Courier-Post

Linda Johnson, Associated Press

Courier-Post
12-30-2002

TRENTON:

An addiction treatment doctor who says his implanted medication pellets help recovering addicts stay clean plans to bring them to patients elsewhere.

Dr. Lance Gooberman, who operates the U.S. Detox Inc. clinic in Merchantville since 1996 has made an implanted half-inch pellets containing medicine that blocks the high from opiates.

The pellets, patented by Gooberman in March 1991, are inserted just under the skin on the back of the arm. They contain the drug naltrexone which blocks the effects of heroin and other opiates for about two months to help recovering addicts overcome temptation.

The U.S. Food and Drug Administration approved naltrexone in the early 1970s for treating drug addiction and more recently alcoholism. It is widely used on addicts, usually in pills, but recovering addicts sometimes stop taking them so they can get high.

At least one company now had a long-acting injection of naltrexone.

Gooberman and a colleague last month were exonerated of malpractice charges in the deaths of patients receiving a different treatment, rapid opiate detoxification under anesthesia. The long investigation and trial Gooberman said overshadowed all the good his pellets have done.

While the pellets are not approved for sale by the FDA, Gooberman can compound them for use in his own patients.

He said he’s implanted at least 100 pellets per month since 1996 in patients -including some from England and the West Coast-recovering from addiction to heroin, methadone and other opiates.

As far as he can tell, the pellets help keep patients clean for two months and many come back for more implants.

“This has been a wonderful idea. It’s working, “Gooberman said, “I want to make this more broadly available to more people.”

He plans to license use of his pellet-making procedure and an insertion kit to other addiction specialists. Gooberman also hopes to privately raise about $5 million to perform three types of experiments -chemical analyses, tests on guinea pigs and tests in healthy volunteers – so he can seek FDA approval to sell his pellets.

But he has no hard data to prove how long the pellets are effective, other addiction experts say.

“It sounds like a good idea, assuming there is a recognized way to screen people to see who is appropriate for this,” said Robert Hunsicker, president of the National Association of Addiction Treatment Providers.

Hunsicker said use of the pellets is being widely discussed in the field, especially for patients who repeatedly relapse.

Dr. Donald R. Jasinski, Chief of the Center for Chemical Dependence at Johns Hopkins Bayview Medical Center, said many researchers have had ideas like Gooberman’s but could not find a long-term system that consistently releases opiate-blocking medicine.

“Naltrexone itself works but this preparation is not FDA approved, nor has it been tested with rigorous science,: Jasinski said.

Gooberman’s patients are convinced it works – as long as they keep getting pellets.

Stacey, a 25 year old college student from Toms River, said they kept her off heroin for eight months, but she relapsed because I haven’t hit bottom.” She returned to Gooberman for detoxification treatment in July and has since gotten two pellets implanted, has no cravings and hasn’t used drugs since.

“He’s a miracle worker. He really is,” said Stacy, who has referred more than a dozen other addicts to Gooberman.

Irene Waldron, a Wilmington, Del. Nursing home administrator said the pellets got her son Glenn off heroin for nearly a year before he relapsed. After another painful detoxification, Glenn got a new pellet implanted Friday.

“I was really depressed this morning and once I got it in my arm, I perked right up,” said Glenn, 30 a carpenter. “I’m starting over for the fourth time. I’m done” with drugs.

His mother, who lobbies on issues affecting the elderly, now plans to ask the Delaware Legislature to consider use of naltrexone to reduce the amount of time drug offenders must spend in jail.

“It’s the only humane way that I can see where addicts can get clean,” Waldron said.

Meanwhile, Gooberman awaits final disposition of his malpractice case.

After a trail that ran intermittently for 18 months, an administrative law judge last month ruled Gooberman and his colleague were innocent of malpractice and generally had acted in good faith, but had violated some record-keeping rules.

The Judge recommended brief suspensions of their medical licenses.

But Gooberman says their attorney will argue before the same Board of Medical Examiners, which has the final say, that a suspension is unwarranted.