Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615N. Wolfe Street, Baltimore, MD 21205 USA.
Addict Behav. 2013 Dec;38(12):2868-73. doi: 10.1016/j.addbeh.2013.08.008. Epub 2013 Aug 17.
There are few systematic assessments of street-obtained buprenorphine use from community-based samples in the United States. The objective of this study was to characterize the prevalence, correlates, and reasons for street-obtained buprenorphine use among current and former injection drug users (IDUs) in Baltimore, Maryland.
In 2008, participants of the ALIVE (AIDS Linked to the IntraVenous Experience) study, a community-based cohort of IDUs, were administered a survey on buprenorphine. Street-obtained buprenorphine represented self-reported use of buprenorphine obtained from the street or a friend in the prior three months.
Six hundred and two respondents were predominantly male (65%), African-American (91%), and 30% were HIV-positive. Overall, nine percent reported recent street-obtained buprenorphine use, and only 2% reported using to get high. Among active opiate users, 23% reported recent use of street-obtained buprenorphine. Use of buprenorphine prescribed by a physician, injection and non-injection drug use, use of street-obtained methadone and prescription opiates, homelessness, and opioid withdrawal symptoms were positively associated, while methadone treatment, health insurance, outpatient care, and HIV-infection were negatively associated with recent street-obtained buprenorphine use in univariate analysis. After adjustment, active injection and heroin use were positively associated with street-obtained buprenorphine use. Ninety-one percent reported using street-obtained buprenorphine to manage withdrawal symptoms.
While 9% reported recent street-obtained buprenorphine use, only a small minority reported using buprenorphine to get high, with the majority reporting use to manage withdrawal symptoms. There is limited evidence of diversion of buprenorphine in this sample and efforts to expand buprenorphine treatment should continue with further monitoring.
在美国，基于社区样本对街头获得的丁丙诺啡使用情况进行系统评估的研究较少。本研究的目的是描述马里兰州巴尔的摩市目前和以前的注射吸毒者（IDU）中街头获得的丁丙诺啡的使用情况、相关因素和原因。
2008 年，参与 AIDS Linked to the IntraVenous Experience（ALIVE）研究的 IDU 社区队列的参与者接受了丁丙诺啡调查。街头获得的丁丙诺啡代表在过去三个月内从街头或朋友处获得的丁丙诺啡自我报告使用情况。
602 名受访者主要为男性（65%）、非裔美国人（91%），30%为 HIV 阳性。总体而言，9%的人报告最近有街头获得的丁丙诺啡使用情况，只有 2%的人报告使用丁丙诺啡来获得快感。在活跃的阿片类药物使用者中，23%的人报告最近使用了街头获得的丁丙诺啡。医生开具的丁丙诺啡处方、注射和非注射药物使用、街头获得的美沙酮和处方阿片类药物使用、无家可归和阿片类药物戒断症状与最近使用街头获得的丁丙诺啡呈正相关，而美沙酮治疗、医疗保险、门诊治疗和 HIV 感染与最近使用街头获得的丁丙诺啡呈负相关。在调整后，活跃的注射和海洛因使用与街头获得的丁丙诺啡使用呈正相关。91%的人报告使用街头获得的丁丙诺啡来控制戒断症状。
尽管 9%的人报告最近使用了街头获得的丁丙诺啡，但只有少数人报告使用丁丙诺啡来获得快感，大多数人报告使用丁丙诺啡来控制戒断症状。在该样本中，丁丙诺啡的滥用证据有限，应继续扩大丁丙诺啡治疗，并进行进一步监测。
