Opioid-Dependence Implant: New Treatment Option | Pacific Bay Recovery

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Opioid-Dependence Implant: New Treatment Option

A new treatment option for addiction is Probuphine (buprenorphine), a 6-month implant that delivers a small dose of daily medication. Buprenorphine was first approved by the Food and Drug Administration in 2002 for the treatment of opioid addiction. Probuphine was developed by Braeburn and Titan Pharmaceuticals.

Opioid Dependence What to do?How does Probuphine Work?

The implant involves 4 one-inch-long rods placed under the skin of the upper arm. This procedure is done in the doctor’s office. The implant provides 6 months of continuous buprenorphine dosing. Probuphine works by binding to opioid receptors in the body to prevent physical withdrawal from opiates, blocking the effects of opiates, and limiting cravings for opiates.

Does Insurance cover Probuphine?

Most of the larger health insurers are covering Probuphine. The implantable device costs around $5,000 or $825 per month. However, some insurance companies are not yet covering the implant, citing that pills cost less. Probuphine is cheaper than Vivitrol, which is a form of naltrexone injected once a month. Vivitrol currently costs around $1,000 a month.

What are the Most Commonly Overdosed Opioids?

The most common drugs involved in prescription overdose deaths are:

  • Methadone
  • Oxycodone (OxyContin)
  • Hydrocodone (Vicodin)

What does the Statistics on Overdose Tell Us?

Overdose deaths involving prescription pain relievers have quadrupled since 1999 in the United States, and so have the sales of these drugs. From 1999 to 2015, more than 165,000 people died in America from prescription opioid overdoses. In addition, more than 14,000 people died from prescription opioid overdoses in 2014 alone. Overdose rates are the highest among individuals age 25-54 years. Men are more likely to die from an overdose, but the mortality gap between women and men is closing.

In 2015, around 2 million people in the U.S. abused or became dependent on prescription opioid medications. Around 1 in 4 people received prescriptions for pain relievers for non-cancer diagnoses. In addition, each day in the U.S, more than 1,000 people are treated in emergency departments for misuse of prescription medications.

How are Probuphine Implants Inserted and Removed?

The Probuphine rod implants are inserted and removed only by a specially trained physician. The doctor numbs the skin of the upper arm using a local anesthetic. A small incision is made, and the implants are placed under the skin. After closing the small incision with sutures, a bandage is applied, which must be kept clean and dry for 3-5 days. You can apply an ice pack to the site for 20-30 minutes several times a day to relieve pain.

The doctor will give you a patient identification card, which you must carry with you at all times. The card contains the date the implants were inserted, and the date they must be removed. You will schedule an appointment with the doctor for removal. The procedure involves a simple office procedure, much like the insertion procedure.

Does Probuphine Work?

According to a phase 3 study by the manufacturing companies, Probuphine is quite effective for treating opioid addiction. The study involved 177 participants who received either Probuphine implants or sublingual buprenorphine tablets for six months. According to the study, the efficacy rate for Probuphine was 96.4% compared to 87.6% for the sublingual buprenorphine group.

In another clinical study, buprenorphine implant patients had significantly more negative urine drug screens during weeks 1-16. The Probuphine implant patients had 40% more negative urine tests for illicit opioids. Participants who received buprenorphine implants had fewer clinician-rated and patient-rated withdrawal symptoms experienced a greater change in ratings of severity of opioid dependence and had lower patient ratings for cravings.

Resources
CDC. Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at http://wonder.cdc.gov.
Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2014 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 1999-2014, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html.
Frenk SM, Porter KS, Paulozzi LJ. Prescription opioid analgesic use among adults: United States, 1999–2012. NCHS data brief, no 189. Hyattsville, MD: National Center for Health Statistics. 2015.
Ling W, Casadonte P, Bigelow G, et al. Buprenorphine Implants for Treatment of Opioid Dependence: A Randomized Controlled Trial. JAMA: The Journal of the American Medical Association, 2010; 304 (14): 1576 DOI: 10.1001/jama.2010.1427
Ossiander EM. Using textual cause-of-death data to study drug poisoning Ossiander EM Am J Epidemiol. 2014 Apr 1;179(7):884-94. doi: 10.1093/aje/kwt333. Epub 2014 Feb 1112.)
Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2014.