A comparison of methadone and buprenorphine–naloxone as opioid substitution therapy: the patient perspective in NHS Lanarkshire

Hill, Duncan; Conroy, Stephen J.; Afzal, Afreen; Lang, Debbie; Steele, Siobhan; Campbell, Derna

doi:10.3109/14659891.2014.894589

Cited by 10 publications

(14 citation statements)

References 8 publications

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“…Indeed, patients have likened it to a form of social control because it can tie them to strict medication-related rules and monitoring systems, such as urinalysis and daily attendance at services (Chandler et al, 2013;Crawford, 2013;Neale, 2013;Strike et al, 2013;Treloar & valentine, 2013). Studies have compared patients' views of oral methadone with oral buprenorphine (Hill et al, 2015;Kelly et al, 2012;Schwartz et al, 2008;White et al, 2007). However, findings from this research have been inconsistent and inconclusive; for example, there is evidence that patients prefer methadone on some criteria and buprenorphine on others (White et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Opioid users' willingness to receive prolonged-release buprenorphine depot injections for opioid use disorder

Tompkins

Neale

Strang

2019

Journal of Substance Abuse Treatment

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A B S T R A C TAims: Prolonged-release implantable and depot injection formulations of buprenorphine are very recent developments in the treatment of opioid use disorder. Such formulations remove the need for daily dosing and provide patients with sustained concentrations of buprenorphine over a period of weeks or months. We explored opioid users' personal willingness to receive prolonged-release buprenorphine depot injections and factors influencing their interest. Methods: The study took place in London during 2018, before depot buprenorphine was licensed for use in Europe. Thirty-six face-to-face, semi-structured qualitative interviews were conducted with people who were: i) using heroin daily and not receiving any treatment for opioid use (n = 12); or ii) prescribed daily oral buprenorphine (n = 12); or iii) prescribed daily oral methadone (n = 12). Participants were asked about their willingness to receive depot buprenorphine and were encouraged to discuss factors that might alter their opinions. Interview data were analysed following the stages of Iterative Categorization. Findings: Participants expressed a high level of willingness to receive depot buprenorphine. Their views were influenced both positively and negatively by six key features of depot buprenorphine: i) reduced contact with pharmacies and drug treatment services; ii) impact on illicit drug use and recovery; iii) the perceived effectiveness of depot buprenorphine; iv) the duration and dosage of depot buprenorphine injections; v) clinical administration of the depot buprenorphine injection; and vi) potential for side effects associated with the depot buprenorphine injection. Conclusions: Willingness to receive a given medication is complex, individual and changeable. Opioid users seem likely to welcome greater choice and flexibility in respect of opioid agonist medications and appear more likely to accept and adhere to depot buprenorphine if it enables them to reduce their illicit drug use and facilitates their recovery. Research is now needed to assess whether patients' reported willingness to receive depot buprenorphine translates into actual uptake and adherence. (Clinical Guidelines on Drug Misuse and Dependence (Update), 2017).

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Section: Introductionmentioning

confidence: 99%

Opioid users' willingness to receive prolonged-release buprenorphine depot injections for opioid use disorder

Tompkins

Neale

Strang

2019

Journal of Substance Abuse Treatment

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“…4 Given the increased provision of these services, in particular OST and IEP, pharmacist education is essential to deliver safe, effective, and patient-centered care. Many opioid users feel stigmatized 5 as can others using IEP or other treatment services. Feelings of stigma can be a barrier to treatment progress 5 and education should be targeted at the nature of addiction and the opportunities to put patients at ease.…”

Section: Introductionmentioning

confidence: 99%

“…Many opioid users feel stigmatized 5 as can others using IEP or other treatment services. Feelings of stigma can be a barrier to treatment progress 5 and education should be targeted at the nature of addiction and the opportunities to put patients at ease. 6 Historically, pharmacist education in substance misuse allayed some of the concerns and fears staff had and assisted in reducing prejudices.…”

Section: Introductionmentioning

confidence: 99%

A Scenario-Based Virtual Patient Program to Support Substance Misuse Education

Zlotos

Power

Hill

et al. 2016

American Journal of Pharmaceutical Education

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Objective. To evaluate virtual patient (VP) programs for injecting equipment provision (IEP) and opiate substitution therapy (OST) services with respect to confidence and knowledge among preregistration pharmacist trainees. Methods. Preregistration trainee pharmacists pilot-tested the VP programs and were invited to complete pre/post and 6-month assessments of knowledge and perceived confidence. Results. One hundred six trainees participated and completed the pre/postassessments. Forty-six (43.4%) participants repeated the assessments at six months. Scores in perceived confidence increased in all domains at both time points postprogram. Knowledge scores were greater posteducation than preeducation. Knowledge scores were also greater six months after education than preeducation. Knowledge scores at six months were lower than posteducation for both programs. Conclusion. Virtual patients programs increased preregistration pharmacists' knowledge and confidence with regard to IEP and OST immediately after use and at six months postprogram. There was a loss of clinical knowledge over time but confidence change was sustained.

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“…Their participants’ experiences of BUP/NX are consistent with the experiences discussed within this research; namely, the participants were positive about their experiences, and the advantages of BUP/NX over methadone included ‘the “clear‐headed response”, improved well‐being and concentration, possibility of less social stigma, reduced craving, decreased side effects (especially drowsiness) and easier to withdraw from’ (Hill et al . , p. 173).…”

Section: Introductionmentioning

confidence: 97%

Readiness and recovery: Transferring between methadone and buprenorphine/naloxone for the treatment of opioid use disorder

Bishop

Gilmour

Deering

2018

Int J Mental Health Nurs

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Long-acting opioids are prescribed as part of treatment for opioid use disorders; methadone and buprenorphine are well researched and commonly prescribed for the treatment of opioid use disorder. Meta-analysis suggests that buprenorphine has a slightly poorer retention rate in treatment as compared to methadone. Benefits of buprenorphine/naloxone include greater ease in ceasing treatment and less use of illicit opioids while in treatment as compared to methadone. There are a number of qualitative and mixed-method studies that ask patients about their experiences of methadone maintenance and buprenorphine maintenance treatment. This research aimed to understand perspectives of receiving buprenorphine/naloxone for the treatment of opioid use disorder. A qualitative descriptive approach was used. Seven participants with a current diagnosis of opioid use disorder treated with buprenorphine/naloxone were interviewed. Thematic analysis extracted four themes: drivers for opioid substitution treatment change; readiness for buprenorphine/naloxone substitution treatment; absence of effect from buprenorphine/naloxone; and an increased sense of citizenship on buprenorphine/naloxone. This study identified a number of factors influencing participants' decision-making in transferring between methadone and buprenorphine/naloxone for the treatment of their opioid use disorder. Methadone was preferred by those seeking sedation and wishing to continue using other opioids, and buprenorphine/naloxone was most effective for participants no longer wishing to experience sedation and seeing opioid abstinence as an end point in their recovery. Changing treatment expectations are important to consider when determining medication selection and highlight the importance of quality information when determining the most suitable medication for the treatment of opioid use disorder.

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A comparison of methadone and buprenorphine–naloxone as opioid substitution therapy: the patient perspective in NHS Lanarkshire

Cited by 10 publications

References 8 publications

Opioid users' willingness to receive prolonged-release buprenorphine depot injections for opioid use disorder

Opioid users' willingness to receive prolonged-release buprenorphine depot injections for opioid use disorder

A Scenario-Based Virtual Patient Program to Support Substance Misuse Education

Readiness and recovery: Transferring between methadone and buprenorphine/naloxone for the treatment of opioid use disorder

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