Illicit use of buprenorphinealoxone among injecting and noninjecting opioid users.

摘要

OBJECTIVES: We examined the use, procurement, and motivations for the use of diverted buprenorphinealoxone 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 buprenorphinealoxone illicitly, with 41% having done so in the previous month. More injection drug users (IDUs) than non-IDUs reported the use of diverted buprenorphinealoxone (86% vs 65%, P = 0.01). The majority of participants who had used buprenorphinealoxone 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 buprenorphinealoxone for these reasons. Significantly more non-IDUs than IDUs reported ever using buprenorphinealoxone 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 buprenorphinealoxone than in methadone. Common reasons given for not being currently enrolled in a buprenorphinealoxone program included cost and unavailability of prescribing physicians. CONCLUSIONS: The use of diverted buprenorphinealoxone was common in our sample. However, many opioid users, particularly IDUs, were using diverted buprenorphinealoxone 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 buprenorphinealoxone diversion and improve the accessibility of buprenorphinealoxone through licensed treatment providers.