Prevention Point Philadelphia reports more interest in long-acting monthly injectable medication for opioid use disorder

From Philly and the Pa. suburbs to South Jersey and Delaware, what would you like WHYY News to cover? Let us know!

Prevention Point Philadelphia’s drop-in center on Kensington Avenue used to be a place where Kali Lamb went to rest, clean up or get a bite to eat while she was homeless and injecting drugs. But on a recent Tuesday morning, Lamb sat comfortably in a soft hoodie and sipped on a cup of coffee, a backpack at her feet. She checked the time to make sure she was on schedule for work in Center City.

Lamb, 37, has found purpose and passion in her new career as a paralegal. She helps people get their criminal records expunged. As a former convict from charges related to active addiction, Lamb said she can relate to people trying to recover their lives.

“From the moment that you lose control of your own life, every person out there wants a solution,” she said. “It’s just finding a solution that you can make work in your life.”

For Lamb, finding recovery in addiction involved taking Sublocade, a type of buprenorphine medication for opioid use disorder. Unlike other medications that have to be taken orally on a daily basis, Sublocade is a once-a-month injection.

“Like, okay, for the next month, this is going to be in my system and I have to think about it once and it’s done,” Lamb said.

At Prevention Point Philadelphia, officials report that interest in long-acting medications for opioid use disorder is growing significantly. The organization administered 312 Sublocade injections in fiscal year 2023 and double the number in fiscal year 2024.

Providers hope that raising awareness about this option will make addiction treatment accessible to even more people.

“When you don’t have to worry about taking something two or three times a day, especially if you’re unsheltered and have trauma and a number of other factors affecting your ability to take medication, the Sublocade is an amazing option,” said Silvana Mazzella, lead executive officer at Prevention Point.

Research shows that medication assisted treatment is highly effective in helping people enter or maintain addiction recovery.

Methadone and buprenorphine are medications that can reduce cravings and withdrawal symptoms for people transitioning from high levels of street opioids like fentanyl, heroin or pills. But most treatments must be taken on a regimented daily schedule.

Lamb said that might not be feasible for a lot of people who can’t access daily medication in a reliable fashion, especially if they’re unhoused or if they’re at risk of getting detained. But a medication that lasts for a month like Sublocade could provide some reassurance, she said.

“If you are at risk of being arrested on a daily basis, it’s nicer to know that you have this in your system where you don’t have to worry about not getting dosed for a week,” Lamb said.

Sublocade got approval from the U.S. Food and Drug Administration in 2017. While it’s been around for several years, Prevention Point clinic Dr. Serge-Emile Simpson said there have been challenges to prescribing it in the past.

It has a higher price tag compared to some other medications for opioid use disorder, so getting insurance to cover it was a problem. There was also special training required for providers who wished to administer the drug, Simpson said, and maintaining a local supply of the drug often came with other delays.

Now, more insurance plans cover Sublocade, and Prevention Point has a standing order with a local pharmacy to make sure the medication is readily available.

But there was still another hurdle to overcome, Simpson said. Providers noticed that some people in Kensington sell portions of their Suboxone prescriptions, a daily oral buprenorphine medication that comes in dissolvable strips, out on the street.

The people selling the medication would then use the money to buy food, clothes, bus tickets or even street drugs, while people buying the Suboxone would use it to manage withdrawal symptoms between injections or hits, or to supplement their own Suboxone treatment if they felt like their dosing wasn’t high enough to feel well, Simpson said.

“We could not get people interested in Sublocade because it would have bitten into their cash flow if they were selling some or all of their Suboxone,” he said. “That’s a significant sort of impediment to getting them started.”

Prevention Point added an incentive program to its Sublocade treatment, where patients get $100 in gift cards for their initial monthly shot and then $25 every time they come back to continue their monthly treatment.

Simpson said while it may seem controversial, the model has been successful in keeping people in treatment and recovery, reducing their use of street drugs and supporting them with a way to buy food and other daily items.

“I think it’s my job as a physician to give them all the tools,” Simpson said. “They need to survive and be safe, and so if that is money and the Sublocade together, then that’s what I’ll do.”

Prevention Point still offers Suboxone and other kinds of medications for opioid use disorder. Mazzella said providers are not pushing people to switch from one treatment to another, but Sublocade is just another option that might work better for some people and their lifestyles.

That was the case for Lamb, who took Sublocade for nearly two years before weaning herself off medication altogether as she continues to maintain recovery in addiction.

“There is no one way to do sobriety right,” she said. “As long as you are positively changing your life and you wake up feeling better about yourself than you did the day before, then you’re doing it right. And that’s what this gave me.”