darn you're good at unearthing gold in the news feed...
Vivitrol as an opioid antagonist, poses a problem w/managing pain...so you get a monthly injection & have accident or surgery... stuck
re: buprenorphine “crutch” metaphor…I use it in my practice for those who refuse medication.. “so if you fracture your leg would you not have a cast to promote healing, would you not use a crutch? ... how's that gonna work out?”
Ultimately in opioid addiction recovery one strives for function w/out any crutches as healing takes hold .. yes insulin is required to manage chronic diabetes.. but life changes in diet & exercise can significantly modify that chronic condition making insulin injections unnecessary ….medication is vital to stabilize a patient so they can themselves embrace recovery and make life changes that require hard work... unfortunately Alkemes is targeting law enforcement officials by banking on their lack of understanding and their bias to deploying “non-addictive” medication as the solution; to promote chemical restraint in the form of an antagonist vs a partial agonist... my field experience tells me there is a high relapse rate in those mandated to take this as a condition of parole or court diversion process.. no research available yet I gather… Gotta hand it to Alkemes … good targeted marketing to the controllers of the purse strings; what’s TTNP mgmt done lately in the research department? …There is space in addiction Tx for both buprenorphine & naltrexone…. 2 different interventions for 2 different stages in recovery; apples and oranges… the treating professional in collaboration w/the patient can only make the decision if the treatment is to have lasting benefit …... now I remember back in the day, Medicaid did not cover Vivitrol.. didn't cover suboxone either for that matter...(the ACA changed all that) so in those states that plan to curb Medicaid expansion, who will pay for this antagonist, particularly if research reveals a statistically significant relapse rate in those mandated to take Vivitrol.. BTW anyone have any idea where TTNP is on the pain indication for probuphine?
