The complex relation between access to opioid agonist therapy and diversion of opioid medications: a case example of large-scale misuse of buprenorphine in the Czech Republic

Opioid agonist therapy (OAT) has been available in a standard regime in the Czech Republic since 2000. Buprenorphine is the leading medication, while methadone is available only in a few specialised centres. There is an important leakage of buprenorphine onto the illicit market, and the majority of...

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Published inHarm reduction journal Vol. 15; no. 1; pp. 60 - 11
Main Authors Mravčík, Viktor, Janíková, Barbara, Drbohlavová, Barbora, Popov, Petr, Pirona, Alessandro
Format Journal Article
LanguageEnglish
Published England BioMed Central Ltd 04.12.2018
BioMed Central
BMC
Subjects
Access
Addictions
Adolescent
Adult
Alcohol
Analgesics, Opioid
Availability
Buprenorphine
Care and treatment
Case Study
Complications and side effects
Czech Republic - epidemiology
Diversion
Drug dosages
Drugs
Economic aspects
Female
Harm reduction
Health Services Accessibility - statistics & numerical data
Heroin
Humans
Illicit Drugs
Illicit market
Male
Markets
Methadone
Methadone - therapeutic use
Middle Aged
Mortality
Narcotics
Narcotics - therapeutic use
Opiate Substitution Treatment - statistics & numerical data
Opioid abuse
Opioid substitution treatment
Opioid-Related Disorders - epidemiology
Opioid-Related Disorders - rehabilitation
Opioids
Patients
Public health
Sexual behavior
Stagnation
Substance abuse treatment
Substance-Related Disorders - epidemiology
Therapy
Young Adult
Czech Republic
France
Luxembourg
Europe
Availability
Opioid substitution treatment
Buprenorphine
Barriers
Illicit market
Mortality
Crime
Opioids
Access
Cost
Diversion
Heroin
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Abstract Opioid agonist therapy (OAT) has been available in a standard regime in the Czech Republic since 2000. Buprenorphine is the leading medication, while methadone is available only in a few specialised centres. There is an important leakage of buprenorphine onto the illicit market, and the majority of Czech opioid users are characterised by the misuse (and injecting) of diverted buprenorphine medications. Most prescribed buprenorphine for OAT is not covered by current national health insurance schemes, and patients have to pay considerable prices to afford their treatment. This affordability barrier together with limited accessibility is likely the leading factor of limited coverage of OAT and of recent stagnation in the number of patients in the official treatment programmes in the Czech Republic. It also encourages doctor shopping and the re-selling of parts of their medication at a higher price, which represents the main factor that drives the Czech illicit market for buprenorphine, but at the same time co-finances the medication of clients in official OAT programmes. Improving access to OAT by making it financially affordable is essential to further increase OAT coverage and is one of the factors that can reduce the illicit market with OAT medications.
AbstractList Abstract Opioid agonist therapy (OAT) has been available in a standard regime in the Czech Republic since 2000. Buprenorphine is the leading medication, while methadone is available only in a few specialised centres. There is an important leakage of buprenorphine onto the illicit market, and the majority of Czech opioid users are characterised by the misuse (and injecting) of diverted buprenorphine medications. Most prescribed buprenorphine for OAT is not covered by current national health insurance schemes, and patients have to pay considerable prices to afford their treatment. This affordability barrier together with limited accessibility is likely the leading factor of limited coverage of OAT and of recent stagnation in the number of patients in the official treatment programmes in the Czech Republic. It also encourages doctor shopping and the re-selling of parts of their medication at a higher price, which represents the main factor that drives the Czech illicit market for buprenorphine, but at the same time co-finances the medication of clients in official OAT programmes. Improving access to OAT by making it financially affordable is essential to further increase OAT coverage and is one of the factors that can reduce the illicit market with OAT medications.
