Opioid users' willingness to receive prolonged-release buprenorphine depot injections for opioid use disorder

Abstract

A B S T R A C TAims: Prolonged-release implantable and depot injection formulations of buprenorphine are very recent developments in the treatment of opioid use disorder. Such formulations remove the need for daily dosing and provide patients with sustained concentrations of buprenorphine over a period of weeks or months. We explored opioid users' personal willingness to receive prolonged-release buprenorphine depot injections and factors influencing their interest. Methods: The study took place in London during 2018, before depot buprenorphine was licensed for use in Europe. Thirty-six face-to-face, semi-structured qualitative interviews were conducted with people who were: i) using heroin daily and not receiving any treatment for opioid use (n = 12); or ii) prescribed daily oral buprenorphine (n = 12); or iii) prescribed daily oral methadone (n = 12). Participants were asked about their willingness to receive depot buprenorphine and were encouraged to discuss factors that might alter their opinions. Interview data were analysed following the stages of Iterative Categorization. Findings: Participants expressed a high level of willingness to receive depot buprenorphine. Their views were influenced both positively and negatively by six key features of depot buprenorphine: i) reduced contact with pharmacies and drug treatment services; ii) impact on illicit drug use and recovery; iii) the perceived effectiveness of depot buprenorphine; iv) the duration and dosage of depot buprenorphine injections; v) clinical administration of the depot buprenorphine injection; and vi) potential for side effects associated with the depot buprenorphine injection. Conclusions: Willingness to receive a given medication is complex, individual and changeable. Opioid users seem likely to welcome greater choice and flexibility in respect of opioid agonist medications and appear more likely to accept and adhere to depot buprenorphine if it enables them to reduce their illicit drug use and facilitates their recovery. Research is now needed to assess whether patients' reported willingness to receive depot buprenorphine translates into actual uptake and adherence. (Clinical Guidelines on Drug Misuse and Dependence (Update), 2017).

<p>Depot Buprenorphine Injection In The Management Of Opioid Use Disorder: From Development To Implementation</p>

“…Early survey-based research on patients’ perspectives on depot formulations had been favorable with high ratings on topics such as the ability for depot medications to make life easier, avoid stigma, and free-up time for other activities 25. Yet, a series of in-depth qualitative studies have raised concerns 12,13,26,27. These include issues with a surgical procedure, the invariability of the daily dose, concerns for infection, and social isolation – due to no longer frequenting the methadone clinic 12,26.…”

Novel Long-Acting Buprenorphine Medications for Opioid Dependence: Current Update

“…There are a few qualitative studies available, indicating some interest of patients in this novel kind of treatment [56][57][58]. Arguments from a patient's perspective for these novel treatment approaches are less contact or time spent with drug-treatment services, as well as "make life easier, avoid stigma" and more time for other activities [58][59][60].…”

Readiness to try extended-released buprenorphine and related factors of interest: comparison between incarcerated and non-incarcerated subjects with opioid use disorder.

“…Both expert opinions and national guidelines have pointed out that XR-BUP formulations could be of particular interest in prisons, in particular for both convenience and e cacy reasons [4,16]. However, because the concept of XR-BUP has raised concerns in some opioid users, with respect to a possible limitation of freedom and coercive treatment [6,7], it was thus particularly important to address whether incarcerated people with OUD were ready to try XR-BUP, or, by contrast, reluctant to receive it.…”

“…Surveys among people using opioids or treatment-seeking OUD subjects have revealed that these new galenic forms raise some interest for the reasons listed above. However, interviewees also raised some concerns, in particular in terms of coercive treatment and reduction in the ability to stop OAT and resume recreative opioid use, depending on individual preferences and treatment objectives [6][7][8].…”