The Emerging Buprenorphine Epidemic in the United States

Wish, Eric D.; Artigiani, Eleanor; Billing, Amy; Hauser, Wanda; Hemberg, Jordana; Shiplet, Myron; DuPont, Robert L.

doi:10.1080/10550887.2011.642757

Cited by 35 publications

(22 citation statements)

References 4 publications

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“…Trust and independence will be more challenging issues to address in the future, particularly as buprenorphine diversion appears to become more common. 25 …”

Section: Discussionmentioning

confidence: 99%

Consumer attitudes about opioid addiction treatment: A focus group study in New York City

Sohler¹,

Weiss²,

Egan³

et al. 2013

J of Opioid Management

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Objective To develop effective programs for people who are opioid-dependent and to impact the opioid epidemic in New York City, it is crucial that we monitor attitudes about opioid addiction treatments among opioid users who have experienced barriers to engagement and retention in addiction treatment. Design We conducted a qualitative study using focus groups. Methods We conducted six focus groups in three needle exchanges in New York City, which were audio recorded, transcribed, and systematically coded. We report on the main themes related to the study objectives. Participants Participants of each needle exchange who were opioid-dependent and had some knowledge of both methadone and buprenorphine were eligible. Results There were four main findings. Participants felt: (1) buprenorphine is an appropriate option only for those heroin users who are motivated to stop using; (2) they have less control over their addiction treatment with methadone than they would have with buprenorphine; (3) buprenorphine treatment is not accessible to many New York City residents who would benefit from this treatment; and (4) lack of access to buprenorphine treatment is the cause of treatment-related diversion. Conclusions Both methadone maintenance and buprenorphine treatment opportunities are necessary to address the diverse treatment needs of opioid-dependent people in New York City. However, the current medical model of buprenorphine treatment may be too restrictive for some opioid-dependent people, and may be contributing to the use of illicit buprenorphine. New models to deliver buprenorphine treatment may address these problems.

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“…Trust and independence will be more challenging issues to address in the future, particularly as buprenorphine diversion appears to become more common. 25 …”

Section: Discussionmentioning

confidence: 99%

Consumer attitudes about opioid addiction treatment: A focus group study in New York City

Sohler¹,

Weiss²,

Egan³

et al. 2013

J of Opioid Management

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“…Interviews with participants from Baltimore, Maryland (n = 15), focusing on their perceptions of buprenorphine availability in their neighborhoods, indicate an "increased use of buprenorphine in their neighborhoods over the past two years and that it was being bought and sold on the street." 26 The same study estimated that, based on information from Substance Abuse and Mental Health Services Administration, the number of emergency department visits related to buprenorphine increased from 4,400 in 2006 to 14,266 in 2009. Few deaths have been reported when buprenorphine is used singularly (because of its ceiling effect), but the potential for overdose increases when it is combined with benzodiazepines.…”

Section: Suboxone Maintenance Treatmentmentioning

confidence: 95%

Suboxone Misuse Along the Opiate Maintenance Treatment Pathway

Fürst

2013

Journal of Addictive Diseases

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This study explores strategies that Suboxone misusers utilize while in drug treatment. Ethnographic interviews were conducted with 14 patients who had cycled in and out of Suboxone treatment. The objective of the study is to identify strategies implemented by patients who intermittently use opiates/opioids while in Suboxone treatment. Findings indicate that some patients serially stop and start treatment in a Harm Reduction setting in New York City. Many patients suggest that they manage their opiate/opioid dependency through a sequential use of Suboxone and heroin to avoid withdrawal and to continue their misuse of opiates/opioids. Results are discussed in conjunction with the difficulties inherent to substance abuse treatment and suggestions for improvement are offered.

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“…31-35 However, many American prison and jail administrators remain reluctant to offer opioid agonist pharmacotherapy in their facilities, largely because of their preference for drug-free interventions 36-40 and concerns about diversion of medication, especially with buprenorphine. 41 …”

Section: Introductionmentioning

confidence: 99%

Extended-release naltrexone for pre-release prisoners: A randomized trial of medical mobile treatment

Gordon

Vocci

Fitzgerald

et al. 2017

Contemporary Clinical Trials

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Background Extended-release naltrexone (XR-NTX), is an effective treatment for opioid use disorder but is rarely initiated in US prisons or with criminal justice populations. Mobile treatment for chronic diseases have been implemented in a variety of settings. Mobile treatment may provide an opportunity to expand outreach to parolees to surmount barriers to traditional clinic treatment. Methods Male and female prisoners (240) with pre-incarceration histories of opioid use disorder who are within one month of release from prison will be enrolled in this randomized clinical trial. Participants are randomized to one of two study arms: 1) [XR-NTX-OTx] One injection of long-acting naltrexone in prison, followed by 6 monthly injections post-release at a community opioid treatment program; or 2) [XR-NTX+ MMTx] One injection of long-acting naltrexone in prison followed by 6 monthly injections post-release at the patient's place of residence utilizing mobile medical treatment. The primary outcomes are: treatment adherence; opioid use; criminal activity; re-arrest; reincarceration; and HIV risk-behaviors. Results We describe the background and rationale for the study, its aims, hypotheses, and study design. Conclusions The use of long-acting injectable naltrexone may be a promising form of treatment for pre-release prisoners. Finally, as many individuals in the criminal justice system drop out of treatment, this study will assess whether treatment at their place of residence will improve adherence and positively affect treatment outcomes.

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The Emerging Buprenorphine Epidemic in the United States

Cited by 35 publications

References 4 publications

Consumer attitudes about opioid addiction treatment: A focus group study in New York City

Consumer attitudes about opioid addiction treatment: A focus group study in New York City

Suboxone Misuse Along the Opiate Maintenance Treatment Pathway

Extended-release naltrexone for pre-release prisoners: A randomized trial of medical mobile treatment

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