Arielle Cruz
Several implants to treat opioid and alcohol addiction are being developed by companies and healthcare providers. One such implant is the naltrexone implant, which is inserted under the skin and releases medication over a period of 2-6 months. Naltrexone implants are not approved by the U.S. Food and Drug Administration (FDA), but their pill and injectable forms are. Another implant, Probuphine, was approved by the FDA in 2016 and contains the medication buprenorphine. Additionally, the Brain-PACER study is investigating the use of deep brain stimulation (DBS) to treat alcohol and opioid addiction. This involves implanting electrodes in the brain to deliver electrical impulses and modulate neural activity. Delpor, a biotech company, is also working on a titanium implant that releases medication for up to a year.
| Characteristics | Values |
|---|---|
| Implant Name | Naltrexone Implant, Probuphine |
| Manufacturer | Delpor, Braeburn |
| Implant Type | Titanium implant, Brain implant |
| Drug Mechanism | Releases medication over time, Blocks opioid receptors in the brain |
| Treatment Duration | 2-6 months, 6 months, 1 year |
| Treatment for | Opioid addiction, Alcohol use disorder |
| Treatment Efficacy | More effective than oral medication, Requires fewer doses |
| Treatment Status | FDA-approved, In clinical trials |
| Treatment Concerns | Requires surgical skill for implantation, Requires comprehensive treatment program |
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What You'll Learn
Naltrexone implants
The NIH HEAL Initiative is supporting research on naltrexone implants, including funding a biotech company called Delpor, based in Brisbane, California. Delpor is developing a titanium implant that goes under the skin and slowly releases medication for up to a year. The aim is to give patients more options and make it easier for them to stay on treatment long enough to achieve long-term recovery.
It is important to note that naltrexone implants should be used in conjunction with other aspects of a comprehensive treatment program, such as counselling and behavioural therapies, to ensure prolonged recovery.
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Deep brain stimulation
The idea of using DBS for addiction treatment came from observations that people who received DBS for Parkinson's disease showed less compulsive behaviour. Some case reports also found that DBS helped eliminate drug addiction in patients who initially received the treatment for other reasons. DBS has been found to reduce cravings in people with hard-to-treat alcohol use disorder, and it may help with addictions by targeting some of the same brain circuits involved in OCD and compulsive behaviour.
Several clinical trials have been conducted on DBS treatment for addiction to psychoactive substances, including nicotine, alcohol, cocaine, opioids, and methamphetamine/amphetamine. While these trials have shown positive treatment effects, they have been small-scale, and more research is needed to verify the effectiveness of DBS for addiction. The National Institute on Drug Abuse is funding research at private companies to make medication for addiction treatments more accessible and user-friendly.
One challenge in treating substance use disorders is patient adherence to treatment regimens. DBS may help address this challenge by providing a long-lasting delivery system for medication. HEAL-funded neurosurgeon Ali Rezai, M.D., is evaluating the use of DBS for patients with severe, treatment-resistant opioid use disorder. Throughout the study, Rezai and his team offer 24/7 support to participants and can adjust stimulation as needed.
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Implant effectiveness
Naltrexone implants are small medication pellets inserted under the skin to treat opioid dependence and alcohol use disorder (AUD). The implants work by gradually releasing the medication over a period of 2 to 6 months. Naltrexone is an opioid antagonist that works by attaching itself to opioid receptors in the brain. It helps reduce opioid cravings and blocks the effects of opioids, including the euphoria, to treat opioid addiction. It also blocks the endorphins released by alcohol from binding to their receptors to treat AUD.
Naltrexone implants have been proven to be extremely effective due to their longer duration of efficacy and protection against overdose. Dr George O'Neil, a physician and inventor from Perth, Australia, has treated thousands of patients with naltrexone implants at his Fresh Start Clinic. Patients who have undergone this treatment have reported that they feel more "with it" after six months, and are able to decide if they need another implant or feel good after one.
However, naltrexone implants are not approved by the U.S. Food and Drug Administration (FDA). The FDA has approved the pill and intramuscular injectable forms of naltrexone to treat opioid dependence and alcohol addiction. The extended-release injectable version of naltrexone is sold under the brand name Vivitrol. Nevertheless, a substantial number of clinical studies have indicated the effectiveness of naltrexone implants in treating alcohol use disorder and opioid addiction.
Despite the positive indications, more research is needed to substantiate the findings and prove the effectiveness of naltrexone implants. If proven effective, naltrexone implants could become a powerful new tool against the opioid crisis and alcohol use disorder. The NIH HEAL Initiative is supporting research at private companies like Delpor to develop an implant that can steadily release medication for opioid use disorder for a year.
