“Methadone vs. Suboxone: Choosing a medication for opioid addiction - Fox Baltimore” plus 1 more
“Methadone vs. Suboxone: Choosing a medication for opioid addiction - Fox Baltimore” plus 1 more |
Methadone vs. Suboxone: Choosing a medication for opioid addiction - Fox Baltimore Posted: 20 Dec 2019 12:00 AM PST For decades, methadone was the only government-approved medication for opioid addiction. But in recent years, patients seeking treatment for opioid use disorder (OUD) have had another option: Suboxone (buprenorphine), an approved medication that for many patients, has advantages over methadone. "Both are safe, and each has its role," says Ken Egli, M.D., Ideal Option's co-founder and medical director. Studies confirm that without medication—whether methadone or buprenorphine—at least 90% of OUD patients will relapse. Medicine cuts relapse and overdose rates in half. How Suboxone and Methadone work on the brain To some extent, buprenorphine (Suboxone) and methadone work in a similar fashion, but there are differences. While buprenorphine is a partial opioid agonist, methadone is a full opioid agonist. That means buprenorphine partially activates opioid receptors while methadone fully activates them. Both suppress withdrawal symptoms and opioid cravings, but buprenorphine is less likely to cause severe side effects or euphoria. Both medications are long-lasting. A single dose will occupy the opioid receptors for over 24 hours. So, taking either medication once a day will keep the brain's opioid receptors satisfied while staving off nausea and anxiety. Chemically speaking, buprenorphine and methadone have different effects on the brain. "Buprenorphine binds very tightly to the opioid receptors, so if you take heroin on top of it, the heroin won't get to the receptors," Dr. Egli explains. In other words, you won't get high. Methadone doesn't bind to opioid receptors as tightly as buprenorphine does. "You can stack other opiates on top of it, so if you take methadone and then heroin, you will get an additive effect," says Dr. Egli. This can also cause overdoses. With both medications, patients typically need treatment for years, maybe even a lifetimethe same way patients with depression may take antidepressants indefinitely, or patients with diabetes may take insulin forever. According to the National Institute on Drug Abuse, "These medications restore balance to the brain circuits affected by addiction, allowing the patient's brain to heal while working toward recovery." Another difference between the two medications is that Suboxone has a lower potential for abuse and overdose. Though Suboxone can be dangerous if taken with alcohol, sedatives, or muscle relaxers, high doses of the medication typically will not cause harm. Taking too much methadone, on the other hand, can cause respiratory depression and severe heart problems. Each year, more than 5,000 people die of overdoses related to methadone. However, Egli points out, only a minority of these deaths result from methadone prescribed at treatment clinics. "Methadone overdoses are primarily from methadone diverted on the street or bought illegally," he says. It is not uncommon for people in the throes of opioid addiction to seek out methadone in an attempt to get high or avoid feeling sick from withdrawal. Ideal Option patient Manasseh, 27, recalls that she'd regularly steal her grandmother's methadone. "My grandma was an 'everything addict,' and she had methadone lying around," recalls Manasseh, who began using drugs at age eight. Many years later, while still mired in addiction, she learned about methadone clinics. "I thought, 'That's a free way to get high.' But I never went and actually did it." When Manasseh sought treatment for OUD at age 25, she chose Suboxone because of her previous addiction to methadone. Jenna, another Ideal Option patient, actually did go to methadone clinics to sustain her addiction to pills and heroin. "At the time, I had no plans of recovery—I was just trying to get high," recalls Jenna, a long-time IV heroin user. Eventually, after several drug-free months in jail and with the support of her family, Jenna started on Suboxone to maintain her sobriety. Jenna