Buprenorphine Shown Safe and Effective in Reducing Opioid Use

A scholarly article published in The American Journal of Psychiatry found that buprenorphine was “noninferior” in elimiating opioid misuse as compared with methadone dosing. Noninferior is another way of saying reasonably similar in effectiveness.

The study was based on 272 patients meeting diagnostic criteria for Opioid Use Disorder, and was conducted over a 24 week period at 7 Canadian hospitals and community treatment clinics.

While the study did not differentiate between dependency severity levels or a patient’s years in active addiction, it did generally establish that buprenorphine was as effective in preventing opioid misuse when compared with a group of patients receiving methadone.

Progress and stabilization were primarily based on drug-testing urinalysis results although other factors were taken into consideration such as retention in opioid treatment for a longer duration of time.

Mounting evidence regarding buprenorphine safety and its overall therapeutic benefit will help to drive increases in funding for additional opioid treatment clinics and easier medication access for prospective patients desiring addiction recovery.

Opioid Use Disorder and Medication Assistance

Nearly every U.S. family is affected by addiction with opioid use disorder rising significantly in the last 10 years. Despite this trend, a surprising number of individuals still do not have access to medication-assisted therapy.

Buprenorphine based medications enjoy a proven track record of success in helping patients achieve long lasting stablization and elimination of their opioid withdrawal symptoms. A study recently published in the International Journal of Drug Policy found that almost 87% of those with opioid use disorder were not yet receiving therapeutic medications that could increase their likelihood of a successful recovery.

The good news is that there has been a substantial increase nationwide in the number of treatment providers who offer buprenorphine and counseling services. Organizations like BrightView and Acadia are opening clinics in multiple states and aim to expand their service availability in the year ahead.

With opioids now vulnerable to being adulterated with deadly fentanyl and other substances, it is important that people struggling with opioid use disorder (OUD) find treatment and support as soon as possible.

Buprenorphine based medications and methadone are making a real difference in restoring quality of life, and enabling patients to become once again fully productive, and able to focus on a healthy lifestyle. Medication assistance is key, and for many people opens a door that was previously closed for a very long time.

Sublocade Now Available

Sublocade is a newly released medication alternative for treating opioid addiction. It is a product of Indivior, the pharmaceutical company responsible for Suboxone. Sublocade is a once monthly injection of time-released buprenorphine typically provided to patients who have been receiving buprenorphine for at least (7) days and who are stable on their medication.

The injection is subcutaneous (under the skin). The medication gradually breaks down (biodegrades) and releases buprenorphine for 30 days so that opioid withdrawal symptoms are effectively managed.

Sublocade was FDA-approved in the United States in late November 2017 and is presently available. The U.S. Food and Drug Administration is making a concerted effort to address the ongoing opioid epidemic by making medication-assisted therapies available across the country. More information about Sublocade can be found on the Indivior website.

Ohio Increases Buprenorphine Access

In 2017, Ohio increased its number of buprenorphine-approved prescribers by 266. This was the result of a $2.3 million dollar Federal grant that provided state-wide training to doctors, nurse practitioners, and physician assistants as reported by Cleveland.com.

Historically, Ohio had numerous communities that were underserved with 19 counties having no buprenorphine providers at the beginning of 2017. The number of counties without buprenorphine access has presently been dropped to just 10. This increase in approved Ohio physicians will allow many more individuals to gain access to life-saving opioid addiction treatment.

The linked article above reports that additional trainings will be made available in 2018 in order to bring buprenorphine services to all areas of Ohio. In related news, a National Budget proposal aims to earmark $13 billion in new funding over years 2018 and 2019 in order to fight back the ongoing opioid crisis. How much money is ultimately allocated for this purpose will be determined by Congress.

New Patient Limit Raised for Buprenorphine Physicians

buprenorphine doctor 2The DATA 2000 Act allowed approved physicians to treat 30 patients with opioid addiction using buprenorphine, and up to 100 patients following an approved application to SAMHSA (Substance Abuse and Mental Health Services Administration).

