Buprenorphine Diversion Driven by Withdrawal Prevention, Abstinence Maintenance

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Although buprenorphine is approved for the treatment of opioid use disorder, barriers to its use include cost and potential for diversion and abuse.
Although buprenorphine is approved for the treatment of opioid use disorder, barriers to its use include cost and potential for diversion and abuse.
The following article is part of The Clinical Advisor's coverage from the 2018 American Association of Nurse Practitioners' annual meeting in Denver. Our staff will be reporting live on original research, case studies, and professional outreach and advocacy news from leading NPs in various therapeutic areas. Check back for ongoing updates from AANP 2018. 

DENVER – Individuals who use diverted buprenorphine typically use it to prevent withdrawal symptoms or to maintain abstinence, according to research presented at the American Association of Nurse Practitioners 2018 National Conference.

Many users of diverted buprenorphine cited barriers to treatment access as a reason for not obtaining a prescription for the opioid partial agonist. Because recent legislation has extended buprenorphine waivers to qualified nurse practitioners and physician assistants, these clinicians may be able to help alleviate barriers to access.

The study included participants who had previously received treatment for opioid use disorder and had participated in the RADARS® System Survey of Key Informants' Patients (SKIP) Program (n=303). The researchers surveyed participants about their use of buprenorphine (with or without a prescription), reasons for use, and barriers to treatment. The online survey included both closed- and open-ended questions.

In total, 57.8% (n=175) of participants reported using buprenorphine without a prescription, and 37.1% (65) of those participants had never received a prescription. The most frequently reported reasons for diversion of buprenorphine were to prevent withdrawal (79%), to maintain abstinence (67%), or to wean themselves off drugs (53%), all of which are consistent with the therapeutic use of this product. Only 4% of participants indicated that buprenorphine was their drug of choice for getting high.

Among participants who had a history of using diverted buprenorphine, 84% obtained the drug from a dealer and 33% reported difficulty locating a clinician or obtaining the drug on their own.

Via the open-ended answers, participants said that clinician availability and office visit expenses create significant barriers to accessing buprenorphine prescriptions.

Of participants who used diverted buprenorphine, 81% indicated that they would prefer to use prescribed buprenorphine, if it was available.

Disclosure:  This study was sponsored by Indivior.

For more coverage of AANP 2018, click here.

Reference

Swingle D, Ellis MS, Chilcoat H. Understanding the use of diverted buprenorphine: the impact of barriers to access. Presented at the American Association of Nurse Practitioners 2018 National Conference. June 26-July 1, 2018; Denver, CO. Poster 15.

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