{"id":4656,"date":"2016-08-17T00:00:00","date_gmt":"2016-08-17T06:00:00","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/2016\/08\/17\/help-for-opioid-addiction-at-uch-may-be-more-than-skin-deep\/"},"modified":"2021-07-07T15:30:38","modified_gmt":"2021-07-07T21:30:38","slug":"help-for-opioid-addiction-at-uch-may-be-more-than-skin-deep","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/help-for-opioid-addiction-at-uch-may-be-more-than-skin-deep\/","title":{"rendered":"Help for opioid addiction at UCH may be more than skin deep"},"content":{"rendered":"
<\/div>
\"\"
One of four tiny implantable Probuphine rods that deliver measured doses of buprenorphine.<\/figcaption><\/figure>\n

The four thin, tiny white rods look like nothing special. But they could be powerful allies for individuals recovering from dependence on opioids.<\/p>\n

The rods, each about the size of a matchstick, are part of the first implantable system for delivering consistent, low doses of buprenorphine, a drug used for maintenance treatment of opioid dependence, and naloxone, which prevents narcotic overdose. The Food and Drug Administration approved the implant, called Probuphine, in late May<\/a>.<\/p>\n

University of Colorado Hospital is among the first in Colorado to offer Probuphine. In a one-day training session last June in Albuquerque, Patricia Pade, MD<\/a>, learned to implant the device just below the skin in a patient\u2019s upper arm. Pade received a special Drug Enforcement Agency number required to perform the office-based procedure.<\/p>\n

The implant is another addiction-treatment tool for Pade, who practices at UCH\u2019s Center for Dependency, Addiction and Rehabilitation (CeDAR), directs the University of Colorado\u2019s Addiction Medicine Fellowship Program and leads an addiction medicine consult service at UCH. She also heads a consult service<\/a> for chronic pain patients at moderate to high risk of addiction to prescribed opioid medications.<\/p>\n

Pade hasn\u2019t implanted Probuphine in a patient yet. \u201cIn Albuquerque we practiced on pork loins,\u201d she quipped. But she\u2019s optimistic that the device will help some patients ease their transition from dependence to recovery.
\nPhysicians implant the rods in the upper arm in an office-based procedure.<\/p>\n

A measured response<\/h2>\n
\"\"
Physicians implant the rods in the upper arm in an office-based procedure.<\/figcaption><\/figure>\n

\u201cThe beauty of the medication is that it delivers to the bloodstream 8 milligrams of buprenorphine every day,\u201d Pade said. Patients receive the measured dose for six months, at which point a physician removes the Probuphine. If it\u2019s necessary, the physician can repeat the procedure in the other arm, she said.<\/p>\n

An implant relieves the patient of remembering to take Suboxone<\/a> tablets, which also combine buprenorphine and naloxone, Pade said. \u201cThat\u2019s very good for individuals who are older or worried about their cognitive status, or people who don\u2019t want the hassle of having to remember to take pills,\u201d she said. Individuals who are incarcerated, live in remote areas or travel out of the country might also benefit from an implant, she said.<\/p>\n

Implanting medications in a patient\u2019s arm doesn\u2019t eliminate the possibility of drug diversion, but it obviously lowers the risk dramatically.<\/p>\n

\u201cIt\u2019s certainly harder to divert; there is a much higher threshold than there is with oral medications,\u201d said Steve Millette, CeDAR\u2019s executive director.<\/p>\n

Seeking stability<\/h2>\n

The buprenorphine delivered by the Probuphine implant is itself a narcotic. But Pade emphasized it does not get patients high. Rather, it helps people control their cravings and regain a measure of stability in their lives.<\/p>\n

Nor is maintenance therapy an end in itself, Millette added. Rather, it\u2019s a potential bridge to recovery. \u201cThe medicine helps people become more functional and learn how to live with the addiction,\u201d he said. \u201cIt\u2019s a movement in the direction of greater health.\u201d<\/p>\n

For example, patients freed of the obsession with getting the next opioid dose for their chronic pain might turn instead to physical therapy, mindfulness, meditation or other non-drug treatments, Millette said. \u201cThe implant isn\u2019t a one-trick pony. It\u2019s another tool in the kit.\u201d<\/p>\n

Those in the addiction treatment field are grateful to have another option to offer the growing number of patients battling opioid-related substance use disorders<\/a>, said Alexis Carrington, MD. Carrington started an addiction medicine fellowship at CeDAR in July.<\/p>\n

\u201cThere are only a few medications we have to rely on,\u201d Carrington said. The FDA\u2019s approval of Probuphine, she added, \u201cis a sign of how serious the problem is.\u201d<\/p>\n

Carrington, who will receive the Probuphine training along with her addiction medicine fellowship colleague Ryan Jackman, MD, noted that the upper-arm implant is discreetly placed and produces minimal scarring. That\u2019s important for more than cosmetic reasons.<\/p>\n

Medical maintenance<\/h2>\n

One of the challenges of prescribing maintenance therapy, Millette explained, is that halfway houses and sober living facilities traditionally have not accepted patients who are taking the medications, partially because they want to avoid monitoring patients for drug diversion. He believes Probuphine will solve that concern while also shifting these facilities\u2019 long-held belief that recovery requires total abstinence from drugs.<\/p>\n

\u201cPatients on maintenance therapy can become more independent and function in spite of their conditions,\u201d Millette said. \u201cThat helps to make it all the more evident that addiction is a chronic disease and reduces the stigma surrounding it.\u201d<\/p>\n

The Probuphine implant is not for everyone, Pade said. \u201cIt\u2019s not appropriate for patients who require higher doses of medication to control their craving and pain,\u201d she said.<\/p>\n

That still will leave a sizable group of patients who could benefit from the implant, said Millette, who envisions CeDAR taking a leadership role in studying the new treatment\u2019s effectiveness.<\/p>\n

\u201cIt\u2019s our intention to lead the field in bringing the service into our comprehensive model of care,\u201d he said. \u201cSome people believe that taking medications means not getting sober. We will have a population of patients to evaluate, study and learn from, and we have a willingness to find out.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

The four thin, tiny white rods look like nothing special. But they could be powerful allies for individuals recovering from dependence on opioids. The rods, each about the size of a matchstick, are part of the first implantable system for delivering consistent, low doses of buprenorphine, a drug used for maintenance treatment of opioid dependence, […]<\/p>\n","protected":false},"author":2143,"featured_media":8269,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[159,17,1163,2148],"class_list":["post-4656","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-addiction-and-rehabilitation","tag-addiction-treatment","tag-opioids","tag-uchealth-center-for-dependency-addiction-and-rehabilitation"],"acf":[],"yoast_head":"\nHelp for opioid addiction at UCH may be more than skin deep - UCHealth Today<\/title>\n<meta name=\"description\" content=\"The four thin, tiny white rods look like nothing special. 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