Patients Discuss Their Naltrexone Implants

By Kelly Burch 06/18/19
The implant is currently not available in the United States.
Image: 
patient discussing the naltrexone implant with her doctor

Six years ago, Peta Walker was ready to give up her fight against heroin and amphetamine addiction. She had tried medication-assisted treatment with methadone, but it had not worked for her.

Desperate, she tried one more thing: a long-lasting stomach implant that releases naltrexone, a medication sold under the brand name Vivitrol that blocks the effects of opioids. 

To Walker’s surprise and delight, it worked. “I’m doing things that I always dreamed of,” she told The New York Times

Currently in the United States, naltrexone is available as a daily tablet or as a shot that lasts for a month. But the implant that Walker received from a doctor in Australia lasts for six months. 

The doctor, George O’Neil, has been using the implants for nearly 20 years. The device isn’t approved in Australia, but he is able to give it to patients because the law allows people at risk of death to try unregulated medical treatments. The procedure costs about $4,800 U.S. dollars (about $7,000 Australian dollars). 

For decades, O’Neil has been content to use his device on a relatively small scale, but now the implant is gaining international attention. “I’m good at dreaming, but there’s people around me good at doing,” O’Neil said. 

When the Times reported the story, researchers from Columbia University in New York were watching O’Neil place an implant in a patient. The research team has been awarded nearly $7 million to study the possibility of a naltrexone implant, with an additional $14 million in funding available if the results are promising. 

Dr. Adam Bisaga, a professor of psychiatry who is leading the study, said that a long-lasting implant is more appealing than a shot because it helps people commit to a longer stretch of sobriety. 

“If we have a way of targeting the ambivalence—and the way you do that is long-acting preparation—that will be a major advance,” he said. “In the U.S., it’s pretty clear that it’s an acceptable and viable treatment.”

Vivitrol, the injectable form of naltrexone, is already a popular medication in the United States because it lasts for a month and is not an opioid, unlike methadone and other medication-assisted treatment options. That makes it particularly appealing in law enforcement settings and jail, because it is impossible to divert Vivitrol for illegal use. The implant, if approved in the U.S., could broaden the appeal of naltrexone even more. 

However, all forms of naltrexone do have some drawbacks. People who use naltrexone and then use opioids are at increased risk for overdose. In addition, to get started on the drugs people need to go through opioid withdrawal to first clear opioids from the system. 

Despite that, the drug—and the implant—appeals to many people, including 25-year-old Jessica Martin, who received the implant recently. 

“I feel better now coming here,” she said. “I feel confident that I’ll stop it.”

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.

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