A 'game-changing' treatment in the opioid-dependence fight
Opioids – illicit drugs such as heroin, and pain relievers such as codeine, oxycodone and morphine – are the major contributors to overdose deaths in Australia, highlighting the need to upscale interventions that help reduce opioid-related harm and mortality.
One important established intervention is opiate agonist therapy, which helps prevent withdrawal and reduce cravings for opioid drugs, and has been shown to be effective in improving wellbeing, and reducing illicit opiate use and overdose mortality.
The therapy involves taking the medications methadone or buprenorphine, and helps people addicted to opioid drugs to stabilise their lives and reduce the harms associated with their drug use.
However, one drawback of opiate agonist therapy is the need to attend pharmacies or clinics several times a week to receive medication. These frequent dosing requirements can reinforce stigma, and make it difficult for patients to engage in other activities.
A long-acting solution
A new formulation of buprenorphine has recently been launched, and promises to improve the treatment of opioid dependence. This long-acting injectable depot slowly releases over the course of a week or month to block the effects of opioid use.
A recent study published in Drug and Alcohol Dependence, led by Turning Point, Monash University and The University of Sydney, found that long-acting injectable buprenorphine may bring many benefits for patients, particularly during the COVID-19 pandemic when access to in-person services has been constrained.
While there’s a growing body of evidence that long-acting injectable buprenorphine delivered via a weekly or monthly injection is effective to treat opioid dependence, how patients experience it is uncertain.
In this world-first study, researchers conducted interviews with 30 patients in Victoria and New South Wales who had recently been prescribed long-acting injectable buprenorphine.
Benefits for patients
Long-acting injectable buprenorphine led to benefits for many patients, including opportunities to avoid stigma experienced at pharmacies or clinics by not having to attend daily; time to engage in other activities (such as travel, work, study, caregiving) by releasing participants from previous strict treatment regimens; and cost savings by not having to pay pharmacy fees associated with daily dosing.
Additionally, for many participants, being released from past, strict daily-dosing treatment regimens allowed them to form a new sense of self and a “freedom” to move forward in life.
“It’s absolutely freed up so much of my time, and I’m not tied to the clinic. I feel like I’ve got more control over my life which is a good thing,” said Justine* who had recently been prescribed long-acting injectable buprenorphine.
However, for some patients who were particularly marginalised, moving to long-acting injectable buprenorphine disrupted engagements with important social and practical supports available at pharmacies or clinics, and constrained their control over their own dosing.