This Tiny Plastic Implant May Disrupt America’s Opioid Addiction Problem


It was only after Sarah Wilson’s parents accused her husband of stealing from them that she came clean about her opioid problem. The Jacksonville mother of four was hit by a drunk driver in 2008, leaving her with significant nerve damage in her back. Wilson worked as a police dispatcher and her insurance was good and publicly funded, but eventually she had to give up her career as the pain became too much for her to bear.

“It got to the point where my legs were giving out from under me,” Wilson said. “I couldn’t feel my hands. I lost my health insurance and eventually my doctor told me I couldn’t afford treatments anymore, but I could afford narcotic painkillers.” […]

Probuphine isn’t a drug as much as it’s a novel way to administer treatment. In a 15-minute in-office visit, a doctor will insert four white, tube-like flexible implants into a patient’s upper arm. Those implants are each the size of a matchstick and will continuously release a low dose of medication into the bloodstream and up to the brain. The drug will then fasten onto the same neural receptors triggered by heroin or prescription narcotic painkiller use, effectively curbing one’s desire to get high. The implants will be replaced every six months. Think of it like a microscopic IV with no physical traces. The convenience is the primary perk—Probuphine patients don’t have to worry about remembering their pills or refilling their prescriptions. But Wilson was drawn to its safety.

“I was 100 percent onboard because I’m a mom. Even though the drug itself is a life-saver for me and my family, we had it in a locked safe, because it scares me having it in the house,” she said. “Like, if one of my kids got a hold of it, or if our house got broken into and somebody else got a hold of it, [with the implant] I don’t have to worry about that anymore.” […]

But others aren’t as convinced about the treatment’s efficacy and safety. Diana Zuckerman is a former post-doctoral fellow at Yale Medical School and currently serves as the president of the Washington, DC-based think tank The National Center of Health Research, which recently noted gaps in Probuphine’s trials.

“I think the big issue is the transition,” said Zuckerman, who was not involved with the trials. “People are going to go from taking pills to using this implant. The implant doesn’t work immediately. It takes a while for it to work and settle into the level that it’s supposed to be. And during that time the person is still going to be taking pills, and that becomes a vulnerable time. How many pills should that person take before the implant is really working, and should they continue to take pills after it’s working?”

According to Zuckerman, medical companies rarely have the motivation to do research once a treatment has been approved by the FDA. At the end of the day, her main concern is that a subdermal implant like Probuphine treats opioid addicts with more opioids.

“Obviously we’ve got a huge problem in this country, and we’ve got to find a way, and I think step number one is to prevent people from becoming addicted by having doctors not prescribe [opioids] so loosely,” Zuckerman said. “But step number two is finding out a better way to help people once they’re addicted. We don’t seem to have a good handle on that.”

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