Written by Hafsah Ganatra
Contrary to common belief, the number one cause of injury-related deaths in America is not related to car accidents or gun violence, but as of 2017 is related to drug overdose and opioid addiction. Described as a crisis and declared by President Trump as a “nationwide public health emergency,” opioid addiction has taken a front and center position as an area in need of reform in the eyes of the government and federal health agencies. By 2016, two million Americans were addicted to either prescription or illicit opioids, and as a result 33,091 opioid overdose deaths occurred in 2016 alone. With such widespread attention, the question arises about what can be done to end this egregious epidemic and what treatments are available for those requiring them [1].
Opioid dependency can be difficult to deal with, mainly because opioid use does not simply surmount to illicit drug use. Instead, opioids—which provide physical and psychological pain relief—are often times prescribed through doctors for patients suffering chronic pain. As a result, these patients can develop a tolerance and dependency for their required medication, therefore leading to opioid addiction [2]. A common treatment currently in use for opioid addiction includes sublingual buprenorphine tablets, a medication thought to alleviate withdrawal symptoms and dependency. However, this form of treatment can often result in complications with “adherence, diversion, and non-medical use” [3]. In response to these limitations on buprenorphine’s efficacy, a new method of treatment was created in the form of buprenorphine implants that could last approximately six months. In a 2013 study determining the effects of these implants, a double-blind trial was conducted with adult patients in twenty treatment centers in which they were implanted with either buprenorphine or a placebo underneath their skin on their nondominant arms, and these patients’ urine samples were then tested for opioids. The efficiency of the implants was measured by the percent of urine from each individual that tested negative for opioids through a 24-week period. The results of this study indicated that buprenorphine implants caused a significant decrease in opioid use among opioid-dependent patients [3].
With this new form of treatment, those with an opioid addiction can find convenience through a single implant, instead of sticking to a strict policy of adherence with the risk of forming another addiction through misuse. However, having been proven effective, the question still remained: how safe are buprenorphine implants? To answer this question, a 2017 study published in the Journal of Addictive Behaviors, Therapy, & Rehabilitation tested the effects of new buprenorphine implants for their safety and prolonged use. This study was conducted through the use of two clinical trials that lasted six months, and in each trial researchers treated opioid-dependent patients for negative effects from the implants. The researchers found that not only could the implants be considered safe for up to one year, but also that 83.4% of patients believed the implants to be effective in reducing their cravings [4].
In 2016, the FDA approved six-month buprenorphine implants [5]. Though a progressive step forward for helping to treat patients, reducing addiction and overdose-related deaths requires “non-judgmental evidence-based treatment” [6]. Although drug overdose and opioid addiction remain a terrible crisis, the growing opioid epidemic is giving rise to new research and emerging hope for those that are affected.
References:
1. “President Donald J. Trump Is Taking Action on Drug Addiction and the Opioid Crisis.” The White House, The United States Government, 26 Oct. 2017,
2. “Opiate Abuse & Addiction Effects, Signs & Symptoms.” Mount Regis Center, Mount Regis Center.
3. Rosenthal, R.N., Ling, W., Casadonte, P., Vocci, F., Bailey, G.L., 2013. Buprenorphine Implants for Treatment of Opioid Dependence: Randomized Comparison to Placebo and Sublingual Buprenorphine/Naloxone. PubMed Central. 108: 2141-2149.
4. Dammerman R.., Bailey G.L., Beebe K., Chen M., Rosenthal R.N., 2017. Long-Term Buprenorphine Implants for Treatment of Opioid Dependence: Safety Outcomes from Two Open-Label Extension Trials. Journal of Addictive Behaviors, Therapy & Rehabilitation. 6: N.p.
5. “6-Month Buprenorphine Implant Approved.” 2016. Brown University Child & Adolescent Psychopharmacology Update. 18: 7-8.
6. Davis, C., Green, T., Beletsky, L., 2017. Action, Not Rhetoric, Needed to Reverse the Opioid Overdose Epidemic. The Journal of Law, Medicine & Ethics. 45: 20-23