Probuphine: Does It Work For Opioid Dependence

Medically reviewed by

Dr. Gerardo Sison

April 1, 2019

One who is dependent on drugs will, at times, come to the conclusion that they require help in getting clean and remaining sober. Other times, a court-ordered stay at a rehabilitation center helps someone who is struggling with addiction find new methods of getting clean. Whether a patient is pushed to seek treatment or checks themselves into a rehabilitation facility, they can utilize medications that provide extra help toward recovery.

Opioid addiction is extremely difficult to combat. Those who are dependent on pain killers or heroin may not seek the help that they need because the addiction is so strong and keeps a hold on the user’s mind, often distorting reality and making it difficult to make positive decisions. Those who are controlled by their heroin—or other opioid addiction—may be in a difficult situation that causes them to seek methadone treatment instead of a medication that provides better transitioning into sober life.

Today, there are several approved medications for opioid dependence, as well as some that are under review for approval by the FDA. Those approved have high success rates for recovery and are now available as generics which reduces the cost of treatment, promoting those who never could afford any type of treatment a positive alternative. As new medications are being researched, some people are skeptical about the functions and success potentials associated with these new, unapproved modes of treatment. Whether it can be agreed upon that the new medications are useful or not, research being done and attempts being made to find better modes of recovery is always positive news.

Medicating Opioid Addiction

The most common medications for addiction to such opiates as heroin, morphine, oxycodone, and others are methadone, buprenorphine, and naltrexone. Each of these works in different ways to provide an “antagonist” to the receptors in the brain that become filled with the opioid-derived drug. Most of these medications are prescribed through a certified doctor or psychiatrist’s office, though some are government subsidized and must be applied for and received through a clinic.

Functions Of Other Medications

Just as illicit drugs derived from opium poppies attach to receptors in the brain and cause endorphin effects called highs, medications for addictions to these drugs also attach to receptors, blocking anything that would produce a high, preventing debilitating withdrawal symptoms, and sometimes, making someone sick if they take a drug while on medication.

Medications for opioid addiction are different in that they can either provide partial agonists (instead of full antagonists) to the brain receptors, meaning that they have a ceiling effect and do not allow the brain to emit a euphoric sensation. Many doctors will only prescribe these partial agonists, as they and others within the medical community attest to full antagonist medications having similar effects as the actual drugs that a patient is trying to be free from.

Common Results Of Medications

Though every medication can differ from patient to patient, depending on DNA and metabolization rates, most people can agree on the common symptoms and results associated with the medications they’ve taken to diffuse their opiate addiction.

Methadone is one of the types of medications that is debated in the medical field as to success rates and side effects that many patients experience. With Methadone, patients will most commonly find themselves overly sleepy, lethargic, unable to drive at times, depressed, having a lack of motivation, and even high. Though the “high” that can come with certain doses of Methadone is not exactly like that of heroin or other opiates, it is something that can sometimes act as a gateway back to drug use, as the user feels reminded of and craves the high they had before. Methadone is usually administered through clinics which have strict schedules and will drop patients if they miss a dose of medicine. This can make the experience of getting clean more stressful, though it does weed out the patients who are less serious about recovery.

In addition to Methadone, there are effective medications, such as Suboxone and Subutex for opioid addiction. Suboxone and Subutex are nearly identical medications and partial agonists which hit a ceiling at around 4 mg. This means that the opioid receptors in a patient’s brain will be saturated after taking 4 mg of their medication and that if they took more or decided to do heroin while the med was still in their system (it has a ½ life of 36 hrs.), the blocked receptors would not allow for any “high” feelings or any drug to seek into the body effectively.

The difference between Suboxone and Subutex is that Suboxone includes Naloxone, which is an additive that causes immediate withdrawal symptoms if taken in combination with another drug or even alcohol. This prevents users from breaking their sobriety as it would make them extremely ill. With both medications, patients usually report feeling much like themselves, being alert and aware, having no “high” effect, but also experiencing difficulty sleeping for the first few months of taking the medication. Both medications can be taken in low doses for the duration of a patient’s life, if they choose to be less at risk this way.

How Probuphine Works In Opioid Addiction

Probuphine, containing buprenorphine, is similar to Suboxone in that it is a partial agonist, blocking the brain from any other substance that could affect the opioid receptors. It acts as a “continuous drug delivery” medication, such as a time release or extended-release form of any other medication. Implanted into the upper arm, the drug is released regularly over a period of 6-12 months. The long-term release of medication is not only convenient for those who find taking medication every day and having monthly checkups for new scripts more difficult, but it also helps with potential relapse. Just as it would be in taking Subutex, Probuphine smothers any euphoric dopamine release in the brain. Taking drugs while the implant is active in the body would be a waste of money and effort on a user’s part.

Studies And Approval

Many studies have been done in an effort to have Probuphine approved by the FDA and introduced to the public. Studies have included a comparison to Suboxone/Subutex in similarity as a partial agonist. Double-blind trials have been made which included safety trials and placebo effects. Through the studies that were initially made, positive outlooks were seen in those implanted with Probuphine arm implants. These positive results were both in efficacy and safety in long-period outputs and in urine analysis. Through initial trials (before FDA review), urine showed less opioid content, meaning that the effectiveness of the medication reduced a patient’s use of an illicit opioid during their trial. Those with placebo implants were seen to have cravings and test positive more often for outside opioid use.

After the trial phases were complete, data was reviewed by the FDA, who was seeking a comparison between Probuphine and Suboxone for their approval. Since Probuphine is to implanted one time in 6 months, the dose that it emits daily is low, but has tested to be just as effective as Suboxone. The FDA requested more trials with different dosage levels of medication in the implants, maintaining that patients would need different amounts of medication daily. Titan, makers of Probuphine may have lost their investment in the drug becoming approved, as the initial expenses have depleted the value of shares in their company. Medical professionals and those addicted to drugs alike seem to still be holding out hope that the implant becomes available to those who need its help.

Other Types Of Treatment And Seeking Help

Though the FDA has not made Probuphine a legal, publicly available form of treatment for opioid dependence, there are other treatment options that those struggling with addiction should consider. Aside from Suboxone/Subutex, Methadone treatments, and other medications, there are several styles of therapy and rehabilitation that can assist someone in recovery.

For those experiencing more difficulty in seeking a sober life, inpatient rehab may be your best route. In these rehabilitation centers, medications are often available. For those who may consider rehab to be too expensive, try searching for Christian substance abuse treatment centers, where many programs are long-term and free of charge. Contact RehabCenter.net for help and information on getting treatment today.