believes that without Suboxone, she'd have been more tempted to seek out her old drug-using friends when she was released from jail. "Suboxone is like a safety net," she says. "It helps with cravings and buys you time to think about whether you really want to take drugs. It's like an armor." The Convenience of Suboxone Jenna checks in at Ideal Option every 28 days, to renew her prescription and meet with her provider. Like many patients, she graduated to monthly visits after initially going twice a week, then weekly, and then every two weeks. The ability to spread out visits over time is a big reason many patients prefer Suboxone over methadone. By law, methadone patients must come to the clinic frequently and often must be observed taking the medication. While the tight supervision is helpful for patients who don't have family support and for those who can't get to both a clinic and a pharmacy, the restrictions can be excessive for patients who live with family and have stability in their lives. What's more, the privacy afforded Suboxone patients helps them avoid the stigma of going to a methadone clinic. Switching from Methadone to Suboxone Ultimately, patients need to decide for themselves which medication suits them best. "Some people just don't like Suboxone, and some people just don't like methadone," says Dr. Egli. "I do have a number of patients who used to be really heavy users, and they like methadone better." Still, for most OUD patients, Dr. Elgi recommends trying Suboxone first. "If that didn't work, I'd consider methadone, but it's much easier to start with Suboxone and switch to methadone than the other way around." About Ideal Option Ideal Option is one of the nation's largest providers of evidence-based medication-assisted treatment for individuals with substance use disorder. Founded in 2012 by two emergency medicine physicians, Ideal Option's mission is to provide underserved populations with low-barrier access to proven treatment—saving lives, healing families, and helping communities. Ideal Option has seven locations in Maryland, including two in Baltimore. To learn how Ideal Option can help you or your loved one or to make an appointment, call 1-877-522-1275 or visit https://www.idealoption.com/. | |||||||||||||
Posted: 05 Dec 2019 12:00 AM PST ATLANTA, Dec. 5, 2019 /PRNewswire/ -- UCB today announced 14 posters have been selected for presentation at this year's American Epilepsy Society Meeting, taking place in Baltimore, Maryland, December 6-10. The UCB scientific program includes the presentation of clinical data describing BRIVIACT® (brivaracetam) CV, VIMPAT® (lacosamide) CV, and NAYZILAM® (midazolam) Nasal Spray CIV, now available in the U.S. for the acute treatment of intermittent, stereotypic episodes of frequent seizure activity (i.e., seizure clusters, acute repetitive seizures) that are distinct from a patient's usual seizure pattern in patients with epilepsy 12 years of age and older.1Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. During the meeting, posters on epilepsy research are also scheduled for presentation, as well as UCB's developmental drug candidate, padsevonil. Padsevonil is not yet approved by the FDA. These scientific presentations provide further insight into UCB's epilepsy portfolio and reinforce the company's commitment to generating sustainable patient value for people living with epilepsy around the world. "Our leadership in epilepsy combines insights from patients and caregivers, collaborations with leading experts from around the world, and cutting-edge scientific methods to address important unmet medical challenges," explained Charl van Zyl, Head of Neurology & Executive Vice President, UCB. "We are committed to developing solutions that address areas of acute need while delivering sustainable value and improved experiences for people living with epilepsy." UCB will be presenting five posters on NAYZILAM and hosting a Symposium "Epilepsy Treatment Update for Patients Suffering from Seizure Clusters" tomorrow, Friday, December 6, 6:00 - 9:00 PM, at the Baltimore Convention Center, Room 314-315. During the symposium, Patty Shafer RN, MN, Senior Director of Health Information and Resources