There are drugs available right now that ease withdrawal symptoms for those who suffer from painkiller addictions. Methadone is a treatment that patients have to go get daily, and it is only available at limited clinics. Buprenorphine is a drug that can decrease a person’s cravings for painkillers as they go through withdrawal, and increases the chance that they will stay clean and not relapse. It is also considered safer than methadone in terms of overdose risk. Currently buprenorphine comes in pill form or as a dissolvable strip that patients can put under their tongue.
There are problems with these kinds of delivery methods as patients sometimes forget to take their dose or they sell their medication. Though there is a smaller risk of overdosing on this drug as there is on other addiction treatment drugs, there is still a risk.
Probuphine is a new development that is implant, so rather than getting into a patient’s system as a pill the buprenorphine gets to the patient’s system through the bloodstream and eliminates the risk of patients forgetting to take the medication, or selling their pills or strips.
The implant lasts for six months at a time and is inserted just under the skin of a patient’s inner arm. Doctors would need to be trained on how to insert and remove the probuphine implants safely.
Some health professionals are not fully convinced that probuphine is a better solution to the problem. The director of public health policy initiatives at the National Center for Health Research, Dr. Tracy Rupp, said that it can take up to a month for the implant to distribute the same amount of buprenorphine as the strips so she thinks patients would still have to take the oral medications while they were first adjusting to the implant because in this transition period, she worries that patients would be at risk of relapse. She also worries that patients would suffer bleeding and maybe risk infection every six months when an incision is made to insert the implant.
In trials 86 percent of patients who were on the probuphine implant did not have evidence of illicit opioid use in their systems, and 72 percent of patients on the strips did not show signs of illicit opioids use. There was only one clinical trial that showed the effectiveness of this drug, and Rupp noted that some urine samples that were missing were simply counted as negative for the trial, but patients may have been skipping urine tests because they may have taken outside drugs and were afraid of a positive result.
Julie Kramer is a member of the Psychopharmacologic Drugs Advisory Committee (which gave their positive recommendation to the FDA to approve this drug in a 12 to 5 vote), who voted against the approval. She said that she is concerned about approving this drug right now because they do not know the effects of taking this beyond six months, or if it is even effective for more than six months. Some addicts need years to become fully sober.
There are estimated to be around 2.5 million people in this country suffering from opioid addiction, and a large majority of them are addicted to prescription opioids.