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Implant safety
Naltrexone implants are a type of opioid addiction and alcoholism treatment. They are small medication pellets inserted under the skin that gradually release the medication over a period of 2-6 months. Naltrexone is an opioid antagonist that works by blocking the brain's ability to respond to opioids and attaching itself to opioid receptors in the brain. It also helps to block the endorphins released by alcohol from binding to their receptors.
Naltrexone implants are not approved by the U.S. Food and Drug Administration (FDA). However, the pill and intramuscular injectable forms of naltrexone are approved to treat opioid dependence and alcohol addiction. A substantial number of clinical studies have indicated the effectiveness of naltrexone implants in treating alcohol use disorder and opioid addiction.
One concern regarding the safety of naltrexone implants is the need for surgical implantation. However, the procedure is relatively simple and can be performed by a medical professional with some surgical skill, such as a family practice doctor or an ER doctor. This improves accessibility, especially in rural areas with limited access to surgeons.
Another safety consideration is ensuring that naltrexone implants are used as part of a comprehensive treatment program. Naltrexone maintenance treatment (NMT) should be combined with counselling and behavioural therapies to ensure prolonged recovery. Additionally, naltrexone implants should not be relied upon as the sole treatment for addiction, as individual responses may vary.
While naltrexone implants have shown promising results, further research is needed to substantiate their effectiveness and safety. The NIH HEAL Initiative is supporting research at private companies like Delpor, which is developing a titanium implant for the gradual release of naltrexone over a year. This longer-lasting delivery system aims to improve patient adherence to treatment and increase the chances of long-term recovery.
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Implant manufacturers
Naltrexone implants are small pellets inserted under the skin to treat opioid dependence or alcohol use disorder (AUD). The implants work by gradually releasing the medication over a period of 2-6 months. Naltrexone is an opioid antagonist that works by attaching itself to opioid receptors in the brain. It helps reduce opioid cravings and blocks the effects of opioids, as well as blocking the endorphins released by alcohol from binding to their receptors.
Naltrexone implants are currently not approved by the U.S. Food and Drug Administration (FDA), but the pill and intramuscular injectable forms of naltrexone are approved to treat opioid dependence and alcohol addiction. However, clinical studies have indicated the effectiveness of naltrexone implants, and they are being considered as a powerful new tool against opioid and alcohol use disorders.
In Australia, Dr. George O'Neil has invented a type of implantable naltrexone that slowly dissolves in the body, releasing an effective dose of the drug for about 6 months. His Fresh Start Clinic in Perth has treated thousands of patients with this approach.
Another implant for opioid addiction treatment, Probuphine, was approved by the FDA in 2016. Probuphine contains the medication buprenorphine, which has been a popular tool for eliminating opioid withdrawal symptoms in people addicted to heroin and prescription painkillers. It is pitched as more convenient than traditional forms of buprenorphine and provides protection against diversion, theft, or accidental use by children.
In addition to these implants, there is ongoing research and development of other implantable treatments for opioid and alcohol addiction. For example, Delpor, a biotech company based in California, is working on a titanium implant that would go under the skin and slowly release medication for up to a year. King's College Hospital NHS Foundation Trust in London and Addenbrooke's Hospital in Cambridge are also set to trial deep brain stimulation (DBS) implants for treating alcohol and opioid addiction. This technique involves implanting a slender electrode in the brain and a pacemaker under general anaesthesia to deliver electrical impulses that modulate neural activity and help alleviate symptoms of addiction.
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Frequently asked questions
Implants to treat opioid and alcohol addiction are small devices inserted under the skin that slowly release medication to help reduce cravings and prevent relapse. The implants are typically effective for about six months, after which they need to be replaced.
Implants offer a convenient way to administer medication without the need for daily doses. They also help improve medication compliance and reduce the risk of medication being lost, stolen, or taken by someone else. Additionally, implants provide continuous medication release, reducing the risk of relapse and overdose.
There are several types of implants available for opioid addiction treatment. The first implant approved by the FDA for opioid addiction treatment is Probuphine, which contains the medication buprenorphine. Naltrexone implants, such as those developed by Delpor, are also effective in blocking the brain's ability to respond to opioids, reducing the euphoric effects of opioid-based drugs.
There are two main types of implants available for alcohol addiction treatment: disulfiram-based and naltrexone-based implants. Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenase, causing immediate "hangover" effects if alcohol is consumed. Naltrexone, on the other hand, belongs to the class of opioid receptor blockers and can help prevent relapse during alcoholism treatment.
