View lacks balance

The editorial staff of the Bangor Daily News has written in support of the methadone clinic in Bangor, based on uncertain data and unclear reasoning. The staff has likewise reported the results of Dr. Johnson’s article on opiod dependence in the New England Journal of Medicine (Nov. 2 issue, pp. 1290+) in a biased, self-serving and unbalanced fashion.

The article by Dr. Johnson states that methadone treatment of opiod addiction has to be in high doses to have beneficial results similar to buprenorphine, a safer and less addictive medication. When methadone is used in lower doses it is not as effective as buprenorphine.

The editorial about Dr. Johnson’s article in the same issue of the NEJM by Dr. O’Connor states that buprenorphine has advantages over methadone including fewer withdrawal symptoms, lower risk of overdose, and can be administered effectively three times per week instead of seven times per week for methadone. Dr. O’Connor also reports that recent studies have shown that buprenorphine can be effectively used to treat opiod addiction in the privacy of a general physician’s office, as opposed to a methadone clinic.

It therefore seems to me that buprenorphine is as effective as high-dose methadone, less addicting, safer than methadone, easier to use at three times per week than methadone at seven times per week, and can be more conveniently and privately taken in a physician’s office than a methadone clinic.

I believe the Food and Drug Administration will move quickly to authorize the use of buprenorphine in the United States, due to the serious need for treatment that is more accessible and safer than provided by a methadone clinic.

The citizens of Bangor should insist that Acadia Hospital not open the methadone clinic. Bangor should wait for the new and improved treatment to become available. Until then, the Winslow methadone clinic can provide this needed service.

I regret that the BDN did not present a more balanced review of Dr. Johnson’s article in the NEJM.

Paul Shapero, M.D.

Bangor