from the Epilepsy Foundation will discuss the rationale for their Seizure Clusters Workgroup and research. Panelists James Wheless, MD; Patricia Penovich, MD; and David Burdette, MD will discuss misconceptions around seizure clusters, followed by a clinical presentation on NAYZILAM. "We believe in developing medicines for people living with epilepsy that may help them achieve control and return to the lives they want to live," said Mike Davis, Head of U.S. Neurology. "The availability of NAYZILAM, which coincides with this AES meeting, reinforces our commitment to progressing tailored medicines to provide additional choices and support to the epilepsy community with the first new rescue option in two decades." UCB will also present "Therapeutic Update: The Additional Burden of Generalized Tonic-Clonic Seizures" with lunch on Sunday, December 8, 12:00 - 1:00 PM, at the Hilton, Key Ballroom 8, Second Floor. John Stern, MD will discuss generalized tonic-clonic seizures and the possibility of mitigating their risk through earlier and more effective treatment interventions. UCB is hosting a "Commitment to Epilepsy Care" Scientific Exhibit on Monday, December 9, 8:00 – 11:00 AM, in the Baltimore Convention Center, Level 300, Room 321-323, to give attending healthcare professionals and researchers an opportunity to learn more about UCB's epilepsy research, clinical studies recruiting, and the company's approach to the development and discovery of medicines. The UCB Congress Exhibit Booth is located within the main exhibition hall, Booth 308. Following is a guide to the UCB-sponsored data presentations: BRIVIACT Posters: Long-term tolerability and retention of adjunctive brivaracetam in children,2 Jan-Peer Elshoff, PharmD, PhD, Teresa Gasalla, MD, Sami Elmoufti, MS, Melinda Martin, PhD, Xavier Nondonfaz, MD, Anup D Patel, MD
Time course of 75%–100% efficacy response of adjunctive brivaracetam in adults with focal (partial-onset) seizures and secondarily generalized seizures: a pooled post hoc analysis,3 Cedric Laloyaux, PhD; Sami Elmoufti, MS; Teresa Gasalla, MD; Melinda Martin, PhD; Pavel Klein, MD
Baseline Seizure Related Disability Assessment Scale (SERDAS) scores in an observational study of brivaracetam,4 Dale C. Hesdorffer, Melinda Martin, Roger J. Porter, Julie Varner, Anne-Liv Schulz, Ying Zhang, Jacqueline A. French
Real-world study of brivaracetam in the US: an interim analysis,5 Roger J. Porter, MD; Melinda Martin, PhD; Julie Varner, PhD; Anne-Liv Schulz, MD; Dale C. Hesdorffer, PhD; Ying Zhang, MS; Jacqueline A. French, MD
NAYZILAM Posters: Somnolence and time to return to baseline functionality after midazolam nasal spray delivery in patients with seizure clusters: post hoc analysis of a randomized, double-blind, placebo-controlled trial,6 Kamil Detyniecki, MD; Rita Campos, PharmD; Teresa Gasalla, MD; Jody Cleveland, MS; Toufic Fakhoury, MD
Tolerability and efficacy of midazolam nasal spray in outpatient treatment of patients with seizure clusters by concomitant AEDs: post hoc analysis of randomized, double-blind, placebo-controlled trial,7 Steve S Chung, MD; James W Wheless, MD; Svetlana Dimova, MD, PhD; Eun Jung Choi, MD, PhD; Aliceson King, MD, MPH; Jody Cleveland, MS
A systematic review of the clinical, humanistic and economic burden of seizure clusters,8 Eun Jung Choi, MD, PhD; Steve S Chung, MD; J Claire Wilson, PhD; Saifuddin Kharawala, DPM, MBBS; Gavneet Kaur, MPharm
Rescue medications in seizure clusters: a systematic review of treatment patterns and treatment impact,9 Saifuddin Kharawala, DPM, MBBS; Jerzy P. Szaflarski, MD, PhD; Gavneet Kaur, MPharm; Eun Jung Choi, MD, PhD; J Claire Wilson, PhD; Lawrence Hirsch, MD
Abuse liability of midazolam nasal spray (MDZ-NS) in adult recreational benzodiazepine users: phase 1, randomized, double-blind, double-dummy, active- and placebo-controlled, crossover trial,10 Isabella Szeto, Tze-Chiang Meng, Peter J. Van Ess, Jo McCarthy
VIMPAT Poster: A multicenter, observational trial in Taiwan to evaluate the safety and tolerability of lacosamide in clinical practice for the treatment of epilepsy,11 Tony Wu, MD, PhD; Yao-Chung Chuang, MD, PhD; Hui-Chun Huang, MD; Peiyuan F Hsieh, MD; Wang-Tso Lee, MD; Shuo-Bin Jou, MD; Xinlu Du, MD; Scarlett Hellot, MSc; Carrie McClung, MS