The 100 patient limit was recently raised to 275 patients out of a necessity for physicians to treat more people in response to the rising American opioid addiction crisis. Those doctors eligible for the 275 patient limit must have received a waiver to treat 100 patients for at least one year. In order to apply for the 275 patient limit, physicians must provide their DEA number, State medical license number, and buprenorphine training certificate information.

Nurse Practitioners (NPs) and Physician Assistants (PAs) can now receive training and become approved to write prescriptions for buprenorphine-based products. This expansion of buprenorphine availability will help those struggling with addiction to more readily find a provider in their community who is able to treat their opioid dependency.

Insurance Company Removes Barrier to Buprenorphine

buprenorphine-medicationA major health insurer, Cigna Corp., has agreed to discontinue the practice of requiring physicians to obtain preauthorization in the prescribing of buprenorphine products. This is a superior decision that will enable physicians to more quickly help patients suffering with opioid addiction.

The Wall Street Journal published this information in their recent business segment and highlighted that the preauthorization process typically introduced a wait time of several days as well as an extensive list of questions that patients must answer in order to be eligible for buprenorphine treatment.

This groundbreaking achievement of removing barriers was accomplished by Eric Schneiderman, the New York State Attorney General. He pressed for answers as to why the insurer’s policy introduced potential barriers to treatment when buprenorphine has been proven to be highly effective and in demand.

Attorney General Schneiderman’s advocacy for opioid addicted patients has opened the door to saving lives while publicizing a need to enable physicians to utilize medication-assisted treatment that is irrefutably beneficial in managing opioid withdrawal, reducing opioid overdose risks, and reducing relapse potential with illicit opiates.

Lannett Receives FDA Approval

Lannett Company, Inc. announced this week that they have received approval from the Food & Drug Administration to manufacture generic Buprenorphine and Naloxone sublingual tablets. Available dosages will come in 2mg and 8mg tabs similar to the equivalent dosages available with Suboxone.

Lannett specialize in generic pharmaceuticals for a wide range of medical purposes. Arthur Bedrosian, Lannett’s CEO, was quoted as saying that “Buprenorphine and Naloxone Sublingual Tablets, a Class III drug, is an important medication for the treatment of opioid addiction”.

The increased affordability of a generic Buprenorphine option coupled with higher patient limits for buprenorphine-approved physicians should open the door for addicted individuals to receive improved access to important addiction treatment services.

Buprenorphine is currently available by prescription in every metropolitan area throughout the United States as well as most smaller towns and cities.

Comparing Buprenorphine and Methadone

Buprenorphine and methadone are the two leading medications available for the treatment of opioid addiction. Their primary medical benefit is their ability to eliminate opioid withdrawal symptoms like nausea, vomiting, diarrhea, runny nose, chills, sweating, muscle ache, cramps, anxiety, agitation, and sleeplessness.

Buprenorphine and methadone are FDA-approved and have been in use for a combined 50+ years. Scientific research has proven the effectiveness of both medications, and they have been deemed a best practice treatment intervention by the Substance Abuse and Mental Health Services Administration (SAMHSA).

Methadone is a full opioid agonist whereas buprenorphine is categorized as a partial opioid agonist. Because of this, buprenorphine has a better safety profile and has less potential for overdose than does methadone. Buprenorphine’s improved safety profile allows it to be offered by prescription from a physician’s office. Methadone is more highly regulated and must be administered every day in a clinic setting.

Being able to take buprenorphine products at home (like Suboxone) provides much more convenience for those individuals with daytime jobs and other pressing responsibilities. Patients receiving methadone must report in to a clinic each day and be observed taking their methadone medication. Buprenorphine-based products like Suboxone or Probuphine do not require the patient to report in daily to a clinic.

Buprenorphine is often taken orally as a tablet (Subutex) or thin film (Suboxone) where it is dissolved sublingually (under the tongue). Methadone is typically dispensed as a liquid that is swallowed. Probuphine (which contains buprenorphine) is a relatively new time-released medication that in inserted under the skin.

More information on this topic is available at SAMHSA and Methadone.US.