Baltimore City Health Commissioner Joshua Sharfstein plans to testify Thursday before a committee of state lawmakers in Annapolis on the benefits of buprenorphine, the drug that helps heroin addicts kick their habit.

“Buprenorphine can be abused — there’s no question about that,” Sharfstein said. “But it’s a balance of risk and benefits, and in Baltimore, it’s not a close call. The benefits far outweigh the risks.”

In a Jan. 4 letter to lawmakers, Sharfstein said concerns of illegal sales of “bupe” were overblown.

“This problem does not represent a significant public health threat at this time,” Sharfstein wrote. “We have not heard reports ... of people in Baltimore routinely using or injecting buprenorphine to get high.”

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The federal Food and Drug Administration approved buprenorphine in 2003 as a treatment for heroin addiction. A mild painkiller, buprenorphine is considered far less dangerous than methadone — a synthetic opiate used to treat heroin addicts since the 1970s.

Mayor Sheila Dixon is requesting $5 million in additional state funding to increase access to buprenorphine — a 10 percent increase over current funding of $50 million for drug treatment handled through Baltimore Substance Abuse Systems.

Some lawmakers have expressed concerns that the drug could be abused.

“It’s a fair question to ask what we’re doing to minimize the risk,” Sharfstein said. “But we’re doing a lot to prevent that.”

More than 10,000 city residents were admitted for heroin treatment in fiscal 2006. More than 200 people die each year from overdoses involving heroin or other narcotics, statistics show.

Buprenorphine reduces cravings, is less likely to be used illegally and causes fewer overdoses than other drugs traditionally used to treat heroin addicts, Sharfstein said.

Dr. Michael Hayes, an addiction treatment specialist in Baltimore, said buprenorphine’s unique ability to counteract cravings while not getting people high has raised hopes that addicts can be treated by their own physician.

“Methadone has to be tightly controlled, but because buprenorphine is extremely safe, it was our hope it would allow physicians to get back into treating addiction themselves,” he said.

Of 388 patients entered in the Baltimore Buprenorphine Initiative through June 30, 65 percent have remained in treatment for 90 days, and 67 percent participate in continual counseling or other supportive treatment.

City police have reported they don’t have a problem with an illegal buprenorphine trade.

“The illegal buprenorphine market is not a significant law enforcement concern,” Sharfstein wrote.

lbroadwater@baltimoreexaminer.com