In a recent article from the journal
Addictive Behaviors,
researchers discovered that buprenorphine was rarely, if ever, used by IV drug users to get high. In fact, the vast majority of people who reported acquiring the medication from an illicit source did so with the expressed purpose of avoiding withdrawal symptoms. This seems to contradict the common misconception that heroin users "get high" on Suboxone, therefore we should promote abstinence-based treatment. To the contrary, studies like this one could be interpreted as evidence there is not enough access to these medications - if there were, people wouldn't be forced to seek the drugs from street dealers or friends.
Interested to hear your take on the subject.
Below is a table from study. You can read the abstract here:
http://www.sciencedirect.com/science/article/pii/S0306460313002232
Table 2. Knowledge and Use of Buprenorphine among 602 Injection Drug Users in Baltimore, Maryland.
| Buprenorphine
N (%) | Suboxone
N (%) | Subutex
N (%) | Buprenex
N (%) | Any
N (%) |
|---|
| Ever heard of drug | 537 (89) | 355 (59) | 52 (9) | 68 (11) | 541 (90) |
| Seen sold on street | 430 (71) | 232 (39) | 13 (2) | 18 (3) | 446 (74) |
| Ever used | 246 (41) | 112 (19) | 12 (2) | 9 (1) | 273 (45) |
Usual sourcea
Doctor
Friend
Street | 124 (50)
32 (13)
55 (22) | 71 (63)
8 (7)
18 (16) | 9 (75)
1 (8)
1 (8) | 6 (67)
2 (22)
0 | 152 (56)
35 (13)
64 (23) |
| Used last 3 months | 73 (12) | 50 (8) | 4 (1) | 1 (< 1) | 95 (16) |
| Used last 30 days | 47 (8) | 35 (6) | 3 (< 1) | 1 (< 1) | 69 (11) |
| year 1stused (median) | 2005 | 2006 | 2006 | 2003 | 2005 |
| Ever used to get high | 26 (4) | 10 (2) | 2 (< 1) | 1 (< 1) | 30 (5) |
Usual sourcea
Doctor
Friend
Street | 1 (4)
10 (38)
15 (58) | 2 (20)
3 (30)
5 (50) | 0
1 (50)
1 (50) | 0
0
1 (100) | 2 (7)
12 (40)
18 (60) |
| Used to get high in last 3 months | 14 (2) | 7 (1) | 1 (< 1) | 0 | 15 (2) |
| Used to get high in last 30 days | 5 (1) | 3 (< 1) | 1 (< 1) | 0 | 8 (1) |
| Used to get high more than once | 20 (3) | 8 (1) | 1 (< 1) | 1 (< 1) | 23 (4) |
Totals may not add to 100 because of missing, don’t know, and refused responses; Individuals may be represented more than once in the “Any” column if they reported on more than one drug.
a
Proportion of the usual source of drug is among those who had reported ever using/ever using to get high
Citation:Genberg, B. et al. (2013). Prevalence and correlates of street-obtained buprenorphine use among current and former injectors in Baltimore, Maryland. Addictive Behaviors.
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ReplyDeleteBut that's an important distinction - "among informed people". Unfortunately, many policymakers, public health advocates, and even chemical dependency and mental health professionals are not well-informed of the science of opioid addiction. I can tell you anecdotally that I regularly hear folks in the treatment field say that they discourage the use of maintenance medications because they don't want their clients trading one high for another. Studies like these are important because they help increase the knowledge of the general public - granted, I agree with you that this survey has limitations. However, I think the main point I was trying to make is that if buprenorphine were more easily accessible, street sources wouldn't be needed - or, certainly, quite as common.
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