Opioid Dependence Treatment

Opioid Addiction, now referred to as Opioid Use Disorder, is a medical condition characterized by a destructive pattern of opioid use that causes significant impairment or distress. This destructive pattern develops as a result of dependency. You know you are dependent when you experience withdrawal symptoms as a result of not taking opioids. Typical withdrawal symptoms include anxiety, nervousness, irritability, sweats, chills, muscle aches and sometimes diarrhea. In order to alleviate these symptoms and feel normal, one must take opioids on a regular basis. This leads to a vicious cycle of using more opioids at higher doses. In order to maintain this expensive habit, one is often led to the use of heroin. Dependency and addiction destroy lives and relationships.

We have an opioid addiction and dependency crisis in America. Utah is among the worst states for opioid related deaths from overdose. Treatment programs run the gamut from long-term inpatient rehabilitation to outpatient programs involving frequent visits. Historical success rates at treating opioid dependence have been disappointing. The good news is that we are getting better at it. Much of the cause for optimism is the growing use of buprenorphine.

Buprenorphine is currently marketed under the brand names Suboxone, Zubsolv and Subutex. There are also generic formulations. The latest treatment option involves the use of implants in the arm. These implants are small white rods, each 26mm long, which slowly release drug to maintain steady blood levels of buprenorphine. The rods last for a period of 6 months. This product, called Probuphine, is a major advancement in the treatment of opioid dependency. The implant allows maximum freedom and flexibility since patients are no longer subject to the daily administration of medication.

I have been treating patients with opioid dependence for 10 years using the drug buprenorphine orally. Last year I had the opportunity to receive training on the new buprenorphine implant called Probuphine referred to above. I am excited that I can now offer probuphine to patients looking for other treatment options. If you have an interest in Probuphine or any of the other buprenorphine products I am available for consultations.


(See Dr. Kamalu talk about the Probuphine implant on ABC4 Utah)

The following is an explanation of the Probuphine implantation procedure along with actual pictures.

Probuphine is a buprenorphine-containing rod that slowly releases drug to maintaining steady blood levels. Here is a picture of one of these rods inside its packet.


The procedure takes about 30 minutes to complete. The first step is to correctly mark the location on the arm where the implants will be inserted. This is about 8-10 cm from the medial epicodyle. The area is then cleaned and a sterile drape is applied. Finally the area is anesthetized (numbed) with 1% Lidocaine.


A small incision is made where the implants will be inserted. This is the only incision.


This is what the cannula looks like that will be used to insert the implants.


The next two pics show an implant being inserted.



Finishing up by applying a bandaid and ace wrap. No sutures are left. There is a one week followup to ensure healing.



“Dr. Kamalu did a great job. The procedure was painless. The medication is great. I have my life back.  –Brent Sterner

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