Tracing the affordances of long-acting injectable depot buprenorphine: A qualitative study of patients’ experiences in Australia

Barnett, Anthony; Savic, Michael; Lintzeris, Nicholas; Bathish, Ramez; Arunogiri, Shalini; Dunlop, Adrian; Haber, Paul; Graham, Robert J.; Hayes, Vicky; Lubman, Dan I.

doi:10.1016/j.drugalcdep.2021.108959

Cited by 45 publications

(33 citation statements)

References 22 publications

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“…In general, the patients continuing with depot injections expressed high treatment satisfaction. The main benefits they highlighted with the depot injection – social and practical benefits such as increased freedom in everyday life, greater opportunities to decide over their own time, and increased opportunities to travel, as well as psychological benefits such as an increased sense of freedom and “normality”, a reduced stigma, and a shift in self-perception – are well in line with previous research on user perspectives, both among opioid users prior to the launch of depot injections and among patients who have received such treatment [ 20 , 22 – 24 ].…”

Section: Discussionsupporting

confidence: 80%

“…Qualitative research brings users’ perspectives into the field of addiction treatment [ 19 ]. While several studies conducted prior to the introduction of depot buprenorphine explored patients’ attitudes, information needs, and willingness to receive depot medications [ 20 – 23 ], only one previous study has examined the perspectives of patients on receiving depot injections in an OAT setting [ 24 ]. This qualitative study is based on interviews with 30 Australian patients about their experiences of buprenorphine depot injections.…”

Section: Introductionmentioning

confidence: 99%

“…To this end we conducted semi-structured in-depth interviews focused on how depot injections impact the patients’ everyday lives, contacts with caregivers, and attitudes towards OAT treatment and services. In contrast to earlier study [ 24 ], including only participants currently treated with depot injections, we interviewed a wider group of patients in order to explore their reasons for continuing, discontinuing, or declining depot injections in favor of other treatment alternatives. Interviews include participants from several centers, working independently, enabling us to detect a potential impact of the local “pharmaceutical atmosphere”.…”

Section: Introductionmentioning

confidence: 99%

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Patient perspectives on depot buprenorphine treatment for opioid addiction – a qualitative interview study

Johnson

Flensburg

Capusan

2022

Subst Abuse Treat Prev Policy

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Background Recently developed buprenorphine depot injections have the potential to reduce risk for diversion and misuse, and to increase adherence with fewer visits for supervised intake. However, it is unclear how patients perceive this new form of medication. The purpose of this study was to explore patients’ experiences of depot injections and their reasons for continuing, discontinuing, or declining depot injection treatment. Methods We conducted semi-structured qualitative interviews with 32 people, 14 of whom had ongoing depot injection treatment, 11 who had discontinued depot-injections and switched to other medication and seven who had declined treatment with depot formulations. Interviews were transcribed, coded, and analysed using NVivo, based on this overall stratification into three participant groups. Results The main categories relate to the effects and side effects of the depot formulation, social and practical factors, psychological benefits and disadvantages, and interactions with treatment staff. Social and practical factors were of importance for choosing depot formulations, such as increased freedom and their making it easier to combine treatment with work and family life, as well as psychological advantages including “feeling normal”. Initial withdrawal symptoms that resolved themselves after a number of injections were reported by most participants. Reliable information and patient-staff relationships characterized by trust helped patients to cope with these initial problems. Those who discontinued treatment often did so near the beginning of the treatment, reporting withdrawal symptoms and insufficient effects as the main reasons. Coercion and insufficient information contributed to a negative pharmaceutical atmosphere at one of the clinics, which may have adversely influenced perceptions of depot formulations and decreased willingness to accept and continue treatment. Conclusions Buprenorphine depot injections may have social, practical, and psychological benefits compared to other formulations. However, depot injections are not perceived as an attractive option by all patients. Trust, consistent and adequate information, and awareness of the implications of the pharmaceutical atmosphere should be considered when introducing new medications.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient perspectives on depot buprenorphine treatment for opioid addiction – a qualitative interview study

Johnson

Flensburg

Capusan

2022

Subst Abuse Treat Prev Policy

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“…However, for some clients, moving to depot buprenorphine disrupted engagements with important social/practical supports available at pharmacies/clinics. 107 More broadly, early research has indicated that depot buprenorphine is a viable treatment option in prison settings (with benefits including lower risk of diversion and potentially lowering harms associated with injecting drug use, ie, blood-borne virus risks). 108 Going forward, how depot buprenorphine is experienced in different international contexts, including how it may reduce stigma experienced in care settings, remains an important area of research.…”

Section: Strategies To Reduce Stigmamentioning

confidence: 99%

The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy

Cheetham¹,

Picco²,

Barnett³

et al. 2022

SAR

Self Cite

100

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Illicit drug use disorders are the most stigmatised health conditions worldwide, and stigma acts as a meaningful barrier to treatment entry and treatment provision. In the context of dramatically rising opioid-related harms, it is critical that we understand the drivers of stigma and how it affects opioid use disorder treatment and policy. The aim of this narrative review is to discuss how opioid-related stigma impacts treatment provision and harm reduction, and provide potential strategies to reduce stigma at a social and structural level. We used the Framework for Integrating Normative Influences on Stigma (FINIS) to identify sources of opioid-related stigma at the macro (structural stigma), meso (public stigma) and micro (internalised stigma) levels. Reducing stigma requires strategies that target multiple levels, however addressing inequity in the laws, regulations, and rules that segregate people with opioid and other substance use disorders from mainstream society is essential.

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“…The authors are aware of two recent papers that provide a quantitative and qualitative perspective of those with OUD and the introduction of LAIB in Australia, which have demonstrated impacts on SDH by LAIB (Barnett et al, 2021;Lintzeris et al, 2021). The qualitative study by Barnett et al (2021) explored patient views after receiving LAIB and found it allowed for more freedom in dosing, increased time to dedicate to education, and reduced economic burdens associated with treatment. However, some patients found the lack of control in their dosing, and lack of daily support and routine as a result of the LAIB a negative.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Long-acting injectable buprenorphine for opioid use disorder: A systematic review of impact of use on social determinants of health

Martin

Maher

McKeon

et al. 2022

Journal of Substance Abuse Treatment

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Tracing the affordances of long-acting injectable depot buprenorphine: A qualitative study of patients’ experiences in Australia

Cited by 45 publications

References 22 publications

Patient perspectives on depot buprenorphine treatment for opioid addiction – a qualitative interview study

Patient perspectives on depot buprenorphine treatment for opioid addiction – a qualitative interview study

The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy

Long-acting injectable buprenorphine for opioid use disorder: A systematic review of impact of use on social determinants of health

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