The opioid addiction problem in the United States is reaching epic proportions. Some local law enforcement agencies like the Gloucester Massachusetts Police Department are leading the way in trying to get help for those addicted to opioids (which include painkillers and heroin) but there is still a stigma attached to addiction. Rather than seeing it as the neurobiological issue it is, with long-term impact on the brain, many still see it as simply a failure of character.
At the end of May, the U.S. Food and Drug Administration approved Probuphine, the first buprenorphine implant for the maintenance treatment of opioid dependence. Marketed under the brand name Probuphine, the implant is designed to provide a constant, low-level dose of buprenorphine for six months in patients who are already stable on low-to-moderate doses of other forms of buprenorphine. The implant is part of a comprehensive treatment program that deals not only with the neuroscience of addiction but with the social aspects as well.
Previously buprenorphine for the treatment of opioid dependence was only approved as a pill or a film placed under the tongue or on the inside of a person’s cheek until it dissolved. This dosage plan works, but pills and film can be lost or stolen and sometimes those in recovery will simply stop taking the medication if they relapse. Using an implant is much more effective since it eliminates some of the struggle those in recovery can face, and it’s discreet. The delivery system consists of four small rods roughly the size of matchsticks that are implanted by a doctor, under the skin, usually on the inside of the upper arm. Medication is released over time, going directly into the bloodstream.
FDA Commissioner Robert M. Califf, M.D said in a press release,"Opioid abuse and addiction have taken a devastating toll on American families. We must do everything we can to make new, innovative treatment options available that can help patients regain control over their lives. Today’s approval provides the first-ever implantable option to support patients’ efforts to maintain treatment as part of their overall recovery program.”
As medical science comes to understand more about the cognitive effects of addiction, which can include memory loss, depression, anxiety and paranoia, the terminology has changed. Addiction is defined as a cluster of behavioral, cognitive and physiological phenomena that may include a strong desire to take the drug, difficulties in controlling drug use, persisting in drug use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, as well as the possibility of the development of tolerance or development of physical dependence. Physical dependence is not the same as addiction. Newer diagnostic terminology uses the term “opioid use disorder,” which includes both milder forms of problematic opioid use as well as addiction.
Using buprenorphine is part of a comprehensive approach to treatment known as Medication assisted therapy or MAT. When the program is followed symptoms are reduced as is the desire to use, without the cycle of highs and lows associated with opioid misuse or abuse. It also decreases the high that can be caused by the use of other opioids, making continued opioid abuse less attractive. Along with counseling and psychosocial support, a MAT program can reduce the risk of death for those in recovery by as much as half. The video below talks more about this new approach to the problem of addiction, check it out.
Sources:
Kaiser Health News ,
FDA,
NPR
