The implant is about the size of a matchstick.
The Medical University of South Carolina became the first in the state to administer probuphine, a buprenorphine implant for the treatment of opioid dependence.

Angela Dempsey, an obstetrician and gynecologist, says the outpatient surgery went well. The procedure, similar to that of contraceptive implantation, was not that different from what she usually does, but having a male patient was a bit different, she says.

“Situations like this raise the question of how siloed medicine has become. This is a model for improving patient access and experience and not limiting the treatment options,” she says, adding that it took the coordinated effort of many MUSC specialties to make offering this a reality. “I don’t think there’s any dispute what a crisis this is. We really have to have quite an organized response to this.”

Dempsey worked in coordination with a team that includes pharmacists and addiction specialists at MUSC Health’s Institute of Psychiatry to be able to offer this treatment. Probuphine, implanted in the arm, is designed to provide a constant, low–level dose of buprenorphine for six months in patients who are already stable on low–to–moderate doses of other forms of buprenorphine.

That there’s a need for more treatment options such as this is obvious.

• Since 1999, the number of overdose deaths involving opioids, including prescription opioids and heroin, quadrupled.
• From 2000 to 2015 more than half a million people died from drug overdoses, with 91 Americans dying every day from an opioid overdose.
• In South Carolina, opioid–related deaths rose from 237 in 2013 to 516 in 2014, with more than 600 people dying from opioid and heroin overdoses in 2015, according to the S.C. Department of Health and Environmental Control.

Instrumental in getting this new treatment approved at MUSC was psychiatrist Sarah Book, an addictions specialist and professor in MUSC’s Department of Psychiatry and Behavioral Sciences.

Last May, the FDA approved the use of Probuphine for this purpose, but it hasn't been a treatment patients could get in the state, she says.

“The FDA has a very tight control over the process. To begin, a patient has to be engaged in addictions treatment at a program like MUSC’s Center for Drug and Alcohol Programs that is familiar with treating opioid use disorder using buprenorphine as Medication Assisted Therapy. In addition, the program has to have a surgeon to actually do the implant at MUSC. As you can imagine, it’s not too often that one program is going to be able to offer both types of expertise.”

At MUSC, the Addiction Sciences Division, formerly known as the Center for Drug and Alcohol Programs, and OB/GYN clinics are located close geographically, so doctors considered working together. “We have the addiction expertise, and they have the surgical expertise and were interested in working with us. They see what a problem it is, too.”

Being able to offer this treatment also provides a valuable training opportunity for doctors who are doing their addiction fellowships at MUSC, which is known for its strong focus on addictions research and clinical treatments. “We’re training the next generation of providers to fight this.”

Because the medication is surgically implanted, it reduces the hassle factor her patients’ experience in remembering to take a medication, and it minimizes the risk of diversion and abuse, she says.