Use of Illegally Acquired Medical Opioids by Opiate-Dependent Patients in Detoxification Treatment

Abstract

Take-home dosages in maintenance treatment are of great therapeutic importance, but they include the risk of the substitute being distributed illegally. We reviewed the extent of consumption of illegally acquired medical opiates by 142 opiate- or poly-addicted patients consecutively admitted to a detoxification ward. 76 (53.5%) of them admitted to taking illegally acquired medical opiates, usually methadone, at least once. The cumulative duration was 30 days (median). Motivation was usually due to difficulties in acquiring heroin, however one third reported use in an attempt at self-detoxification or as transition before entering maintenance treatment. Maintenance patients were usually the source of the opiates. The results prove the necessity of stringent conditions for take-home dosages, and illustrate deficits in the health care system.

Opioid pharmacotherapy: Treatment, regimes, constructions and control

“…Along with previous findings (Scherbaum et al, 2005), financial aspects seemed to be important, at least among participants currently not in OST. Among OST patients, insufficient dosage and problems to comply with treatment regulations were the main reasons for NPU, which may point to a mismatch between patient expectations and the mode of OST delivery (Schulte, Gansefort, Stöver, & Reimer, 2009).…”

“…the lower prices of substitution medication compared to heroin (EMCDDA, 2005;Scherbaum, Kluwig, Meiering, & Gastpar, 2005).…”

“…Concerning the extent of NPU, three German studies are currently available. One survey with 142 patients in a detoxification facility found a lifetime prevalence of 53.5% (Scherbaum et al, 2005). One study using long-term monitoring data from drug counselling centres reported an increasing portion of methadone/buprenorphine among currently misused medication from 6.9% in 2003to 20.7% in 2006(Rösner & Küfner, 2007.…”

Buprenorphine Use and Risk of Abuse and Diversion

“…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].…”

“…German data from patients admitted for detoxification showed that 53.5% misused medical opioids, especially methadone [110], mainly because of difficulty in acquiring heroin.…”