Illicit Use of Buprenorphine/Naloxone Among Injecting and Noninjecting Opioid Users

Abstract

Objectives We examined the use, procurement, and motivations for the use of diverted buprenorphine/naloxone among injecting and noninjecting opioid users in an urban area. Methods A survey was self-administered among 51 injecting opioid users and 49 noninjecting opioid users in Providence, RI. Participants were recruited from a fixed-site syringe exchange program and a community outreach site between August and November 2009. Results A majority (76%) of participants reported having obtained buprenorphine/naloxone illicitly, with 41% having done so in the previous month. More injection drug users (IDUs) than non-IDUs reported the use of diverted buprenorphine/naloxone (86% vs 65%, P = 0.01). The majority of participants who had used buprenorphine/naloxone reported doing so to treat opioid withdrawal symptoms (74%) or to stop using other opioids (66%) or because they could not afford drug treatment (64%). More IDUs than non-IDUs reported using diverted buprenorphine/naloxone for these reasons. Significantly more non-IDUs than IDUs reported ever using buprenorphine/naloxone to “get high” (69% vs 32%, P < 0.01). The majority of respondents, both IDUs and non-IDUs, were interested in receiving treatment for opioid dependence, with greater reported interest in buprenorphine/naloxone than in methadone. Common reasons given for not being currently enrolled in a buprenorphine/naloxone program included cost and unavailability of prescribing physicians. Conclusions The use of diverted buprenorphine/naloxone was common in our sample. However, many opioid users, particularly IDUs, were using diverted buprenorphine/naloxone for reasons consistent with its therapeutic purpose, such as alleviating opioid withdrawal symptoms and reducing the use of other opioids. These findings highlight the need to explore the full impact of buprenorphine/naloxone diversion and improve the accessibility of buprenorphine/naloxone through licensed treatment providers.

Comparative prices of diverted buprenorphine/naloxone and buprenorphine in a UK prison setting: A cross-sectional survey of drug using prisoners

“…The development and implementation of new products to offer treatment for opioid dependence while minimising risks of patient noncompliance and illicit diversion have been used (White et al, 2009). Early phase I trial evidence would suggest extremely positive results, claiming it holds withdrawal symptoms and controls craving with no reported safety issues (Bazazi et al, 2011). A phase II trial of a buprenorphine depot monthly injection is also currently ongoing (Reckitt Benckiser Pharmaceuticals, Inc., 2014).…”

Illicit use of opioid substitution drugs: Prevalence, user characteristics, and the association with non-fatal overdoses

“…Previous research has reported a wide range of estimates for illicit OSD use among IDUs. Estimates of illicit buprenorphine use range from 9% to 41% in US samples (Bazazi et al, 2011;Genberg et al, 2013), to 73% reported in a Finnish sample (where buprenorphine is the most commonly used illegal opiate) (Alho et al, 2007). In terms of illicit methadone use, a US-based study reported a 16% rate of street methadone use over the last six months (Mitchell et al, 2009), while an Australian study reported a decline in recent methadone injecting from 31% to 13% during the relatively short time period (1997)(1998)(1999)(2000) (Darke et al, 2002).…”

Opioid-Abusing Health Care Professionals: Options for Treatment and Returning to Work After Treatment

“…It is commonly diverted to relieve opioid withdrawal symptoms and to reduce the use of other opioids. 7 Patients report using it when they are out of money or opioids. Buprenorphine can be used in doses higher than the daily maintenance dose to provide intermittent euphoria and intoxication.…”