Slashdot Mirror
FDA Approves First Implant Treatment For Opioid Addiction (bloomberg.com)
An anonymous reader writes from a report via Bloomberg: The Food and Drug Administration cleared the first implant in the U.S. to treat heroin and opioid painkiller addictions. The product, Probuphine, may be used to treat addicts continuously for six months with the drug buprenorphine, according to a statement from the agency on Thursday. Titan Pharmaceuticals Inc. and partner Braeburn Pharmaceuticals are the two companies behind the implant and plan to bring it to the market just as Congress passed a bill aimed at addressing the opioid crisis. Buprenorphine differs from methadone in that it doesn't require a treatment program. Doctors can prescribe the implant to patients after they take a four-hour training program. The FDA rejected the implant in 2013 because the original dose that the companies proposed was too low to provide effective treatment. The companies decided to maintain the lower dose and attempt to gain approval by restricting use to patients who already were stable on such amounts. Meanwhile, employers are struggling to find workers who can pass a pre-employment drug test.
This is completely different.
In that case the pharmaceutical industry is profiting by providing a "solution" to problems caused by the tobacco industry. In this case the pharmaceutical industry is profiting by providing a "solution" to addiction problems caused by the pharmaceutical industry.
If the "solution" isn't very effective and provides on-going sales - well, that's just a lucky side-effect.
Well did you?
There's a reason we don't treat alcoholics with whiskey.
I suspect it's not a very good reason or a reason whose motivation is derived from Calvinistic moral calculus.
My friend's step mother is an alcoholic and has been through a half-dozen treatment programs, most of them in-patient programs and still hasn't stopped drinking.
What if we just acknowledged that alcoholics drink, and instead of trying to foist abstinence we instead eliminated the shame associated with "failing" to become a teetotaler and instead put some effort into just getting their drinking down to less-destructive levels?
There were at least two NYTimes articles about this kind of thing in the past year, including a Dutch program that gave chronic alcoholics jobs *and* beer, providing them with structure that got them into a productive life cycle but acknowledged that they could drink, too? From the looks of it, it appeared to be fairly successful. The key things seem to be getting into life patterns that provide meaning and teaching them to drink at levels that are much less destructive. Eliminating the shame associated with drinking seems to be important to this.
From everything I've read, psychiatrists consider buprenorphine an extremely good treatment for opioid addiction. If getting opioid addicts on a stable maintenance dose and back into constructive life habits works for them, why couldn't something similar work for alcoholics?
The relentless focus on total abstinence seems bizarre in comparison to, say, people with depression whom we *encourage* to take maintenance doses of anti-depressants without relentless shaming of those who can't "just get better" and stop taking them.
It would not surprise me at all if we ever found out that some people are biologically susceptible to alcoholism or opioid addiction due to brain chemistry imbalances, just as some people are prone to depression for the same reasons.
There are some people who are going to be a problem, and will be on a self destructive course, perhaps not much at all can be done to treat them. But those might be outliers? Who knows - certainly worth a try.
There's a whole combination of magical thinking clustered around the idea that only total sobriety is acceptable and that alternative solutions (like maintenance dosing or harm reduction) are judged by their failures instead of their successes.
Total sobriety has a terrible track record of success, yet it is judged by its successes and viewed as a solution because of its adherence to the ideology of total sobriety. Maintenance dosing or harm reduction is at least as successful, but is judged for its failures and condemned for its acceptance of non-sobriety.