Hydromorphone polymer implant: A potential alternative to methadone maintenance

Although methadone maintenance remains the best available treatment for opioid addiction, the need for daily oral dosing limits the effectiveness of methadone as opioid substitution therapy. Limitations of methadone 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 low rate of treatment retention, and inadequate treatment capacity. A new opioid delivery device awaiting approval for clinical use may overcome some of these limitations. The device, a button-size polymer containing hydromorphone, releases near constant levels of opioid when implanted subcutaneously. Because of its location and duration of effect, the polymer may eliminate the need for daily clinic visits, reduce the costs and time constraints of treatment, reduce the risk of illicit diversion, provide an incentive for compliance with initial methadone maintenance treatment, and increase treatment capacity and retention.