HYDROMORPHONE POLYMER IMPLANT - A POTENTIAL ALTERNATIVE TO METHADONE-MAINTENANCE

Although methadone maintenance remains the best available treatment fo r opioid addiction, the need for daily oral dosing limits the effectiv eness of methadone as opioid substitution therapy. Limitations of meth adone 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 lo w rate of treatment retention, and inadequate treatment capacity. A ne w opioid delivery device awaiting approval for clinical use may overco me some of these limitations. The device, a button-size polymer contai ning hydromorphone, releases near constant levels of opioid opioid whe n implanted subcutaneously. Because of its location and duration of ef fect, the polymer may eliminate the need for daily clinic visits, redu ce the costs and time constraints of treatment, reduce the risk of ill icit diversion, provide an incentive for compliance with initial metha done maintenance treatment, and increase treatment capacity and retent ion. (C) 1997 Elsevier Science Inc.