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Lucemyra for Opioid Withdrawal

05/17/2018

FDA has approved Lucemyra brand of lofexidine, a non-opioid, for treatment of opioid withdrawal ("mitigation of opioid withdrawal symptoms to facilitate abrupt opioid discontinuation in adults"), billing it as another way of addressing the opioid crisis by easing transition to treatment of the disorder. Previous approaches involved either gradually tapering an opioid or prescribing a combination of drugs off-label. After lofexidine detox patients might move on to abstinence-based treatment or to medication assisted treatment with buprenorphine, naltrexone, or even methadone.

Cynics will likely point out that opioid addicts might divert the drug to enable persisting addiction by easing withdrawal when heroin or other opioids become scarce, rather than seeking treatment, perhaps arguing that painful withdrawal might motivate some to seek relief by escaping the vicious cycle of addiction and withdrawal through treatment.

Availability of the drug could impact black market economics. A user who could not afford another dose of heroin might turn to cheaper lofexidine. This could drive down the price of heroin. If true, this could also reduce crimes committed to obtain money for drugs.

Physicians who prescribe the drug "inappropriately" might not face penalties as harsh as those usually associated with "excessive" prescribing of controlled substances.

Since FDA rushed the drug to approval with only limited studies we do not yet know the full extent of adverse effects or patient acceptance.

In my opinion there is no justification for requiring a prescription for this drug. Others will argue that patients suffering from opioid addiction require a thorough medical evaluation. Regardless, I hope this new drug in the armamentarium will help many.