Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Subst Abus. 2022;43(1):364-370. doi: 10.1080/08897077.2021.1942395. Epub 2021 Jul 2.
: Buprenorphine is an effective treatment for opioid use disorder, yet some persons are concerned with its "alternative use" (i.e., any use unintended by the prescriber). There is limited evidence on the factors associated with alternative use of buprenorphine (AUB); in this study, we examined correlates of recent (past 6 months) AUB. : Multivariable logistic regression was used to analyze survey data from a multi-site, cross-sectional study of people who use drugs (PWUD) ( = 334) in Baltimore, Maryland; Boston, Massachusetts; and Providence, Rhode Island. : One-fifth (20%) of the sample reported recent AUB. In adjusted analyses, significant negative correlates of AUB were female gender (adjusted odds ratio [aOR] 0.48, 95% confidence intervals [CI] 0.24-0.95), recent emergency room visit (aOR 0.45, 95% CI 0.23-0.89), and recent injection drug use (aOR 0.41, 95% CI 0.19-0.88). Significant positive correlates were alternative use of other prescription opioids (aOR 8.32, 95% CI 4.22-16.38), three or more overdoses in the past year (aOR 3.74, 95% CI 1.53-9.17), recent buprenorphine use as prescribed (aOR 2.50, 95% CI 1.12-5.55), and recent residential rehabilitation treatment (aOR 3.71, 95% CI 1.50-9.16). : Structural and behavioral correlates of AUB may help identify PWUD at high risk of overdose with unmet treatment needs.
丁丙诺啡是一种治疗阿片类药物使用障碍的有效药物，但有些人担心其“非医疗用途”（即任何非处方预期的用途）。关于丁丙诺啡非医疗用途（AUB）的相关因素的证据有限；在这项研究中，我们研究了与丁丙诺啡近期 AUB 相关的因素。
我们使用多变量逻辑回归分析了马里兰州巴尔的摩、马萨诸塞州波士顿和罗得岛州普罗维登斯三地多地点横断面研究中药物使用者（PWUD）（n=334）的调查数据。
该样本中有五分之一（20%）的人报告了近期 AUB。在调整后的分析中，AUB 的显著负相关因素为女性性别（调整后的优势比 [aOR] 0.48，95%置信区间 [CI] 0.24-0.95）、最近急诊就诊（aOR 0.45，95% CI 0.23-0.89）和最近注射吸毒（aOR 0.41，95% CI 0.19-0.88）。显著的正相关因素为其他处方类阿片类药物的替代使用（aOR 8.32，95% CI 4.22-16.38）、过去一年中出现三次或更多次药物过量（aOR 3.74，95% CI 1.53-9.17）、最近按处方使用丁丙诺啡（aOR 2.50，95% CI 1.12-5.55）和最近接受住院康复治疗（aOR 3.71，95% CI 1.50-9.16）。
AUB 的结构性和行为相关因素可能有助于确定那些有药物过量风险且治疗需求未得到满足的药物使用障碍者。
