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PostPosted: Sat Dec 03, 2016 3:21 pm 
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Does anyone have experience with the buprenorphine implants? I am considering them as an option so I don't have to worry about dosing and just truly live a "free" of drugs lifestyle. I'm curious if anyone has had positive or negative experiences. Thanks!


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PostPosted: Sat Dec 03, 2016 3:50 pm 
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There's a little bit of info on the forum, not sure of how much. If ya want, u can go to the search bar and type it in, that should bring up a bit. I've heard it's very expensive...that's just what I heard so not positive.

An implant would be awesome because u wouldn't have to worry about prescriptions or traveling with ur medicine, not ever being tempted to take extra...it sounds good but I always worry about it possibly stop working lol. Now we all know I worry way to much and think of every single detail that could go wrong lol. But I would worry about how effective it would stay after it's been in awhile. That and the financial part of it would be my concerns with it. If u have insurance, who knows, it could pay for it. It would definitely be worth checking out if u were truly interested in it.

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PostPosted: Mon Dec 05, 2016 1:35 pm 
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I'll share the little that I know. I was signed up for the training to do the implant, but cancelled after hearing details about the product. The implant costs about $5000 each. Initially, docs had to buy it and then get reimbursed from insurance later. Few docs are going to put out $5000, hoping to get paid back, in order to bill $150 to put in the implant. I don't think many people would even passively invest $5000 in order to get a return of $150, given the amount of paperwork involved in getting insurance to pay for anything-- not even counting the problems that would happen if the drug is on hand but the patient doesn't show up.

They now have a system where a third party takes the patient information and processes the insurance to get the implant. But I don't know how they handle all the issues that arise in such a situation-- i.e. who 'owns' the implant purchased by insurance, the patient or the doctor? Can the patient 'claim' the implant and take it to a different doc to be implanted? etc...

Other doc issues... what if patients get the implant, but then don't follow up? Buprenorphine is supposedly only part of the treatment; what if the patient doesn't maintain abstinence? What if he/she doesn't do counseling? What if the patient relapses on heroin-- does the doc have to remove the implant? How do we get the patient into the office to do that? Is the doc liable for the patient as long as the implant is releasing the drug? Or longer? Until the implant is removed?

From the patient perspective... the implant yields lower buprenorphine levels than a full, 16 mg of buprenorphine. I don't know how much, but the info I've read says it is intended for people who tolerate levels of buprenorphine on the low end of the dose range. As a patient I'd want to know, what does the blood level look like over time? Will I feel lousy during the second 3 months? If I do, what happens? Will I be given supplemental medication, or forced to 'deal with it'? If I think I need more, can I have more? Also, is the release consistent from one person to the next?

As they say, the Devil is in the details. It looks great initially, but it looks more complicated when you look more closely. I also want to know-- could it be used as a taper tool for patients? What does the blood level look like after six months, and how fast does it drop?

The other new tool coming out soon is the 30-day injection, which I think will be a more-attractive option for some of the reasons I described above.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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