The Miriam Hospital, Providence, RI, USA.
J Addict Med. 2011 Sep;5(3):175-80. doi: 10.1097/ADM.0b013e3182034e31.
We examined the use, procurement, and motivations for the use of diverted buprenorphine/naloxone among injecting and noninjecting opioid users in an urban area.
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.
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.
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.
我们研究了在一个城市地区，注射和非注射类阿片类药物使用者中，被转移使用的丁丙诺啡/纳洛酮的使用、采购和使用动机。
在罗德岛州普罗维登斯，51 名注射类阿片类药物使用者和 49 名非注射类阿片类药物使用者中进行了一项调查。参与者是 2009 年 8 月至 11 月间从一个固定地点的注射器交换计划和一个社区外展点招募的。
大多数（76%）参与者报告说他们非法获得了丁丙诺啡/纳洛酮，其中 41%是在过去一个月中获得的。与非注射类阿片类药物使用者相比，更多的注射类药物使用者（IDU）报告使用了被转移的丁丙诺啡/纳洛酮（86%比 65%，P=0.01）。大多数使用过丁丙诺啡/纳洛酮的参与者报告说，他们这样做是为了治疗阿片类药物戒断症状（74%）或停止使用其他阿片类药物（66%），或者因为他们负担不起药物治疗（64%）。与非注射类阿片类药物使用者相比，更多的 IDU 报告说他们出于这些原因使用了被转移的丁丙诺啡/纳洛酮。与 IDU 相比，显著更多的非 IDU 报告说他们曾经使用过被转移的丁丙诺啡/纳洛酮来“兴奋”（69%比 32%，P<0.01）。大多数受访者，包括 IDU 和非 IDU，都对接受阿片类药物依赖治疗感兴趣，对丁丙诺啡/纳洛酮的治疗兴趣大于对美沙酮的治疗兴趣。目前没有参加丁丙诺啡/纳洛酮治疗项目的常见原因包括费用和缺乏开处方医生。
在我们的样本中，被转移使用的丁丙诺啡/纳洛酮的使用非常普遍。然而，许多阿片类药物使用者，特别是 IDU，使用被转移的丁丙诺啡/纳洛酮是出于其治疗目的，如缓解阿片类药物戒断症状和减少其他阿片类药物的使用。这些发现强调了需要探索丁丙诺啡/纳洛酮转移的全部影响，并通过持牌治疗提供者改善丁丙诺啡/纳洛酮的可及性。
