TUESDAY, Oct. 12 (HealthDay News) -- Implanting the
addiction-treatment drug buprenorphine in people who are
opioid-dependent seems to reduce cravings in the short term,
By delivering a low but continuous dose of the medication, the
implant is designed to reduce the risk that patients addicted to
heroin or prescription painkillers (such as Oxycontin) will relapse
after missing doses of buprenorphine or simply stop the daily,
under-the-tongue treatment altogether.
Dr. Walter Ling, from the University of California, Los Angeles,
and his colleagues report their findings in the Oct. 13 issue of
Journal of the American Medical Association.
"In summary, this study found that the use of buprenorphine implants compared with placebo resulted in less opioid use over 16 weeks and also across the full 24 weeks," the research team said in a news release from the journal.
According to the U.S. National Institute on Drug Abuse, the best
way to address opioid addiction is through a combined intervention
involving both behavioral (to help patients learn how to cope
without drugs) and pharmacological treatments.
Medicinal treatment includes drugs such as naltrexone, methadone
The current study involved 163 adults between the ages of 18 and
65 diagnosed as opioid-dependent between 2007 and 2008.
Four buprenorphine delivery devices were implanted under the
skin of one arm in 108 patients. Each device was set to slowly
release 80 milligrams of medication. The remaining 55 patients
received implants without any drug delivery. None of the patients
received buprenorphine by the standard oral delivery route.
All the patients received drug counseling for the six months
that the devices were in place.
Urine samples taken throughout 16 weeks of treatment revealed
that patients given buprenorphine via implants were far less likely
to test positive for illicit opioid use than the others.
About 40 percent of the urine samples taken from the implant
negative for illegal drug use, compared with about 28 percent
of the placebo group.
Also, about two-thirds of those on an implantable buprenorphine
regimen stuck to their treatment program for the full six months,
while only about 31 percent of those getting no medication did so.
None of the buprenorphine patients were deemed to have "failed"
their treatment, as opposed to about 31 percent of those not
getting the medication.
Despite these findings, Dr. John Mariani, director of the
substance treatment and research service at New York State
Psychiatric Institute/Columbia University in New York City,
expressed some reservations about the innovation.
"First of all, oral treatment is a fantastic therapy," he said. "It's a very effective way to deliver treatment, and I would put it up against any other treatment for both substance abuse issues and psychiatric problems."
"Of course, there will be some patients that have adherence problems with the oral option, for which this would be something to consider," Mariani said. "But that's rare. Maybe one in 25 don't stick to it, whereas the vast majority of patients I treat like the effect of oral buprenorphine and they don't tend to stop taking it, because then they start to experience withdrawal."
Mariani noted some drawbacks to the implantable option.
"Although it's not the most invasive procedure to have, it is a
surgical approach and there's always the risk of infection, and
then scarring if and when it has to be removed," he said. "And you
can't individualize the dose, which is very easy to do with the
The introduction of buprenorphine itself changed the landscape
of treating opioid dependence, but this delivery system won't
revolutionize treatment, he said. "It adds something to our
options, but I don't think it will be an approach most people will
For more on opioid-addiction treatment, visit the
National Institute on Drug Abuse.
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