Characterization of diverted buprenorphine use among adults entering corrections-based drug treatment in Kentucky.
Adult
Analgesics, Opioid
/ adverse effects
Appalachian Region
/ epidemiology
Buprenorphine
/ adverse effects
Correctional Facilities
/ trends
Cross-Sectional Studies
Female
Humans
Kentucky
/ epidemiology
Male
Middle Aged
Opiate Substitution Treatment
/ psychology
Opioid-Related Disorders
/ drug therapy
Prescription Drug Diversion
/ psychology
Self Medication
/ psychology
Substance Abuse Treatment Centers
/ trends
Surveys and Questionnaires
Young Adult
Buprenorphine
Diversion
Heroin
Opioid agonist therapies
Polydrug use
Journal
Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587
Informations de publication
Date de publication:
01 03 2020
01 03 2020
Historique:
received:
10
11
2019
revised:
17
12
2019
accepted:
26
12
2019
pubmed:
18
1
2020
medline:
20
1
2021
entrez:
18
1
2020
Statut:
ppublish
Résumé
Illicit, medically unsupervised use of buprenorphine (i.e., "diverted use") among vulnerable and underserved populations, such as corrections-involved adults, remains underexplored. Survey data (2016-2017) collected as part of a clinical assessment of incarcerated adults entering corrections-based substance use treatment in Kentucky were analyzed. For years examined, 12,915 completed the survey. Removing cases for participants who did not reside in Kentucky for >6 months during the one-year pre-incarceration period (n = 908) resulted in a final sample size of 12,007. Over a quarter of the sample reported past-year diverted buprenorphine use prior to incarceration and 21.8 % reported use during the 30-days prior to incarceration, using 6.5 months and 14.3 days on average, respectively. A greater proportion of participants who reported diverted buprenorphine use had previously been engaged with some substance use treatment (77.0 %) and reported greater perceived need for treatment (79.4 %) compared to those who did not report use. Use was more likely among participants who were younger, white, male, and who reported rural or Appalachian residence. Diverted buprenorphine users also evidenced extensive polydrug use and presented with greater substance use disorder severity. Non-medical prescription opioid, heroin, and diverted methadone use were associated with increased odds of diverted buprenorphine use while kratom was not. Diverted methadone use was associated with a 252.9 % increased likelihood of diverted buprenorphine use. Diverted buprenorphine use among participants in this sample was associated with concerning high-risk behaviors and may indicate barriers to accessing opioid agonist therapies for corrections-involved Kentucky residents, particularly those in rural Appalachia.
Sections du résumé
BACKGROUND
Illicit, medically unsupervised use of buprenorphine (i.e., "diverted use") among vulnerable and underserved populations, such as corrections-involved adults, remains underexplored.
METHODS
Survey data (2016-2017) collected as part of a clinical assessment of incarcerated adults entering corrections-based substance use treatment in Kentucky were analyzed. For years examined, 12,915 completed the survey. Removing cases for participants who did not reside in Kentucky for >6 months during the one-year pre-incarceration period (n = 908) resulted in a final sample size of 12,007.
RESULTS
Over a quarter of the sample reported past-year diverted buprenorphine use prior to incarceration and 21.8 % reported use during the 30-days prior to incarceration, using 6.5 months and 14.3 days on average, respectively. A greater proportion of participants who reported diverted buprenorphine use had previously been engaged with some substance use treatment (77.0 %) and reported greater perceived need for treatment (79.4 %) compared to those who did not report use. Use was more likely among participants who were younger, white, male, and who reported rural or Appalachian residence. Diverted buprenorphine users also evidenced extensive polydrug use and presented with greater substance use disorder severity. Non-medical prescription opioid, heroin, and diverted methadone use were associated with increased odds of diverted buprenorphine use while kratom was not. Diverted methadone use was associated with a 252.9 % increased likelihood of diverted buprenorphine use.
CONCLUSIONS
Diverted buprenorphine use among participants in this sample was associated with concerning high-risk behaviors and may indicate barriers to accessing opioid agonist therapies for corrections-involved Kentucky residents, particularly those in rural Appalachia.
Identifiants
pubmed: 31951906
pii: S0376-8716(20)30002-8
doi: 10.1016/j.drugalcdep.2020.107837
pmc: PMC7418075
mid: NIHMS1611174
pii:
doi:
Substances chimiques
Analgesics, Opioid
0
Buprenorphine
40D3SCR4GZ
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
107837Subventions
Organisme : Intramural NIH HHS
ID : Z99 DA999999
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Nothing declared.
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