Journal of Substance Abuse Treatment
Volume 14, Issue 6 , Pages 535-542, November 1997

Hydromorphone polymer implant A potential alternative to methadone maintenance☆

  • Deborah J. Rhodes, MD

      Affiliations

    • Corresponding Author InformationRequests for reprints should be addressed to S.A. Grossman, The Johns Hopkins Oncology Center, 600 N. Wolfe St., Baltimore, MD 21287-8939.
    • ,
  • Stuart A. Grossman, MD

Department of Medicine and the Department of Oncology, The Johns Hopkins Hospital, Baltimore, MD, USA

Received 26 August 1996; received in revised form 21 January 1997; accepted 31 March 1997.

Abstract 

Although methadone maintenance remains the best available treatment for opioid addiction, the need for daily oral dosing limits the effectiveness of methadone as opioid substitution therapy. Limitations of methadone maintenance include the administrative costs and burdensome time commitment associated with daily clinic visits, the danger of illicit diversion and accidental overdose associated with oral dosing, the low rate of treatment retention, and inadequate treatment capacity. A new opioid delivery device awaiting approval for clinical use may overcome some of these limitations. The device, a buttonsize polymer containing hydromorphone, releases near constant levels of opioid when implanted subcutaneously. Because of its location and duration of effect, the polymer may eliminate the need for daily clinic visits, reduce the costs and time constraints of treatment, reduce the risk of illicit diversion, provide an incentive for compliance with initial methadone maintenance treatment, and increase treatment capacity and retention.

Keywords:  polymer, methadone maintenance, intravenous drug use, hydromorphone

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☆ Deborah Rhodes gratefully acknowledges the support of the Robert Wood Johnson Clinical Scholars Program. We thank Annie Umbrich MD, Albert Wu, MD, and Richard Chaisson, MD for their critical review of earlier drafts of the manuscript.

PII: S0740-5472(97)00117-7

Journal of Substance Abuse Treatment
Volume 14, Issue 6 , Pages 535-542, November 1997

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