Understanding the use of diverted buprenorphine
Understanding the use of diverted buprenorphine
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DOI：
10.1016/j.drugalcdep.2018.09.007
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发表时间：
2018-12-01
影响因子：
4.2
通讯作者：
Chilcoat, Howard D.
中科院分区：
文献类型：
--
作者：
Cicero, Theodore J.;Ellis, Matthew S.;Chilcoat, Howard D.
背景：丁丙诺啡被许多国家批准用于阿片使用障碍(OUD)的治疗，但存在转移和滥用问题。有必要了解患者如何以及为什么使用丁丙诺啡，以及获取障碍是否会导致非法使用。方法：在2016年8月至9月期间，具有DSM-IV药物使用障碍标准并主要使用阿片类药物的成年人完成了关键告密者患者在线调查(SKIP)。调查包括封闭式和开放式问题，包括有无处方使用丁丙诺啡的原因、丁丙诺啡的来源、给药途径和治疗障碍。结果：在303名受访者中，175人(58%)报告了丁丙诺啡转用的历史，其中65人(37%)报告从未收到处方。非法使用丁丙诺啡的最常见原因与治疗性使用一致：预防戒断(79%)、保持戒断(67%)或自我戒毒(53%)。大约一半(52%)的人报告使用丁丙诺啡来获得快感或改变情绪，但很少有(4%)的人表示这是他们选择的药物。在使用过丁丙诺啡的受访者中，33%的人报告说他们在找医生或自己获得丁丙诺啡方面存在问题。这些参与者中的大多数(81%)表示，如果可用，他们更喜欢使用处方丁丙诺啡。结论：尽管58%的调查受访者报告了改用丁丙诺啡的历史，但最常被引用的非处方药使用原因与治疗性使用一致。分流的部分原因是准入障碍，而未得到满足的乌德治疗需求依然存在。
Background: Buprenorphine is approved in many countries for the treatment of opioid use disorder (OUD), but problems with diversion and abuse exist. There is a need to understand how and why patients use diverted buprenorphine, and whether barriers to access contribute to illicit use.Methods: Adults > 18 years with DSM-IV criteria for substance use disorder and primarily using an opioid completed the online Survey of Key Informants' Patients (SKIP) between August and September 2016. The survey included closed- and open-ended questions regarding reasons for buprenorphine use with and without a prescription, sources of buprenorphine, route of administration, and barriers to treatment.Results: Of 303 respondents, 175 (58%) reported a history of diverted buprenorphine use, 65 (37%) of whom reported never receiving a prescription. The most common reasons for illicit buprenorphine use were consistent with therapeutic use: to prevent withdrawal (79%), maintain abstinence (67%), or self-wean off drugs (53%). Approximately one-half (52%) reported using buprenorphine to get high or alter mood, but few (4%) indicated that it was their drug of choice. Among respondents who had used diverted buprenorphine, 33% reported that they had issues finding a doctor or obtaining buprenorphine on their own. Most (81%) of these participants indicated they would prefer using prescribed buprenorphine, if available.Conclusions: Although 58% of survey respondents reported a history of using diverted buprenorphine, the most frequently cited reasons for non-prescription use were consistent with therapeutic use. Diversion was partially driven by barriers to access, and an unmet need for OUD treatment persists.