Thursday, September 17, 2009

We are testing out two new implants

It is very exciting for us at The Coleman Institute because we have two new implants that are available for us to use for our patients. Both are looking like they will significantly extend how long the implants last and make it much more convenient for our patients to stay in recovery. One of the problems with implants has been that they deliver a lot more Naltrexone than is really needed in the early part of the implant treatment cycle, and then they lose their effectiveness too quickly. It turns out that patients don’t need very large amounts of Naltrexone to completely block the effects of Heroin, OxyContin or other opiates. All it requires is about 1 nano-gram (1 millionth of a gram), per milliliter of blood. Naltrexone is a very powerful blocker. By making an implant more tightly compressed we should be able to reduce the amount of Naltrexone delivered at the start of the implant cycle and extend the duration of the implant cycle.

The first new implant is a newer and improved version of our current 2 month implant. It is compounded in a bigger machine that can compress the Naltrexone more tightly. The end result is that the implant has 40% more Naltrexone but it is essentially the same size. It is just as easy for us to insert. But because the Naltrexone is more tightly compressed it will last a lot longer.

The second new implant has been under development and early use in Australia for the last couple of years. I have spoken with a physician over there that uses them. He and his colleagues have already begun a major study on these implants. The early results show that they seem to last at least 4 months and possibly 6 months. They are a double implant system - two implants put in at the same time. The implants are being compounded in the US by a large pharmacy in NY.

This is very exciting for us. Longer lasting implants make so much sense. With a 4 month implant, patients can realistically get detoxed with us and then only have to come back 2 more times to stay off all opiates for a year. A 6 month implant would of course mean that, with only one repeat implant, patients and their families can have security and confidence that there will be no opiate use for at least a year. We believe that a 4 – 6 month implant would be ideal for patients and their families. We believe that many more patients will come back if it is more convenient for them. Especially patients who have to make a long trip. Many more patients can get clean and stay clean.

We are excited to be able to use these new implants and we are also very excited to start some research studies on them. I have already begun discussions with researchers at the Medical College of Virginia (MCV). We will study blood levels and look at other measures of how well the implants work. Hopefully the research will get underway in the next couple of months.

For the last 10 years we have seen firsthand just how happy patients are when they get implants. Most patients completely lose their cravings and they start to be able to get their lives back. Now we will have improved implants and we will be able to document this in a research study. Our findings will let other doctors and patients know that Heroin addicts and other people with Opiate dependence really do have choices.

Peter Coleman MD

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