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

Abstract

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.

Self-treatment: Illicit buprenorphine use by opioid-dependent treatment seekers

“…1 Two recent qualitative, ethnographic studies from interviews with people who abused opioids in Baltimore and New England suggest that avoidance of withdrawal symptoms is the primary reason for use of diverted buprenorphine (Mitchell et al, 2009;Monte, Mandell, Wilford, Tennyson, & Boyer, 2009). We are aware of no U.S. research that has used quantitative methods to systematically examine the reasons for use of illicit buprenorphine in treatment-seeking opioiddependent patients or the effects of OBOT treatment on illicit buprenorphine use behavior.…”

Prescription opioid abuse in prison settings: A systematic review of prevalence, practice and treatment responses

“…In community populations, self-report estimates range from 16 to 60% (Davis and Johnson, 2008;Gwin Mitchell et al, 2009;Winstock et al, 2008). Almost 20% of individuals inject opioid maintenance medication that is prescribed for either oral, or sublingual, consumption (Winstock et al, 2008).…”

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

“…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).…”