Buprenorphine implants

The new 12th edition of "A primer of Drug Action" discusses Suboxone therapy for opioid addiction. A recent article by Ling and coworkers at UCLA published in the Journal of the American Medical Association (Oct 13, 2010, vol. 304, pp. 1612-1614) compared 6-months of buprenorphine implants with placebo implants in 163 opioid dependent persons.  Drug free urines in the buprenorphine group occurred in 40% of subjects vs. 28% in placebo-treated persons.  treated persons had a lower incidence of cravings.  Data were encouraging and this offers yet another option for treating opioid dependence.  I would love to see a comparative trial of buprenorphine implants vs. naltrexone implants. That would provide a comparison of a partial agonist vs. an antagonist.  Lets wait and see.
Bob Julien MD PhD

Buprenorphine inplant

Dear Readers: With our 12th edition of "A Primer of Drug Action" released in October 2010, pharmacology continues to progress. In the text I discussed Suboxone (buprenorphine/naloxone) for opioid dependence. I also discussed naltrexone implanted pellets. Now under development is an implantable formulation of buprenorphine (Probuphine) in a polymer matrix sustained 6-month formulation (reference: Drug and Alcohol Dependence, July 2009, volume 103, pp. 37-43). Titan Pharmaceuticals (distributor of Fanapt) is developing this product in the U.S. and currently has it in clinical trial. I refer you to their website: www.titanpharm.com.  This may offer  yet another option for the pharmacological treatment of opioid dependence.  I appreciate the effort, but since buprenorphine is still an agonist opioid (a partial agonist), I hope that development of a naltrexone (antagonist) implant of similar design will be pursued commercially.
Robert Julien, MD PhD