By Ed Coghlan.
We find ourselves in the middle of what is being called “the opioid crisis”. And as the government has become more concerned about opioid addiction-the debate has evolved (or some might say devolved) to the addictive qualities of opioids.
For some in the chronic pain world, that is not only too simplistic but also dangerous to the chronic pain patients who use opioids responsibly to manage their lives.
Let’s add one more element to the debate.
Not all opioids are the same.
That’s the point that BioDelivery Sciences CEO Mark Sirgo was emphasizing in a recent interview with the National Pain Report.
His company developed and distributes BELBUCA® (buprenorphine), a buccal film indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.
Sirgo, who is a doctor of pharmacy, has been working on the technology used in BELBUCA for over a decade.
Like many in the chronic pain industry, he’s frustrated with the federal government.
“Opioids have been used to treat pain for decades and they work-and have brought a lot of people relief,” he said. “With the government involved the pendulum swings from one side to the other and there’s very little compromise in the middle.”
And Sirgo believes his small company is in the middle-an alternative to the addiction crisis that can bring relief to chronic pain patients.
BELBUCA is a Schedule 3 opioid, which is defined to have lower abuse potential and less physical and psychological dependence than other opioids that are all categorized by the DEA as Schedule 2. Essentially, with BELBUCA, you don’t get the same euphoria with taking it that many Schedule 2 opioids “provide”, and Sirgo says that’s the main point.
“It’s euphoria that many people crave, and once that happens that patient can not only become a pain patient, but an addicted pain patient.”
So if this is a better mousetrap, why aren’t more people using it?
You can almost hear Sirgo sigh when asked that.
“If the payers in managed care knew this and the elected officials knew this, there would be momentum and maybe even an edict that chronic pain patients would start on a Schedule III product first, such our product,” said Sirgo. “But we are a small company and getting the word out is difficult.”
Yet they are making some progress, mostly with pain physicians.
“There’s some momentum, we are a very small company and can’t leverage the way a larger pain companies can…but we are making some headway with some managed care companies and doctor practices.”
He said as patients use it after having been on a Schedule 2 opioid like hydrocodone, they often say the “opioid fog lifts,” they have more energy, more positive approaches to life.
“We need more time and more exposure,” he added.
BELBUCA is not a pill—it’s like what he describes as “a thin film resembling a Listerine strip,” a biodegradable film that dissolves in your mouth in a few seconds. And it leads Sirgo to ask a simple question.
“Why wouldn’t a doctor put a chronic pain patient on this first before they moved to a category two opioid?”
While he may be frustrated about the slow adoption, he knows the “opioid epidemic is front and center, and it’s not going away.”
And that gives the Company time to increase its exposure and make the case that not all opioids are the same.
“No one is talking enough about solutions, like better educating healthcare providers and following patients more closely to make sure they are using the pain products responsibly,” he said. “We need to meet in the middle and find a real solution so that patients are not going to continue to suffer from having their medications reduced with no alternative to addressing their pain.”
Sirgo doesn’t proclaim that BELBUCA is the sole solution to address chronic pain.
“It is a responsible choice among opioids,” he said.
In the meantime, Sirgo is waiting for sanity to return to the discussion.
“People who are suffering are the ones we are trying to help. Washington is not helping.”