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New developments in managing opioid addiction: impact of a subdermal buprenorphine implant

Authors Itzoe M, Guarnieri M

Received 31 January 2017

Accepted for publication 6 April 2017

Published 10 May 2017 Volume 2017:11 Pages 1429—1437


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Georgios D. Panos

Video abstract presented by MariaLisa Itzoe.

Views: 579

MariaLisa Itzoe, Michael Guarnieri

Department of Neurological Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA

Abstract: Opioid addiction to prescription and illicit drugs is a serious and growing problem. In the US alone, >2.4 million people suffer from opioid use disorder. Government and pharmaceutical agencies have begun to address this crisis with recently released and revised task forces and medication-assisted therapies (MAT). For decades, oral or intravenous (IV) MATs have helped patients in their recovery by administration of opioid agonists (methadone, buprenorphine, oxycodone), antagonists (naltrexone, naloxone), and combinations of the two (buprenorphine/naloxone). While shown to be successful, particularly when combined with psychological counseling, oral and IV forms of treatment come with constraints and challenges. Patients can become addicted to the agonists themselves, and there is increased risk for diversion, abuse, or missed dosages. Consequently, long-acting implants have begun to be developed as a potentially preferable method of agonist delivery. To date, the newest implant approved by the US Food and Drug Administration (May 2016) is Probuphine®, which delivers steady-state levels of buprenorphine over the course of 6 months. Numerous studies have demonstrated its efficacy and safety. Yet, implants come with their own risks such as surgical site irritation, possible movement, and protrusion of implant out of skin. This review introduces the opioid abuse epidemic, examines existing medications used for therapy, and highlights Probuphine as a new treatment option. Costs associated with MATs are also discussed.

Keywords: addiction, opioids, medication-assisted therapy, long-acting implant, buprenorphine, Probuphine®

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