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Medical Implants for Addiction Treatment

 

Most forms of drug addiction involve multiple substances or cross-addiction. Dependency of this nature is often difficult to treat effectively with pharmaceutical drugs alone, especially since effective symptom management relies heavily on patients taking such medications exactly as prescribed.

A fairly new solution to this problem is the use of medical implants, which are already a common form for medication distribution for cancer patients, for addiction treatment. While teens are more likely to be addicted to multiple substances, it’s a form of dependency that can affect anyone at any age or stage of life, especially when psychological factors that often contribute to addictive behaviors are considered.

Implant Products on the Market

The most prominent implant products on the market worldwide to treat teens and adult patients recovering from dependency are ones that disperse the medications buprenorphine and naltrexone. These implantable devices are being used on a increasingly widespread basis in patients addicted to narcotics and opioid drugs. A buprenorphine-based implant is intended to reduce opioid dependency. Meant to be used short-term, these powerful painkillers have been in the spotlight in recent years due to a high risk of dependency. A naltrexone-based implant is intended to treat addictions involving heroin, prescription painkillers, and other narcotics.

Providing Sustained Support

The rate of success with some medications meant to assist addicts during their recovery process are relatively low. It’s not the medicine itself that’s the problem, but the necessity to keep taking it on a regular basis. According to one estimate, nearly a third of all recovering addicts fail to stick to a regular medication regimen. When psychological issues related to dependency are taken into consideration, taking meds on a regular basis can be difficult even when a patient has a desire to do so. A major benefit of medication in implant form is that it’s automatically dispersed in the right dosage, which also reduces the risk of accidentally or intentionally taking more than what’s recommended.

How Medical Implants Works

The naltrexone implant is inserted just below the skin. It will slowly release medication during a specific period of time, usually anywhere from two to six months, although the length of time depends on how a patient reacts to the implant. Naltrexone does not treat withdrawal symptoms. The Probuphine (buprenorphine) implant works by releasing a steady dose of buprenorphine, a drug that reduces the risk of relapse and helps decrease cravings. Consisting of small rods, Probuphine is implanted under the skin, usually the upper arm, during a visit to the doctor’s office. It takes about 10-15 minutes to implant the device, which remains in place for approximately six months.

How Long an Implant Lasts

The polymer in a medical implant typically takes anywhere from one to two years to break down, at which time a patient will be evaluated to determine if another implant is necessary. There will also be regular monitoring while the implant is in place. Release of the implant’s medication generally occurs on a steady basis for 5-12 months. The release amount may decrease after the first year, depending on the type of implant used. They are usually well-tolerated by patients. Some implant products are designed for short-term use only and others are designed to be adjusted with varying amounts of medication based on what the patient can tolerate.

Implant Availability

Medical implants have been in use throughout Europe and Australia for several years. Oral table and injection forms of naltrexone, a pure narcotic antagonist, are currently used in the United States. The U.S. Food and Drug Administration has approved the use of naltrexone in slow-release and oral form. Approval was recently granted for the use of buprenorphine in implantable form with certain conditions, with the primary one being that it has to be administered by certified health professionals trained in how to perform the in-office procedure to insert the device. It’s also available in pill and dissolvable film form.

Implant Study

In a study involving outpatients being treated for dependence on heroin and amphetamines, those with the a naltrexone implant had higher instances of drug-free urine samples and showed a noticeable decrease in use and dependence. Some of the 100 patients followed during the 10-week study received a placebo implant. The drug-free results doubled for those who had the real implant over subjects with the placebo.

Where Implant Meds Are Likely to Be Used

As the implant forms of recovery medications become increasingly available throughout the United States, use may be more extensive in states with higher rates of abuse and drug-related deaths. According to the Centers for Disease Control and Prevention, narcotic painkillers are prescribed more often in southern states, with Alabama, Tennessee, and West Virginia topping the list. Overdose deaths related to opioids have steadily increased, according to the CDC, with ODs up nearly 15 percent from 2013 to 2014 alone. Especially appealing to teens who may wish to temporarily escape pain, stress, or fear, such substances often lead to the use of more potent forms or experimentation with more addictive substances, which can further complicate the treatment process.

Implant Challenges

The biggest challenge involving implant versions of medications to help with addiction-related issues is educating healthcare professionals and patients on the use of drugs distributed in this form. The FDA has placed some restrictions on the use of such medications, including the requirement that patients must have tolerated the oral or injection form of the same drug before an implant version can be recommended. Braeburn Pharmaceuticals, the manufacturer of Probuphine, plans to conduct extensive training sessions to increase access of their implant medication.

A medical implant is likely to be recommended only after patients have tried other pharmaceutical remedies. Separate withdrawal medications may be necessary for implant medications like naltrexone that don’t treat such symptoms. It should be stressed that effective treatment for substance abuse includes identifying and addressing underlying issues that may have contributed to the addiction in the first place. Doing so significantly increases the odds of enjoying a sustained recovery for patients.

Sources:

http://www.ncbi.nlm.nih.gov/pubmed/22764364

http://www.cbsnews.com/news/new-treatment-gives-hope-for-those-with-opioid-addiction/

http://www.thedailybeast.com/articles/2016/03/27/can-an-implant-stop-heroin-addiction.html

http://www.cbsnews.com/news/the-states-with-the-worst-prescription-painkiller-problem/

http://www.prnewswire.com/news-releases/braeburn-pharmaceuticals-announces-commercialization-plans-for-probuphine-buprenorphine-implant-six-month-treatment-for-opioid-dependence-300277180.html

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