A few days ago, a 28-year-old addict stabbed his aunt to death a few blocks away from Dr. Michael Frost's addiction treatment practice in the small town of Conshohocken, Pennsylvania. Dr. Frost, a board-certified addiction medicine specialist and president of the clinic, says the murder shows how badly painkillers and heroin addiction have effected his small town.
"Conshohocken has never been a violent place, but we have been hit incredibly hard by the opioid addiction epidemic," says Dr. Frost.
Dr. Frost says the problems in Conshohocken are not unique; 91 Americans die every day from opioid overdoses of either legal prescription opioid painkillers or heroin, according to the most recent statistics from the Center for Disease Control.
But Dr. Frost is using a new tool against addiction which he says is yielding promising results with some of his patients. Probuphine, developed by venture-backed Braeburn Pharmaceuticals, is an implantable version of buprenorphine, the opioid addiction treatment drug. Dr. Frost, who was the principal investigator during a clinical trial with Probuphine, is treating up to 20 patients with the six-month implant.
Probuphine, which is implanted under a patient's skin during a quick procedure, was recently approved by the U.S. Food and Drug Association and has recently hit the market. Eighty-five insurance companies, including Aetna and Cigna have agreed to cover the medication and 2,500 doctors are now trained on how to insert and remove the implant.
Buprenorphine, the active chemical in Probuphine, was approved by the FDA in 2002 as a tablet or film used to help opioid addicts manage their addiction and stop abusing drugs. It partially fills opioid receptors in the brain to help addicts avoid experiencing withdrawal symptoms and prevent cravings to use.
To avoid withdrawal or relapse, patients need to take buprenorphine everyday, which poses certain risks, says Dr. Frost. Some addicts choose not to take their pills and sell them instead for their drug of choice. But the Probuphine implant helps to stem those risks.
"With an implant, patients cannot skip a dose and relapse," says Dr. Frost. "It has taken time to develop, but Braeburn is leading a movement towards new technology that no longer relies on a patient to remember to take medicine everyday."
Behshad Sheldon, the CEO of Braeburn, says clinical trials have found that patients who used the Probuphine six-month implant were 85.7 percent more likely to refrain from opioid use compared to 71.9 percent of patients who took buprenorphine tablets or film under the tongue everyday. Patients using the implant were also found to have a 24 percent reduction in fatal overdoses and an 80 percent reduction in going to rehab.
Backed by Apple Tree Partners, Braeburn has raised $187 million in funding. Braeburn licensed the implant technology from Titan Pharmaceuticals.
Sheldon says she believes the addiction medicine industry has suffered for years by stagnation and a lack of innovative new technologies thanks to the stigma against addicts. She says the addiction treatment space has been dominated by the belief that addiction is a moral spiritual failing, but a shift has taken place as opioid addiction has hit each demographic--from politicians to athletes to rich and poor, Sheldon says.
"The time to be moralistic is over, addiction is a chronic disease," says Sheldon. "Like any other chronic disease, addiction requires medicine to manage and needs to be part of treatment in order to be effective."
Sheldon says deaths from opioid overdoses are now the number-one killer of Americans in terms of accidental death; the stigma around addiction needs to take a back seat to treating addiction as a serious medical condition.
"In two years, I have gone to two funerals for people in my life who died from opioid overdoses," says Sheldon. "The consequences are too severe to not start taking innovation in addiction medicine seriously. We have a medicine that helps people manage addiction, just like insulin helps people manage diabetes."
As the opioid addiction epidemic, fueled by legal prescription drugs, has created 2.5 million addicts across the country, according to the CDC, Sheldon says Probuphine can help millions of people.