Opioid agonist therapy (OAT) has been available in a standard regime in the Czech Republic since 2000. Buprenorphine is the leading medication, while methadone is available only in a few specialised centres. There is an important leakage of buprenorphine onto the illicit market, and the majority of Czech opioid users are characterised by the misuse (and injecting) of diverted buprenorphine medications. Most prescribed buprenorphine for OAT is not covered by current national health insurance schemes, and patients have to pay considerable prices to afford their treatment. This affordability barrier together with limited accessibility is likely the leading factor of limited coverage of OAT and of recent stagnation in the number of patients in the official treatment programmes in the Czech Republic. It also encourages doctor shopping and the re-selling of parts of their medication at a higher price, which represents the main factor that drives the Czech illicit market for buprenorphine, but at the same time co-finances the medication of clients in official OAT programmes. Improving access to OAT by making it financially affordable is essential to further increase OAT coverage and is one of the factors that can reduce the illicit market with OAT medications.
Opioid agonist therapy (OAT) has been available in a standard regime in the Czech Republic since 2000. Buprenorphine is the leading medication, while methadone is available only in a few specialised centres. There is an important leakage of buprenorphine onto the illicit market, and the majority of Czech opioid users are characterised by the misuse (and injecting) of diverted buprenorphine medications. Most prescribed buprenorphine for OAT is not covered by current national health insurance schemes, and patients have to pay considerable prices to afford their treatment. This affordability barrier together with limited accessibility is likely the leading factor of limited coverage of OAT and of recent stagnation in the number of patients in the official treatment programmes in the Czech Republic. It also encourages doctor shopping and the re-selling of parts of their medication at a higher price, which represents the main factor that drives the Czech illicit market for buprenorphine, but at the same time co-finances the medication of clients in official OAT programmes. Improving access to OAT by making it financially affordable is essential to further increase OAT coverage and is one of the factors that can reduce the illicit market with OAT medications. Keywords: Opioid substitution treatment, Buprenorphine, Diversion, Illicit market, Access, Availability, Barriers, Cost, Mortality, Crime, Opioids, Heroin
ArticleNumber 60
Audience Academic
Author Janíková, Barbara
Mravčík, Viktor
Drbohlavová, Barbora
Pirona, Alessandro
Popov, Petr
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  organization: European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
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Issue 1
Keywords Availability
Opioid substitution treatment
Buprenorphine
Barriers
Illicit market
Mortality
Crime
Opioids
Access
Cost
Diversion
Heroin
Language English
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Snippet Opioid agonist therapy (OAT) has been available in a standard regime in the Czech Republic since 2000. Buprenorphine is the leading medication, while methadone...
Abstract Opioid agonist therapy (OAT) has been available in a standard regime in the Czech Republic since 2000. Buprenorphine is the leading medication, while...
SourceID doaj
pubmedcentral
proquest
gale
crossref
pubmed
SourceType Open Website
Open Access Repository
Aggregation Database
Index Database
StartPage 60
SubjectTerms Access
Addictions
Adolescent
Adult
Alcohol
Analgesics, Opioid
Availability
Buprenorphine
Care and treatment
Case Study
Complications and side effects
Czech Republic - epidemiology
Diversion
Drug dosages
Drugs
Economic aspects
Female
Harm reduction
Health Services Accessibility - statistics & numerical data
Heroin
Humans
Illicit Drugs
Illicit market
Male
Markets
Methadone
Methadone - therapeutic use
Middle Aged
Mortality
Narcotics
Narcotics - therapeutic use
Opiate Substitution Treatment - statistics & numerical data
Opioid abuse
Opioid substitution treatment
Opioid-Related Disorders - epidemiology
Opioid-Related Disorders - rehabilitation
Opioids
Patients
Public health
Sexual behavior
Stagnation
Substance abuse treatment
Substance-Related Disorders - epidemiology
Therapy
Young Adult
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Title The complex relation between access to opioid agonist therapy and diversion of opioid medications: a case example of large-scale misuse of buprenorphine in the Czech Republic
URI https://www.ncbi.nlm.nih.gov/pubmed/30514306
https://www.proquest.com/docview/2158640572/abstract/
https://pubmed.ncbi.nlm.nih.gov/PMC6280526
https://doaj.org/article/6632298b3afa44e9977f442f7a2247a5
Volume 15
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