A study published in JAMA by researchers from the Icahn School of Medicine at Mount Sinai, New York, investigated subdermal (under the skin) buprenorphine implants and their effect on opioid-dependent patients. They found that after six months patients maintained very low, or no illicit use of opioids relative to daily sublingual (under the tongue) buprenorphine maintenance treatment.
Ninety-three percent of the patients completed the trial. Here are some of the findings:
- Eighty-one of 84 (96 percent) receiving buprenorphine implants and 78 of 89 (88 %) receiving sublingual buprenorphine were responders
- Urine tests were administered monthly and four times randomly.
- Seventy-two out of 84 (86 %) receiving buprenorphine implants and 64 of 89 (72 %) receiving sublingual buprenorphine maintained opioid abstinence.
- Non-implant-related and implant-related adverse events occurred in 48 % and 23 % of the buprenorphine implant group and in 53 % and 13.5 % of participants in the sublingual buprenorphine group, respectively.
“Buprenorphine is an effective treatment for opioid dependence; however, adherence to daily dosing for management of chronic disorders is challenging. An implantable buprenorphine delivery system reduces adherence issues and may improve efficacy,” the authors write.
“This novel implant system may help buttress patients’ decision-making deficits that are a core component of the addiction by making these lifesaving medication adherence decisions far more infrequent,” noted Wilson M. Compton, M.D., M.P.E., and Nora D. Volkow, M.D., of the National Institute on Drug Abuse, Bethesda, Md., in an editorial that accompanied the study.
“However, buprenorphine implants are currently approved by the U.S. Food and Drug Administration for only up to 1 year of treatment for a subgroup of patients who have already achieved and sustained prolonged clinical stability while receiving low to moderate doses of oral transmucosal buprenorphine, a caveat clearly stated in the product label. Even so, this novel approach to delivering care may open up treatment for new, previously difficult-to-reach populations or for those in the criminal justice system. Although further research is needed to determine which populations would benefit the most from these new formulations, the potential of these agents to have a positive role in the current opioid crisis is undeniable.”