News on Drug-Assisted Treatment for Opioid and Heroin Addicts

The National Institute on Drug Abuse announced the Federal Drug Administration's approval of Vivitrol for opioid dependence as well as the results of a study that shows promising findings for an implantable form of buprenoprhine, another extended-release treatment.
 

NIDA Director Dr. Nora D. Volkow said in a news release that the two developments represent dramatic advances in treatment for people addicted to heroin and prescription opioid painkillers.

“Heroin addiction afflicts an estimated 810,000 people in this country, the great majority of who do not either seek or receive treatment. Further, in 2008 1.85 million people in the U.S. met the diagnostic criteria for abuse or dependence on opioid pain relievers, such as Oxycontin and Vicodin (NSDUH, 2009). In fact, opioid abuse (including heroin) is a worldwide problem, with between 12.8 and 21.9 million people abusing opiates in the past year (UNODC, 2010).”

Vivitrol is an extended release formulation of naltrexone, an opioid receptor antagonist. It is the first non-narcotic, non-addictive, extended release medication approved for the treatment of opioid dependence. The safety and efficacy of Vivitrol were studied for six months, comparing Vivitrol treatment to placebo treatment in patients who had completed detoxification and who were no longer physically dependent on opioids.

Patients treated with Vivitrol were more likely to stay in treatment and to refrain from using illicit drugs. Thirty-six percent of the Vivitrol-treated patients were able to stay in treatment for the full six months without using drugs, compared with 23 percent in the placebo group.

The new study reported in the Journal of the American Medical Association shows promising findings for an implantable formulation of buprenorphine (Probuphine), which delivers a constant dose of the medication for up to six months. The goal is to improve upon the efficacy of daily administered buprenorphine, which can be undermined by poor treatment adherence, resulting in craving and withdrawal symptoms that increase the likelihood of relapse.

NIDA is supporting further research on the clinical efficacy of Probuphine, in the hopes that it too will become part of the arsenal of weapons against the crippling effects of opioid addiction.