New Drug Treatment to Address the Opioid Addiction Epidemic
by Lisa DiFalco
Opioid addiction is a significant problem in the US, with some US communities, such as East Liverpool along the Ohio River, using all of their resources to handle the problem on a nightly basis. Police chief, John Lane, said:
“Some nights the entire shift is tied up with just overdoses. If we have any other calls, they just have to wait. We just don’t have enough people to be dealing with this problem.”
This statement underscores the issue that rates of opioid overdose deaths, over the last 17 years, have quadrupled. A new proposal from the Obama Administration encourages drug-based therapies and would expand those able to prescribe the drug, extending it from doctors to nurse practitioners and physician assistants. However, the initiative may find application still difficult. Drug-based therapies have been found to be effective for many but doctors are often limited and cautious about their prescription. Learn of the additional drug treatment option on the horizon that may help to better support patients and doctors.
The Stigma of Treating Drug Addiction with Drugs
Drug-based therapies are often used to treat those undergoing an opiate addiction. However, there are often limits placed on physicians regarding prescriptions, making the option of treating opioid addiction with medications like Suboxone more difficult. Studies done appear to support the use of drug-based therapies for those with an opioid addiction. Individuals taking methadone and Suboxone have an improved ability to:
- Slowly decrease their need to use opioids or heroin;
- Avoid relapses; and
- Keep their job.
Opioid addiction is believed to create permanent damage to the brain, rewiring reward circuits and changing how satisfaction is perceived. Drug-based therapies appear to be the key to helping those addicted to opioids begin to reduce their need for their drug of choice. Some doctors believe that those with an addiction have little free-will in stopping their addiction. Dr. Sarah Wakefield, medical director of the substance-use-disorder initiative at Massachusetts General Hospital, said:
“Once the brain is changed by addiction, that mechanism of choice is damaged. It’s almost like a stroke in that part of the brain. Someone with addiction can no sooner choose not to be addicted than someone with diabetes can choose not to have diabetes.”
However, a stigma surrounds those using medications to treat their addiction. Narcotics Anonymous has discouraged such people from this form of treatment making it difficult for those recovering from an addiction to get the social support the need from some rehab groups.
Physicians are also limited in their treatment. As of 2016, the U.S. Department of Health and Human Services allows doctors, nurse practitioners and physician assistants to treat 275 patients per health professional annually. This limitation appears to be due to the belief that addicts would potentially switch from their previous addiction to an addiction to Suboxone. The great majority of doctors certified to administer Suboxone do not do so. 32,000 doctors have the needed U.S. certification, but only 6,000 administer the drug in 90 percent of the prescriptions. Those suffering from an opioid addiction and physicians need additional options for effective treatment.
A New Drug-Assisted Addiction Treatment Option
Addiction treatment options may be available through an implant from Braeburn Pharmaceuticals. The company made their announcement in May. However, a six-month course of treatment comes with a hefty price tag of $4,950. The implant will deliver Probuphine, a version of the buprenorphine to those seeking treatment from opioid addiction. Buprenorphine has been used for 14 years to help individuals deal with withdrawal symptoms. Buprenorphine is also known as Suboxone. Other opioid addiction treatment options include methadone and naltrexone. This delivery method may help those coping with their addiction to receive a consistent and regulated supply of buprenorphine. It also prevents others than the intended patient from taking the prescription. In a recent trial, over 96 percent of those with the implant had not used opioids for a minimum length of four months. The other trial group taking an oral version had a rate of 87.6 percent.
Medication-assisted treatment is for some the only recovery option that works. The story of Crystal Oertle was shared at the recent National Prescription Drug Abuse and Heroin Summit. She had attempted to quit without success a number of times. After being prescribed buprenorphine, she has been able to experience positive results. Crystal said:
“I personally couldn’t get through the withdrawal symptoms. I couldn’t tough it out. I know that some people can. I couldn’t do it. This last time has been the most successful recovery for me.”
Not everyone can recover from an opioid or heroin addiction without medication. Options are needed to accommodate their needs. Michael Botticelli, director of National Drug Control Policy at the White House said:
“I’ve seen people with opioid-use disorders go through inpatient treatment without medications time and time again, without ever being offered alternatives. We wouldn’t do that with any other disease. If one treatment failed for you, we’d say, let’s look at other possible treatment options.”
There is an obvious need for new addiction treatment options. Braeburn offers training sessions in 55 cities across the US to enable practitioners to administer their implant. To date, over 1,800 medical professionals are certified to offer this new addiction recovery drug-delivery treatment device to patients.
Richard Rosenthal, medical director of addiction psychiatry for the Mt. Sinai Health System and one of the principal Probuphine clinical trial investigators said:
“Everybody is waking up to the fact that we’re in the midst of an opioid epidemic. There are actually very few medications for addiction of any kind. Given the addiction treatment system in the United States, most of the treatment that’s given is psychosocial. There’s very little use of FDA-approved medications.”
This delivery method may make it easier for patients to get the care that they need on a consistent basis, reducing their potential to relapse. Obviously, other drug-assisted therapy options are still needed to stem the epidemic.