National Institute on Drug Abuse/Wikipedia
Source: National Institute on Drug Abuse/Wikipedia

Opioid addiction is a serious problem that requires the attention of the medical community. To illustrate the significance of the problem, the Centers for Disease Control and Prevention stated “since 1999, the rate of overdose deaths involving opioids (including prescription opioid pain relievers and heroin) nearly quadrupled,” and 78 Americans die from an opioid overdose every day. These staggering statistics are an unfortunate reality for those who are dealing with addiction, and it impacts their families and the substance abuse specialists whose job it is to help them.

In order to address the issues with opioid and heroin addiction, healthcare organizations have been seeking innovation within the substance abuse space, and a new tool has been created to help. The FDA recently approved a new arm implant that emits an anti-addiction drug designed to combat the growing numbers of opioid addictions and fatalities. So how will this arm implant, which “emits buprenorphine, a drug that eases cravings for opioids and prevents withdrawal symptoms,” as reported by the Wall Street Journal, change the way that substance abuse counselors treat opioid addiction? 

Source: National Institute on Drug Abuse/Wikimedia Commons

As a substance abuse specialist and assistant director of the Cummings Institute, I believe the implant is an excellent tool to help an addict start on a solid treatment plan, but it is only a start, and the issues facing individuals addicted to opioids is far more nuanced and complex, requiring a team of specialists to come together and combat the growing problems associated with such a severehealth crisis. When we combine anti-addiction medication with a strongbehavioral modification program, including counseling and support groups, the success of recovery is much higher, and it’s essential to examine how an implant like Probuphine can be a part of the larger treatment plan.   

The Pros and Cons​

Probuphine consists of four match stick-sized rods, which are inserted under the skin in the upper arm. It emits six months of the drug buprenorphine, which lessens drug cravings and prevents withdrawal symptoms. The central benefit of the implant is the mode of delivery. It’s common for patients who have been prescribed buprenorphine in tablet form to skip doses and relapse on illegal drugs. Since Probuphine is implanted into the patient’s arm, they have no choice but to take every dose for the full six months, nullifying the high derived from the opioids. 

While helping individuals ease their cravings for opioids and heroin is important, the arm implant is already receiving opposition from individuals who believe that the only way to treat drug addiction is through total sobriety. This has been a controversy in the substance abuse field for decades, and it’s one that I don’t see going away. However, kicking addiction is never easy, and Probuphine may create a way to jump-start treatment and provide time for substance abuse professionals and facilitators to work with the patient.

Another drawback to Probuphine, which will need to be overcome, is that, unfortunately, not everyone will be able to afford the implant. Braeburn Pharmaceuticals, which makes Probuphine, said it would cost less than $6,000 for a six-month supply. But if individuals lack access to medical insurance, this is still a high price tag. While the implant’s aim is to take away the opioid craving, the patient still needs to find the motivation within themselves to quit and stay sober, which brings on one of the greatest drawbacks to implant: it’s a temporary fix, and the real solution has to come from the individual who wants to address the emotional issues behind their addiction.

The Importance of Motivation

Through all my clinical experience, I am aware of the importance of motivation. When it comes to kicking an addiction, the only way that a patient can really change is if they want to modify behavior. Without motivation to take action or seek out treatment, then whatever tactic put into place to solve the addiction will fail over time when the individual relapses. Of course, this same idea holds true for the new arm implant, which will help push the individual through detox, but the motivation still needs to be there, and it will not cure their addiction.

As the patient becomes more positive and willing to embrace their recovery, the substance abuse counselor should work with the patient in creating an individualized treatment plan designed to keep them motivated. I have found that the more we tailor the treatment plan to the patient, the better we are able to help the person change. In order to accomplish this goal, it’s important to look at the patient’s personal history and understand everything about them, such as upbringing, culture, diet, and psychology. Through this we can discover the motivation at the root of their addiction.

A Personalized Strategy

A necessary part of understanding a patient involves finding out what led them to addiction, and it’s important that substance abuse professionals help lead their patients toward confronting their emotional pain and uncovering the root problems of their addiction. By discussing the root of addiction with the patient, as opposed to making them feel like they have done something wrong or simply treating their addiction with Probuphine, the patient is more likely to understand their actions and embrace personal change.

In the end, Probuphine will change the tools that we use to treat addiction, but it will not change the fundamentals of treating addiction. If Probuphine is used as a one-stop solution to opioid and heroin addiction, then it will fail. It can, however, be a useful asset in an overall treatment plan specifically designed for each individual patient. Providers must value teamwork, integrated care, and patient involvement if they want positive results. When a patient has a say in their treatment, they are more likely to reach their goals and stay healthy.

About the Author

Dr. Wendy Boring-Bray, DBH, LPC

Wendy Boring-Bray is the assistant director of the Doctor of Behavioral Health program at the Cummings Graduate Institute for Behavioral Health Studies.

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