Epilepsy Posters: Unit cost of epilepsy-related health care encounters in the US,12 Simon Borghs, MSc; Silky Beaty, PharmD, MSPH; Witesh Parekh, BPharm(Hons), MSc, MRPharmS; Linda Kalilani, MBBS, MPhil, PhD; Nada Boudiaf, MSc; Andrea Loewendorf, MB
Characterization of an experimental mouse model of epilepsy-associated Focal Cortical Dysplasia: Group housing video-EEG Wireless telemetry recordings,13 Natalia Rodriguez Alvarez, Veronique Marie Andre, Lauren Drowley, Martin Armstrong, Stefanie Dedeurwaerdere
Molecular and translational characterization of the in vitro organotypic hippocampal slice model for epilepsy using a systems genetics approach,14 Isabelle Niespodziany, PhD; Liesbeth François, PhD; Patrice Godard, PhD; Catherine Vandenplas; Marek Rajman, PhD; Jonathan Van Eyll, PhD; Stefanie Dedeurwaerdere, PhD
Padsevonil Poster: Investigation of padsevonil, a new investigational antiepileptic drug candidate, by all-optical electrophysiology (Optopatch) in cultured neuronal networks,15 Christian Wolff, PhD; Isabelle Niespodziany, PhD; John Ferrante, BS; Himali Shroff, MS; Owen McManus, PhD; Luis Williams, PhD; Graham T. Dempsey, PhD
* Padsevonil is an investigational drug candidate for epilepsy currently in clinical development. The safety and efficacy of padsevonil have not been established and it is not approved by any regulatory authority worldwide. About BRIVIACT® (brivaracetam) CV 16 BRIVIACT INDICATION AND SELECT IMPORTANT SAFETY INFORMATION BRIVIACT (brivaracetam) CV is indicated for the treatment of partial-onset seizures in patients 4 years of age and older. As the safety of BRIVIACT injection in pediatric patients has not been established, BRIVIACT injection is indicated for the treatment of partial-onset seizures only in adult patients (16 years of age and older). BRIVIACT is associated with important warnings and precautions including suicidal behavior and ideation, somnolence, fatigue, dizziness, disturbance in gait and coordination, psychiatric adverse reactions including nonpsychotic and psychotic symptoms, and hypersensitivity reactions (bronchospasm and angioedema). BRIVIACT is contraindicated in patients with a prior hypersensitivity reaction to brivaracetam or any of the inactive ingredients. In adult adjunctive therapy placebo-controlled clinical trials, the most common adverse reactions (at least 5% for BRIVIACT and at least 2% more frequently than placebo) were somnolence and sedation, dizziness, fatigue, and nausea and vomiting symptoms. Adverse reactions reported in clinical studies of pediatric patients 4 years to less than 16 years of age were generally similar to those in adult patients. BRIVIACT is a Schedule V controlled substance. Please refer to full Prescribing Information available at www.BRIVIACTHCP.com. About VIMPAT® (lacosamide) CV: 17 VIMPAT INDICATION AND SELECT IMPORTANT SAFETY INFORMATION VIMPAT (lacosamide) CV is indicated for the treatment of partial-onset seizures in patients 4 years of age and older. As the safety of VIMPAT injection in pediatric patients has not been established, VIMPAT injection is indicated for the treatment of partial-onset seizures only in adult patients (17 years of age and older). VIMPAT is associated with important warnings and precautions including suicidal behavior and ideation, dizziness and ataxia, cardiac rhythm and conduction abnormalities, syncope, and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), also known as multi-organ hypersensitivity. In the adult monotherapy clinical trial, adverse reactions were generally similar to those observed and attributed to drug in adjunctive placebo-controlled trials, with the exception of insomnia (observed at a higher rate of ≥2%). In the adult adjunctive placebo-controlled trials, the most common adverse reactions (≥10% and greater than placebo) were dizziness, headache, nausea, and diplopia. Pediatric adverse reactions were similar to those seen in adult patients. VIMPAT is a Schedule V controlled substance. Please refer to full Prescribing Information available at www.VIMPATHCP.com. About NAYZILAM® (midazolam) nasal spray CIV 1 NAYZILAM®, the first and only nasal spray for the acute treatment of seizure clusters in epilepsy patients 12 years and older, was approved by the U.S. FDA in May 2019. NAYZILAM INDICATION AND SELECT IMPORTANT SAFETY INFORMATION NAYZILAM® (midazolam) nasal spray CIV is a benzodiazepine indicated for the acute treatment of intermittent, stereotypic episodes of frequent seizure activity (i.e., seizure clusters, acute repetitive seizures) that are distinct from a patient's usual seizure pattern in patients with epilepsy 12 years of age and older. CONTRAINDICATIONS RISKS FROM CONCOMITANT USE WITH OPIOIDS
