43-60 days is what Google says.
so 60 days out there would still be 150 mg --- 120 days 75 -- 32.5 --- 16.25----8.125 --- 4.0625----2.03125 --- 1.015 and so forth with each of these #'s representing 60 days --- that does sound kinda brilliant I must admit. (assuming it works right fet turned me off to the "patch" idea)
thats exactly right..
here is how it works
If that half life is correct this could certainly work. If it does then we have a big weapon against physical dependence. Opiates also carry the psychological addiction in many people and that obviously needs to be successfully addressed.
I had some patients who were in the original clinical trial for sublocade - 2017 maybe 2018? I helped our health center become the first in our state to use it in a community setting, had to get a revised DEA license and go through some extra legal hurdles but in the end it was worth it.
A few things: The long halflife is no joke - we had a patient receive the 300mg, 150mg, and then go to jail for 6 months, did not use while in jail, but came out with low but detectable buprenorphine/norbuprenorphine in his urine. He endorsed no cravings or withdrawal during the 6 month bid and credited it with ultimately helping him to come off of opioids entirely.
I've had a number of patients also successfully taper off painlessly. After a few injecitons it starts to become easier to seperate onesself from 'the clinic'. You're coming in once a month, once every 6 weeks.... it's more and more of a chore than anything. You're not having to take anything every day, and slowly it just titrates out, so slowly that your receptor functioning has time to adjust.
There's anew implant that they're using... brixadi - it's weekly which some like to use since it allows more frequent follow-up and monitoring. The downside to sublocade is you only see folks 1x/month so a lot can happen in the interim. The weekly appointments for patients early on mean that you're having face time with the doctor, the nurse and (hopefully) the social worker (that's how I fit into the picture). Brixadi is a nice alternative since you're only getting a dose a week, but you're still having to come in and check-in with your treatment team etc.
My opinion is that sublocade is ideal for: high functioning well supported people who are ready to stop using, and very high risk people who almost certainly will be exposed to opioids and may go in and out of jail since it ensurs an effective level of buprenorphine for months at a time. For folks that are more in the middle of those two extremes, something like orall bupe or brixadi helps to build up consistency and readiness to change.
