Prior Experience with Non-Prescribed Buprenorphine: Role in Treatment Entry and Retention

• Published in: Journal of substance abuse treatment Vol. 57; pp. 57 - 62
• Main Authors: Monico, Laura B., M.A, Mitchell, Shannon Gwin, Ph.D, Gryczynski, Jan, Ph.D, Schwartz, Robert P., Ph.D, O’Grady, Kevin E., Ph.D, Olsen, Yngvild K., M.D, Jaffe, Jerome H., M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2015; Elsevier Limited
• Subjects: Adult; African Americans; Buprenorphine; Buprenorphine - therapeutic use; Buprenorphine diversion; Clinical trials; Drug Prescriptions; Drug use; Female; Humans; Male; Medication Adherence; Middle Aged; Narcotic Antagonists - therapeutic use; Nonprescription drugs; Opiate Substitution Treatment - methods; Opioid dependence; Opioid-Related Disorders - drug therapy; Psychiatry; Randomized Controlled Trials as Topic; Substance abuse treatment; Treatment retention; Opioid dependence; Buprenorphine diversion; Buprenorphine; Treatment retention
• ISSN: 0740-5472; 1873-6483
• DOI: 10.1016/j.jsat.2015.04.010

Abstract Buprenorphine availability continues to expand as an effective treatment for opioid dependence, but increases in availability have also been accompanied by increases in non-prescribed use of the medication. Utilizing data from a randomized clinical trial, this mixed-method study examines associations between use of non-prescribed buprenorphine and subsequent treatment entry and retention. Quantitative analyses ( N = 300 African American buprenorphine patients) found that patients with prior use of non-prescribed buprenorphine had significantly higher odds of remaining in treatment through 6 months than patients who were naïve to the medication upon treatment entry. Qualitative data, collected from a subsample of participants ( n = 20), identified three thematic explanations for this phenomenon: 1) perceived effectiveness of the medication; 2) cost of obtaining prescription buprenorphine compared to purchasing non-prescribed medication; and 3) convenience of obtaining the medication via daily-dosing or by prescription compared to non-prescribed buprenorphine. These findings suggest a dynamic relationship between non-prescribed buprenorphine use and treatment that indicates potential directions for future research into positive and negative consequences of buprenorphine diversion.