Implant in bicep presents alternative opioid treatment

BOTHELL, Wash. — Few doctors in the Seattle area are prescribing Probuphine, but one who is offering the new implant finds it a welcome choice for the maintenance treatment of opioid dependence.

Dr. Barbara Mendrey said she currently has two patients on Probuphine, which involves surgically placing four, one-inch sticks just below the skin on the arm. The implant, approved last year by the U.S. Food and Drug Administration, is meant to stay there six months during which it releases a steady flow of medication.

Mendrey said the implant works best for people who are already in recovery and who have been stable on about 4 to 8 mg of Suboxone and have paired the medication with counseling. Suboxone is a drug prescribed by doctors to wean patients off of opioids in a controlled manner.

One of Mendrey’s patients is Jason Fry.

“I should have been dead thousands of times,” Fry said.

Fry, 42, told KIRO 7 that he was first introduced to opioids as a 12-year-old, when he was prescribed medicine after surgery. Three years later, he tore a ligament in his ankle playing sports in school, after which he was again prescribed strong pain-killers like Hydrocodone.

“It was like an instant love addiction,” Fry said. “Just a powerful thing. And it just kind of snowballed and grew and grew and grew.”

He said the problem grew until he could take up to 50 Vicodin pills a day without much effect. He said he sometimes stole pills or went to Canada to buy them, though most of his supply came from prescriptions.

“It’s like a little devil sitting on your shoulder, and he runs the show,” Fry said.

After years of addiction, Fry said his wife at the time laid out all of his pill bottles, which covered the entire dining room table. He was urged to seek treatment, so he went to a facility in Idaho for more than a month.

“I was so done living that way. It was exhausting. It’s like this spider web of lies,” he said.

Fry came back to the Seattle area and began treatments of Suboxone.

About six months ago, Mendrey told Fry about the possibility of implants in his arm. He had the surgery done two months ago.

Fry said the prospect of trying a solution that not many people have experienced is exciting.

While there is little research to show what should be done the implant has run its course for six months, Mendrey said the manufacturer, Braeburn Pharmaceuticals, recommends replacing it with another implant.

But if the patient wants to wean off Suboxone entirely, Mendrey said it’s possible to remove the implant and go back to the pill-form of the medication in lower dosage.

The benefit of the implant is that it cannot be stolen, accidentally accessed by children, forgotten, or misplaced.

Mendrey said patients who are on Suboxone sometimes feel fine and mistakenly stop taking the medication. This causes severe withdrawal symptoms. The implant prevents that scenario.

“Some people view it as a crutch. It’s not a cure. It’s a treatment,” Mendrey said. She said that people using this narcotic in a controlled, legal manner, at a low dose, makes them functioning members of society, compared to opiate addicts who may abuse prescriptions or attempt to obtain drugs illegally.

The out-of-pocket cost for Probuphine can be more than $4,000 for the six-month implant.

Mendrey, who is not being compensated by Braeburn Pharmaceuticals, said the company has been working with insurance companies and offers a program for people who cannot afford the medication.

Cox Media Group