Department of Psychiatry, University of Kentucky College of Medicine, Lexington, KY, United States.
Drug Alcohol Depend. 2012 Dec 1;126(3):379-83. doi: 10.1016/j.drugalcdep.2012.05.025. Epub 2012 Jun 15.
As buprenorphine prescribing has increased in the United States so have reports of its diversion. The study purpose was to examine frequency and source of and risk factors for diverted buprenorphine use over a 6-month period in an Appalachian community sample of prescription opioid abusers.
There were 503 participants at baseline; 471 completed the 6-month follow-up assessment. Psychiatric disorders and demographic, drug use, and social network characteristics were ascertained at baseline and follow-up. Multivariable logistic regression was used to determine the predictors of diverted buprenorphine use over the 6-month period.
Lifetime buprenorphine use "to get high" was 70.1%. Nearly half (46.5%) used diverted buprenorphine over the 6-month follow-up period; among these persons, 9.6% and 50.6% were daily and sporadic (1-2 uses over the 6-months) users, respectively. The most common sources were dealers (58.7%) and friends (31.6%). Predictors of increased risk of use of diverted buprenorphine during the 6-month follow-up included inability to access buprenorphine treatment (AOR: 7.31, 95% CI: 2.07, 25.8), meeting criteria for generalized anxiety disorder, and past 30 day use of OxyContin, methamphetamine and/or alcohol.
These results suggest that improving, rather than limiting, access to good quality affordable buprenorphine treatment may be an effective public health strategy to mitigate buprenorphine abuse. Future work should evaluate why more persons did not attempt to access treatment, determine how motivations change over time, and how different motivations affect diversion of the different buprenorphine formulations.
随着美国丁丙诺啡处方量的增加，其被滥用和转移的报告也越来越多。本研究的目的是在阿巴拉契亚地区社区样本中，检测在过去 6 个月中，处方类阿片类药物滥用者丁丙诺啡被滥用和转移的频率、来源和风险因素。
在基线时有 503 名参与者；其中 471 名完成了 6 个月的随访评估。在基线和随访时确定了精神疾病和人口统计学、药物使用和社会网络特征。多变量逻辑回归用于确定 6 个月期间丁丙诺啡被滥用和转移的预测因素。
一生中“为了兴奋”而使用丁丙诺啡的比例为 70.1%。近一半（46.5%）的人在 6 个月的随访期间使用了被转移的丁丙诺啡；其中，9.6%和 50.6%分别为每日和偶尔使用者（6 个月内使用 1-2 次）。最常见的来源是经销商（58.7%）和朋友（31.6%）。在 6 个月的随访期间，增加使用被转移的丁丙诺啡的风险因素包括无法获得丁丙诺啡治疗（AOR：7.31，95%CI：2.07，25.8）、符合广泛性焦虑障碍标准以及过去 30 天内使用过奥施康定、冰毒和/或酒精。
这些结果表明，改善而不是限制高质量负担得起的丁丙诺啡治疗的获取，可能是减轻丁丙诺啡滥用的有效公共卫生策略。未来的工作应评估为什么更多的人没有尝试获得治疗，确定动机如何随时间变化，以及不同的动机如何影响不同丁丙诺啡制剂的转移。
