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home : most recent : madison July 28, 2017

7/8/2017 1:44:00 PM
Anderson Center uses addiction implant on first opioid patient
Dr. Andrew Skinner looks at a patient's arm where probuphine was implanted. Probuphune gives the patient a constant, low-level dose of buprenorphine over six months. Staff photo by Don Knight
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Dr. Andrew Skinner looks at a patient's arm where probuphine was implanted. Probuphune gives the patient a constant, low-level dose of buprenorphine over six months. Staff photo by Don Knight
The Probuphine implant is used for patients who are stable on buprenorphine, which is commonly known by brand names Suboxone and Subutex. The implant is inserted in the lower part of the inside of the upper arm.

The implant is removed after about six months of use. The U.S. Food and Drug Administration suggests patients have another implant put in, but Dr. Andrew Skinner of the Anderson Center hopes not having the habit of taking a daily pill will lead to some patients not needing multiple implants.

Devan Filchak, Herald Bulletin

ANDERSON — Susan has been on Suboxone for 10 years to battle her opioid addiction. She thought she would never be able to break her dependency on the medication-assisted therapy.

She said it was an easy decision when Dr. Andrew Skinner, medical director of the Anderson Center, brought up an option that could break her dependency in months.

Probuphine is an implant that gives the patient a constant, low-level dose of buprenorphine over six months. Once the six months is complete, the implant starts to wean off how much medicine the patient is receiving, and the implant eventually needs to be removed.

Susan said that like many people, she had tried to wean herself off Suboxone multiple times over a period of years, but it didn’t work out. The Herald Bulletin has chosen to not use the 39-year-old Anderson woman’s name by her request because of the stigma relating to opiate addition and medication-assisted therapy.

“I thought I would be (Suboxone) it for the rest of my life,” she said. “(Skinner) and I tried to cut (the dose) down, and I tried to wean myself off of it. It’s just been hard.”

Before probuphine was approved by the U.S. Food and Drug Administration in 2016, buprenorphine could only be given to treat recovering opioid addicts in a sublingual pill form, frequently known as Suboxone and Subutex.

It’s clear that medication-assisted therapy is the most effective method of treating opioid addiction, Skinner said. However, it can be hard for patients to stop using buprenorphine, in part because of the daily habit of taking a pill.

The FDA has suggested people can have another implant put in once the initial implant is removed, but Skinner is hopeful that just one implant will do the trick for some patients.

“My hope is that it helps people continue to recover from addiction by giving them medicine to keep them from getting sick while also getting them free of the habit of continuing to reinforce (the thought), ‘I need to take something to feel OK each day,’” he said.

The implant is inserted under the top layer of skin into the fatty mass in the lower inside area of a person’s upper arm. The implant looks like four matchsticks fanned out.

Probuphine is meant for patients who are stable, already using buprenorphine in a form such as suboxone or subutex in low to moderate doses.

Skinner said the types of insurance that cover the implant vary, but Indiana Medicaid covers the implant

Aside from helping recovering addicts end their dependence on buprenorphine, the implant also takes away the risk of the medication being sold, traded for other drugs or stolen. Skinner said it is no secret that citizens have worried about the use of suboxone and subutex for those reasons.

“I think that a lot of that stigma comes from some of that diversion that it’s out there as a drug that people are buying on the street and misusing,” he said. “This is a way to not have those issues interfere with treatment.”

After four weeks with the implant, Susan said she feels great. She said she was able to return to work just after a long weekend.

Susan said her family is supportive, and she is excited to see how the implant impacts her life after six months.

“I wanted for a long time to remember what it was like to not take something every day,” she said.

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