RISKS OF CARDIORESPIRATORY ADVERSE REACTIONS Respiratory depression was observed with the administration of NAYZILAM during clinical trials. Cardiac or respiratory arrest caused by NAYZILAM was not reported during clinical trials. CENTRAL NERVOUS SYSTEM DEPRESSION FROM CONCOMITANT USE WITH OTHER CENTRAL NERVOUS SYSTEM DEPRESSANTS, OR MODERATE OR STRONG CYP3A4 INHIBITORS Risks from Concomitant Use with Other CNS Depressants Risks from Concomitant Use with Moderate or Strong CYP3A4 Inhibitors SUICIDAL BEHAVIOR AND IDEATION IMPAIRED COGNITIVE FUNCTION GLAUCOMA ADVERSE REACTIONS NAYZILAM is a Schedule IV controlled substance. Please refer to the full Prescribing Information at www.NAYZILAM.com. For additional medical information about NAYZILAM, patient assistance, or any other information please visit our website or call ucbCARES® at 1-844-599-2273. About Epilepsy About UCB in Epilepsy BRIVIACT®, NAYZILAM®, and ucbCARES® are registered trademarks of the UCB Group of Companies. For further information, UCB:
About UCB Forward looking statements – UCB This press release contains forward-looking statements based on current plans, estimates and beliefs of management. All statements, other than statements of historical fact, are statements that could be deemed forward-looking statements, including estimates of revenues, operating margins, capital expenditures, cash, other financial information, expected legal, political, regulatory or clinical results and other such estimates and results. By their nature, such forward-looking statements are not guarantees of future performance and are subject to risks, uncertainties and assumptions which could cause actual results to differ materially from those that may be implied by such forward-looking statements contained in this press release. Important factors that could result in such differences include: changes in general economic, business and competitive conditions, the inability to obtain necessary regulatory approvals or to obtain them on acceptable terms, costs associated with research and development, changes in the prospects for products in the pipeline or under development by UCB, effects of future judicial decisions or governmental investigations, product liability claims, challenges to patent protection for products or product candidates, changes in laws or regulations, exchange rate fluctuations, changes or uncertainties in tax laws or the administration of such laws and hiring and retention of its employees. UCB is providing this information as of the date of this press release and expressly disclaims any duty to update any information contained in this press release, either to confirm the actual results or to report a change in its expectations. There is no guarantee that new product candidates in the pipeline will progress to product approval or that new indications for existing products will be developed and approved. Products or potential products which are the subject of partnerships, joint ventures or licensing collaborations may be subject to differences between the partners. Also, UCB or others could discover safety, side effects or manufacturing problems with its products after they are marketed. Moreover, sales may be impacted by international and domestic trends toward managed care and health care cost containment and the reimbursement policies imposed by third-party payers as well as legislation affecting biopharmaceutical pricing and reimbursement. References: 1. NAYZILAM® (midazolam) nasal spray CIV. US Prescribing Information. SOURCE UCB, Inc. Related Links |
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