Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, 3171 Research Blvd, Kettering, OH, USA.
College of Health Solutions, Arizona State University, 425 N 5(th)Street, Arizona Biomedical Collaborative 121, Phoenix, AZ, 85004, USA.
Drug Alcohol Depend. 2020 May 1;210:107958. doi: 10.1016/j.drugalcdep.2020.107958. Epub 2020 Mar 16.
The opioid overdose crisis in the United States has prompted an expansion of treatment services, including pharmacotherapy with buprenorphine. However, many people who use illicit opioids (PWUIO) self-treat their opioid-use disorder (OUD) with non-prescribed buprenorphine (NPB) in lieu of attending formal treatment. The present study aims to qualitatively understand motivations of people who are self-treating their OUD with NPB.
Qualitative study designed to supplement and contextualize quantitative findings from natural history study of buprenorphine diversion, self-treatment, and use of substance use disorder treatment services. Interviews were audio-recorded, transcribed, systematically coded and analyzed via Iterative Categorization.
The Dayton, Ohio metropolitan area in the midwestern United States; a site previously characterized as high impact in the national opioid overdose crisis.
Sixty-five individuals (35 men and 30 women) who met the DSM-5 criteria for OUD (moderate or severe) and had used NPB at least one time in the six months prior to their intake interview.
Participants described four key motivators for self-treating with NPB: perceived demands of formal treatment, the desire to utilize non-prescribed buprenorphine in combination with a geographic relocation, to self-initiate treatment while preparing for formal services, and to bolster a sense of self-determination and agency in their recovery trajectory.
Use of NPB is a recognized self-treatment modality among PWUIO, with some PWUIO transitioning into sustained recovery episodes or enrollment in formal treatment. Understanding the motivations for opting out of treatment is crucial for improving forms of care for people with OUD.
美国阿片类药物过量危机促使治疗服务扩大，包括丁丙诺啡的药物治疗。然而，许多使用非法阿片类药物的人（PWUIO）自行用未经处方的丁丙诺啡（NPB）治疗他们的阿片类药物使用障碍（OUD），而不是参加正式治疗。本研究旨在定性了解用 NPB 自行治疗 OUD 的人的动机。
定性研究旨在补充和说明丁丙诺啡转移、自我治疗和使用物质使用障碍治疗服务的自然史研究的定量发现。访谈进行了录音、转录、系统编码和迭代分类分析。
美国中西部代顿俄亥俄大都市区；该地点以前被认为是全国阿片类药物过量危机中的高影响地点。
65 名符合 DSM-5 阿片类药物使用障碍（中度或重度）标准的个体（35 名男性和 30 名女性），他们在入组访谈前的六个月内至少有一次使用 NPB。
参与者描述了用 NPB 自我治疗的四个关键动机：对正式治疗的需求感知、与地理迁移相结合使用未经处方的丁丙诺啡的愿望、在准备正式服务时自行启动治疗、以及在恢复轨迹中增强自我决定和代理感。
NPB 的使用是 PWUIO 认可的自我治疗模式，一些 PWUIO 过渡到持续的康复期或参加正式治疗。了解选择不接受治疗的动机对于改善阿片类药物使用障碍患者的护理形式至关重要。
