Name of the Procedure:

Buprenorphine Implant

Common name(s): Buprenorphine Implant Technical/medical term: Buprenorphine Implant, 74.2 mg (HCPCS Code: J0570)

Summary

The buprenorphine implant is a medical procedure where small rods containing the medication buprenorphine are implanted under the skin. Buprenorphine is a medication used to treat opioid dependence by reducing withdrawal symptoms and cravings.

Purpose

Medical Conditions:

• Opioid dependence or addiction

Goals/Expected Outcomes:

• To provide a continuous, low-level release of buprenorphine to help manage opioid withdrawal symptoms and reduce cravings.
• To support patients in maintaining long-term abstinence from opioids.

Indications

Specific Symptoms/Conditions:

• Patients diagnosed with opioid dependence who have already achieved and maintained stability on a low-to-moderate dose of a transmucosal buprenorphine-containing product.

  Patient Criteria:

• Individuals who have been on a stable, low-to-moderate dose of oral buprenorphine for an extended period.
• Patients committed to long-term treatment and follow-up.

Preparation

Pre-Procedure Instructions:

• Patients should discuss current medications with their healthcare provider.
• Any necessary blood tests or health assessments should be completed prior to the procedure.
• No specific fasting is typically required.

Diagnostic Tests/Assessments:

• Baseline health assessment, including liver function tests.

Procedure Description

1. Anesthesia: A local anesthetic is applied to the site where the implant will be placed.
2. Incision: A small incision is made in the upper arm.
3. Implantation: The buprenorphine-containing rods are inserted just under the skin.
4. Closure: The incision is closed with sutures or surgical adhesive, and a sterile dressing is applied.

Tools/Equipment:

• Local anesthetic
• Scalpel or similar surgical instrument
• Buprenorphine implant rods
• Sutures or surgical adhesive

Anesthesia:

• Local anesthesia is used to numb the insertion site.

Duration

• The procedure typically takes about 15 to 30 minutes.

Setting

• The procedure is usually performed in an outpatient clinic or specialized treatment center.

Personnel

• Experienced healthcare professional, typically a physician or a nurse practitioner.
• Support staff such as a nurse.

Risks and Complications

Common Risks:

• Pain or discomfort at the implant site
• Bruising or swelling
• Infection

Rare Risks:

• Allergic reactions to the implant
• Migration of the implant
• Nerve or blood vessel damage

Possible Complications:

• Infections are managed with antibiotics.
• Discomfort is managed with pain relief medications.

Benefits

• Continuous, long-term delivery of medication without the need for daily dosing.
• Reduction in cravings and withdrawal symptoms.
• Stabilization, enabling better focus on recovery and other life skills.

Recovery

Post-Procedure Care:

• Keep the implant site clean and dry.
• Avoid strenuous activity for a few days.

Expected Recovery Time:

• Most patients can return to daily activities within a day.
• Follow-up appointments are necessary to monitor the condition of the implant and overall health.

Alternatives

Other Treatment Options:

• Daily oral buprenorphine tablets or films
• Methadone treatment
• Naltrexone injections

Pros and Cons:

• Oral buprenorphine has the downside of daily dosing but offers flexibility in dosing adjustments.
• Methadone requires daily visits to a clinic but can be effective for those needing intensive supervision.
• Naltrexone injections are another long-acting option but are not suitable for all patients.

Patient Experience

During the Procedure:

• Patients might feel discomfort or pressure during the implant insertion, despite the local anesthesia.

After the Procedure:

• Mild soreness at the implant site.
• Pain management includes over-the-counter pain relievers, as needed.
• Most experience manageable discomfort, quickly resolving within a few days.