Kenney Shannon R, Anderson Bradley J, Bailey Genie L, Stein Michael D
Behavioral Medicine Department, Butler Hospital, Providence, RI 02906, United States; Warren Alpert Medical School of Brown University, Providence, RI 02912, United States.
Behavioral Medicine Department, Butler Hospital, Providence, RI 02906, United States.
J Subst Abuse Treat. 2017 Jul;78:43-47. doi: 10.1016/j.jsat.2017.04.017. Epub 2017 Apr 27.
Buprenorphine medication-assisted treatment (B-MAT) is an efficacious and popular outpatient treatment for opioid use disorder. However, the likelihood of buprenorphine diversion is a public health concern. We examined the relationship between attitudes toward diversion as predictors of both sharing and selling buprenorphine.
Participants (n=476) were patients undergoing short-term inpatient opioid detoxification. Multinomial logistic regression was used to estimate the adjusted association of sharing and selling buprenorphine with demographics, substance use behaviors, and attitudes toward sharing and selling buprenorphine.
Among the two hundred persons who had ever been prescribed buprenorphine (73.4% male, 89% heroin users), 50.5% reported they had shared buprenorphine and 28.0% reported they had sold buprenorphine. Controlling for other covariates, the odds of sharing buprenorphine were 3.17 (95% CI 1.21; 8.32) times higher for persons who agreed that it was "right to share buprenorphine with dope sick friends" than for those who did not agree with this attitude. Attitudes toward selling (OR 2.92; 95% CI 1.35; 6.21) and sharing (OR 4.12; 95% CI 1.64; 10.32) buprenorphine were the only significant correlates of selling, with the odds of selling exponentially greater among persons with favorable attitudes toward sharing or selling buprenorphine.
Although considered diversion, sharing B-MAT is normative among B-MAT patients. Assessing B-MAT patients' attitudes about diversion may help identify patients requiring enhanced oversight, education, or intervention aimed at modifying attitudes to reduce their likelihood to share or sell buprenorphine.
丁丙诺啡药物辅助治疗（B-MAT）是一种治疗阿片类物质使用障碍的有效且常用的门诊治疗方法。然而，丁丙诺啡被挪用的可能性是一个公共卫生问题。我们研究了对挪用的态度作为丁丙诺啡分享和销售预测因素之间的关系。
参与者（n = 476）为正在接受短期住院阿片类物质脱毒治疗的患者。采用多项逻辑回归来估计丁丙诺啡分享和销售与人口统计学、物质使用行为以及对丁丙诺啡分享和销售的态度之间的校正关联。
在曾经接受过丁丙诺啡处方的200人中（73.4%为男性，89%为海洛因使用者），50.5%的人报告他们曾分享过丁丙诺啡，28.0%的人报告他们曾出售过丁丙诺啡。在控制其他协变量后，同意“与毒瘾朋友分享丁丙诺啡是正确的”的人分享丁丙诺啡的几率比不同意这种态度的人高3.17倍（95%置信区间1.21；8.32）。对丁丙诺啡销售（比值比2.92；95%置信区间1.35；6.21）和分享（比值比4.12；95%置信区间1.64；10.32）的态度是销售的唯一显著相关因素，对丁丙诺啡分享或销售持赞成态度的人销售的几率成倍增加。
尽管分享B-MAT被视为挪用，但在B-MAT患者中分享是常见的。评估B-MAT患者对挪用的态度可能有助于识别需要加强监督、教育或干预以改变态度从而降低其分享或销售丁丙诺啡可能性的患者。
