Buprenorphine misuse by injecting drug users was assessed in a survey of 350 needle exchangers, either amphetamine (57%) or heroin users (42%). 89% of heroin users and 24% of amphetamine users reported using buprenorphine at some time during the previous year. Most users reported illicit acquisition. Among illicit users, 87% of heroin users reported intake for withdrawal treatment or self-detoxification, and 11% for euphoria. Euphoria seeking was more common among amphetamine users (62%, p < 0.001). Intravenous misuse was reported by 43% of illicit users, and snorting by 29%. Sole sublingual intake was more common among heroin users than among amphetamine users (46 vs. 20%, p < 0.05), and less common among patients reporting euphoria seeking (20 vs. 46%, p < 0.05).

Nonfatal heroin overdoses and suicide attempts are both common among heroin addicts, but there is limited knowledge about the association between them. The sample in the present study consisted of 149 regular heroin users in Malmö, Sweden. Out of these 98 had taken an unintentional heroin overdose at some time and 51 had made at least one attempt to commit suicide (but not using heroin). Suicide attempts were significantly more common among those who had taken unintentional overdoses as compared with those who had never taken any overdose (p < 0.01). The more overdoses, the greater the risk of suicide attempt.

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The present study aimed to examine whether retention in inpatient opiate detoxification was affected by the introduction of buprenorphine as a standard medication in opiate withdrawal, compared to older substances, when controlling for previous dropouts from detoxification, age, gender and current aftercare treatment planning. This chart review with a naturalistic design studied all inpatient opiate detoxifications in a detoxification unit during five years. In total, 375 patients with a total of 639 detoxification episodes were studied, with the withdrawal medication prescribed being buprenorphine, clonidine, dextropropoxyphene or methadone. In logistic regression, using buprenorphine as reference, completion of detoxification was unrelated to the choice of medication, but associated with the presence of an aftercare plan upon admission, older age and a lower number of previous dropouts. However, dropouts remained significantly longer until dropout with buprenorphine, compared to clonidine and dextropropoxyphene. While the longer time to dropout suggests a higher effectiveness in withdrawal treatment with buprenorphine, no overall effect was seen on actual dropout rates. Lack of an aftercare plan and previous dropouts may be risk factors of dropout in opiate detoxification.