Russell Faria, an osteopathic physician with a new and growing family practice near Covington, has added a new tool to his medical toolkit — a medication than can help people kick addictions to drugs like OxyContin.

As a family medicine practitioner, Faria serves patients from infancy to those in assisted living facilities, so he sees all kinds of problems.

“There’s always the idea of looking for new things to do and there was a need for this different thing to do,” Faria said. “There are a lot of people that have addictions and it’s not just heroin addictions but prescription drug addictions. They started out with painful syndromes that went out of control.”

For many folks an addiction to painkillers, for example, starts out from treatment for an injury such as a sprained ankle, broken leg or herniated disc.

“That’s a bigger problem than people think,” Faria said. “Now they have opiate addictions and they need help. The only kind of drug treatment available up until 2002 was the methadone clinics.”

And then along came suboxone, which allows doctors an office based treatment for opiate addictions, “that helps with withdrawal … that avoids the stigma of methodone clinics.”

Methadone clinics have gotten such a bad reputation, Faria said, that many cities and even some states no longer allow them to set up shop.

“You get zoning issues and a whole lot of other practicalities people don’t want to deal with,” he said. “You’re also getting, to some degree at least, different kinds of people. The methadone clinics are often getting people who are what you call end stage. There’s not much you can do for them.”

On the other hand, someone for whom the concept of suboxone is appealing is someone who has been told, “get off the addiction or you’re going to lose your house, get off the addiction or you’re going to get fired.”

“These people want to change and they searched us out,” Faria said. “They can do it. They can come to a doctor’s office and there’s not many people who are doing it.”

Faria has known about this addiction treatment method for a few years and after moving his practice from Oregon to Kent in 2007 he began asking other doctors who were offering it about their results.

“They all seemed pleased, the ones that were doing it in their own practice, and the patients were pleased and it was working,” he said.

Over the years research scientists have worked to find a better kind of morphine. At one point, naloxone was developed, but it actually has an umbrella affect on neural receptors that respond to opiates thus preventing someone from feeling relief from pain or the high, essentially it “antagonizes the effect of the opiates.”

Researches then developed a drug called buprenorphine which stimulates the receptors but it has a ceiling, Faria explained.

“You’d get enough to relieve pain but not so much you’d get addicted to it,” he said. “Buprenorphine had a strong affinity for the receptors which means it would stick there and stay there for a day or so.”

Combine the two drugs and you get an ideal situation — a medication that provides just enough stimulation that an addicted person won’t suffer from severe withdrawal symptoms while effectively blocking an opiate that could cause them to fall off the wagon of sobriety.

Ideally, Faria said, a patient would come to the office in early withdrawal as suboxone seems to work best when a person has been off the opiate of choice for a day or two.

“If they’re hurting and they’re not happy, you give them suboxone, and they feel better,” he said. “You can maintain them on it … as a practical matter for three to six months then move them off it. Opiate receptors reset themselves and you can withdraw them off suboxone. It seems to be about six months or so that people generally need.”

Faria likened suboxone to coaxing someone off the edge of a roof with a 20 foot plunge to having them stand on the edge of a planter box and jump three feet down.

In order to prescribe suboxone Faria had to take additional training and pass a test to become certified. He was then provided a special designation number by the Drug Enforcement Agency to prescribe the medication.

He was given his designation about three months ago and began treating patients. Before he even received approval to offer suboxone treatment, Faria said, people were calling his office because his name began showing up in the databases of doctors as he was going through the certification process.

A visit to www.suboxone.com shows that Faria is one of 129 doctors within 100 miles of Maple Valley on the Substance Abuse and Mental Health Services Administration list to provide the medication.

One of the reasons he received strong interest so quickly — he’s already got 15 patients — is because the federal government only allows doctors in the first year of treating patients to offer it to 30 people and in the second year it maxes out at 100 patients.

“They call from all over, from north Seattle, they call from Portland, because it’s hard to find people who are certified in the first place who aren’t filled up,” he said.

As part of his research, Faria visited Dr. Scott Fannin on Mercer Island, who told him that suboxone has offered good outcomes for patients.

“I actually went to his office a couple times just to see how it was done,” he said.

The results Fannin described are what Faria has seen in his own patients in just a few months.

“I’ve been pleased,” Faria said. “People can come in looking, frankly, like street people today because they’ve got the problem and they want to get clean. They come in a couple weeks later, they look like a million bucks.”

For more information call Dr. Faria at (253) 639-1883 or visit his Web site at www.drfaria.net.

Reach Kris Hill at khill@covingtonreporter.com or (425)432-1209 ext. 5054.

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