Some antipsychotic medications are administered at intervals up to a month apart as a depot injection with the drug usually suspended in oil, usually vegetable oil such as sesame seed. I am curious as to why other drugs that are administered orally and slowly release over 12 or 24 hours, such as morphine sulphate contin and hydromorphone in Jurnista , have not been developed into a depot injection or an implant similar to contraceptive implants. I kind of understand the implications with drugs such as the above not being available as an implant because some people would dig the implant out to access more of the drug or sell it. It has long evaded me as to why these drugs have not been made into a depot injection. It would totally eliminate diversion. At a guess, depot injections of strong opioids may be unstable and may come with a high risk of overdose.

Perhaps this topic belongs in another area, I hope I have not violated any rules.

Thank you.

After 4 years of emergency medicine I have treated my fair share of opioid overdoses. The answer to this is simpler than you think. Pain is very subjective and can change from day to day. Some people break their hip and refuse pain relief whilst I’ve had my fair share of teenage girl fainting and crying when I inject them. The same applies to cancer patients for which the slow release morphine is mainly targeted for. You get a lot of freedom with this dosing. If the patient is still in pain you can top it up. As morphine is fairly addictive if the patient gets better and they require a lower dose you can gradually wean them off it. Also when dosing it’s not uncommon to overstep the mark every now and again, this isn’t bad medicine it’s very hard to calculate the patient’s tolerance (there’s a lot of trial and error in medicine). Overdosing will make the patient lethargic and dizzy and in some cases shut off their breathing. The antidote naloxone is effective but shot acting and you have to keep them on an infusion. If you had depot injections of morphine you’ll be keeping patients in hospital on an infusion for a month as opposed to 24 hours. In medicine it’s generally useful to keep the most dangerous and addictive drugs short acting.