Illicit Methadone Use and Abuse in Young People Accessing Treatment for Opiate Dependence

Roche, Aoife M.; McCabe, Sara; Smyth, Bobby P

doi:10.1159/000149631

Cited by 36 publications

(38 citation statements)

References 57 publications

(39 reference statements)

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“…With respect to the use of diverted methadone, these findings are consistent with previous research (16,30,41,42) and seem to indicate that the sources (e.g., legitimate MTP patients) and reasons for using diverted methadone (e.g., self-medication) have remained relatively stable over the past 20 years. (14,15,43) Spunt and colleagues identified an out-oftreatment subgroup of illicit methadone users that consisted of younger individuals who used little heroin but purchased diverted methadone for its euphoric effects.…”

Section: Discussionsupporting

confidence: 89%

Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

et al. 2009

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This study examined the uses of diverted methadone and buprenorphine among opiate-addicted individuals recruited from new admissions to methadone programs and from out-of-treatment individuals recruited from the streets. Self-report data regarding diversion were obtained from surveys and semi-structured qualitative interviews. Approximately 16% (n=84) of the total sample (N=515) reported using diverted (street) methadone 2-3 times per week for six months or more, and for an average of 7.8 days (SD=10.3) within the past month. The group reporting lifetime use of diverted methadone as compared to the group that did not report such use was less likely to use heroin and cocaine in the 30 days prior to admission (ps < .01) and had lower ASI Drug Composite scores (p < .05). Participants in our qualitative sub-sample (n=22) indicated that street methadone was more widely used than street buprenorphine and that both drugs were largely used as self-medication for detoxification and withdrawal symptoms. Participants reported using low dosages and no injection of either medication was reported.

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Section: Discussionsupporting

confidence: 89%

Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

et al. 2009

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“…Lifetime prevalence of illicit methadone use among intravenous drug users outside treatment has varied between 17% and 95% in different studies, but high prevalence is the rule rather than the exception. [12][13][14][15] Illicit buprenorphine use is prevalent, as well, [16][17] and in some countries this substance has become the most common opioid on the illicit market. [17][18][19] Methadone and buprenorphine typically enter a user's drug career at a late stage, and they are rare among younger people, unless they have already developed severe drug problems.…”

Section: Introductionmentioning

confidence: 99%

“…Very often these users are not in treatment, and employ them to avoid withdrawal symptoms, or as a means of performing self-detoxification, or managing substitution treatment on their own. 14,16,[20][21][22][23][24] However, among them are also OST patients dissatisfied with their prescribed doses. 24,25 In addition, the substances are used for euphoria-inducing purposes, typically as part of a polydrug use.…”

Section: Introductionmentioning

confidence: 99%

Diversion of Methadone and Buprenorphine from Opioid Substitution Treatment: A Staff Perspective

Johnson

Richert

2014

Journal of Psychoactive Drugs

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BackgroundDiversion-patients who sell or share their medication-is a hotly debated but relatively unresearched phenomenon. We have investigated the prevalence of self-reported diversion of methadone and buprenorphine at OST programs in Sweden. We have also examined if demographic, treatment, and social factors can be associated with an increased risk of diversion. MethodsStructured interviews were conducted with 411 patients from eleven OST programs. A standardized questionnaire with 106 close-and five open-ended questions were used. 280 interviews were done on site, by the researchers, while 131 interviews were conducted by specially trained patients through privileged access interviewing. The data were analyzed through frequency-and averages-calculations, cross-tabulations, and logistic regression analysis. ResultsIn total, 24.1% (n=99) of the patients reported diversion in the past month. 67.6% (n=277) stated that they had diverted at some point. The peer interviews showed significantly higher levels of diversion (37.4% past month) compared with the researcher interviews (17.2%).Neither demographic factors, dosages, nor collection routines were associated with diversion.The likelihood of diversion was higher for patients on mono-buprenorphine (OR=5.64) and buprenorphine-naloxone (OR=2.10), than among methadone patients. Other factors which increased the likelihood of diversion were current illicit drug use (OR=5.60), having had 3 patients as a primary source of illicit methadone or buprenorphine prior to treatment (OR=3.39), and mainly socializing with active drug users (OR=2.12). ConclusionSelf-reported diversion was considerably higher than in previous studies. This is most likely due to the new methodological strategy we used, but may also partly be explained by low availability of OST in Sweden, leading to a high demand for the substances by heroin users outside treatment. Efforts to decrease diversion should primarily focus on psychosocial and lifestyle-changing interventions, and expanded access to treatment, rather than on control measures.

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“…The authors stated that both drugs have high rates of misuse, including doctor shopping, i.e. seeing multiple treatment providers to procure prescription medications illicitly; illicit intravenous application; snorting; and buying or selling on the black market [107][108][109][110].…”

Section: European Studiesmentioning

confidence: 99%

Buprenorphine Use and Risk of Abuse and Diversion

Soyka¹

2014

Adv Pharmacoepidem Drug Safety

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Buprenorphine in Opioid Maintenance Treatment: A Brief UpdateBuprenorphine is an established first-line medication for the treatment of opioid dependence (see APA guidelines [24] AbstractOpioid maintenance therapy with methadone or buprenorphine is a well-established first-line treatment for opioid dependence. However, risk of diversion and drug-related mortality are critical issues during maintenance therapy. These issues are discussed controversially in both the scientific and public arenas and are a matter of concern also among medical authorities. In addition to a formulation containing buprenorphine alone, a combination formulation with buprenorphine and naloxone in a 4:1 ratio is available. The combination formulation was developed with the aim to prevent intravenous use or diversion. This critical review summarizes data on the risk of abuse and diversion of buprenorphine.

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Illicit Methadone Use and Abuse in Young People Accessing Treatment for Opiate Dependence

Cited by 36 publications

References 57 publications

Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

Diversion of Methadone and Buprenorphine from Opioid Substitution Treatment: A Staff Perspective

Buprenorphine Use and Risk of Abuse and Diversion

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