researchers and doctors learn that giving someone with a drug problem a drug is a problem? Why would a doctor give a prescription to an addict who is known to abuse drugs?
Addicts who want to get off drugs do not need more drugs.
Medications such as buprenorphine and methadone are useless without real, comprehensive treatment.
Ryan Botwinik
Baltimore
The writer is clinical coordinator for the Helping Up Mission, an East Baltimore homeless shelter.
Shooting reminds us of dangers of guns
An unspeakable tragedy occurred in the Browning home in Cockeysville last week ("A suspect, few clues," Feb. 5).
The circumstances of the deaths of four family members by gun violence, possibly inflicted by the fifth member, should make us ponder the rationale for keeping a gun in the home for any purpose.
Bridget McMahon
Baltimore
Make all schools meet same standard
If President Bush wants to give public money to private schools ("Vouchers revisited," Feb. 3), let's make it mandatory that private school students take the same tests that public school students take.
Then we can really compare and see how good these private schools are.
Paul Block
Baltimore
Standards regulate actuarial integrity
Contrary to Jay Angoff's faulty and misleading characterization of actuarial accountability and standards of practice, actuaries are accountable for their work ("Faulty forecasts," Opinion
Commentary, Feb. 1).
Indeed, accountability and standards have long been ingrained in the U.S. actuarial profession, and standards have been formalized since the Actuarial Standards Board was established 20 years ago.
To date, the board has issued 44 standards of practice that help actuaries to produce complete, accurate and trustworthy work by identifying acceptable procedures, techniques and approaches for various areas of actuarial practice.
The standards are reviewed and updated regularly.
Actuaries are also bound by a code of professional conduct that, among other things, requires them to abide by those standards.
And the Actuarial Board for Counseling and Discipline investigates alleged violations of the standards and code of conduct and, when appropriate, recommends discipline.
William F. Bluhm
Washington
The writer is president of the American Academy of Actuaries.
SUVs threaten other motorists
I can hardly begin to express my rage at the fact that Congress has wimped out again and given a break to SUVs and light trucks in the new fuel-efficiency legislation ("Not guzzling but still thirsty," Feb. 3).
Since about half of the American public is buying these vehicles, this loophole is a huge compromise to our efforts to control fossil-fuel consumption and fight global warming.
So drivers such as Roy Berkeridge say they feel safer surrounded by a lot of extra steel?
Well, I (in my compact car) don't feel safer surrounded by those humongous road monsters.
If Mr. Berkeridge runs into me in his new SUV, he may come out OK but I'll be toast. But if I get hit by another small car, I have half a chance of coming out of alive.
This means that if I want safety, I have to go out and buy a bigger vehicle and pay an arm and a leg for gasoline like Mr. Berkeridge and his ilk.
So what happens when we all drive monster vehicles? Will the automakers start bringing out super-monsters?
Where will this ridiculous one-upmanship of size take us?
Elizabeth Fixsen
Savage
New tone enhances symphony's stature
Conductor Marin Alsop is bringing a mixture of the old and new to patrons of the Baltimore Symphony Orchestra, who are obviously supporting her in droves ("Audience taken on American odyssey," Feb. 2).
She has become part of Baltimore.
And her charm and warmth, coupled with her musical erudition, have set a new tone at the symphony.
Brava, Maestra.
Dovey Kahn
Pikesville