Clinician Beliefs and Attitudes About Buprenorphine/naloxone Diversion

Overview

Journal Am J Addict

Specialty Psychiatry

Date 2013 Oct 18

PMID 24131165

Citations 20

Authors

Zev Schuman-Olivier

Hilary Connery

Margaret L Griffin

Steve A Wyatt

Alan A Wartenberg

Jacob Borodovsky

John A Renner Jr

Roger D Weiss

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Concern about diversion of buprenorphine/naloxone (B/N) in the United States may affect prescribing patterns and policy decisions. This study examines addiction treatment clinician beliefs and attitudes regarding B/N diversion.

Methods: Participants (n = 369) completed a 34-item survey in 2010 during two national symposia on opioid dependence. We conducted multivariable regression, examining the relationship of perceived danger from B/N diversion with clinician characteristics and their beliefs about B/N treatment and diversion. We compared causal beliefs about diversion among clinicians with and without B/N treatment experience.

Results: Forty percent of clinicians believed that B/N diversion is a dangerous problem. The belief that B/N diversion increases accidental overdoses in the community was strongly associated with perceived danger from B/N diversion.

Conclusions And Scientific Significance: Attitudes and beliefs, not education level, were associated with clinician's perceived danger from B/N diversion. Clinicians with greater B/N patient experience were more likely to believe treatment access barriers are the major cause of B/N diversion.

Citing Articles

Evidence on Buprenorphine Dose Limits: A Review.

Grande L, Cundiff D, Greenwald M, Murray M, Wright T, Martin S J Addict Med. 2023; 17(5):509-516.

PMID: 37788601 PMC: 10547105. DOI: 10.1097/ADM.0000000000001189.

Patients' perceptions of self-administered dosing to opioid agonist treatment and other changes during the COVID-19 pandemic: a qualitative study.

Scott G, Turner S, Lowry N, Hodge A, Ashraf W, McClean K BMJ Open. 2023; 13(3):e069857.

PMID: 36944465 PMC: 10032386. DOI: 10.1136/bmjopen-2022-069857.

Assessing the feasibility, usability and acceptability of the platform among individuals in outpatient buprenorphine treatment: Lessons learned from a pilot randomized controlled trial.

Janzow G, Harding C, Flores M, Borodovsky J, Steinkamp J, Marsch L Drug Alcohol Depend Rep. 2023; 3:100045.

PMID: 36845988 PMC: 9949338. DOI: 10.1016/j.dadr.2022.100045.

Association between Prescribers' Perceptions of the Utilization of Medication for Opioid Use Disorder and Opioid Dependence Treatability.

Adzrago D, Di Paola A, Zhu J, Betancur A, Wilkerson J Healthcare (Basel). 2022; 10(9).

PMID: 36141345 PMC: 9498711. DOI: 10.3390/healthcare10091733.

The relationship between patients' income and education and their access to pharmacological chronic pain management: A scoping review.

Atkins N, Mukhida K Can J Pain. 2022; 6(1):142-170.

PMID: 36092247 PMC: 9450907. DOI: 10.1080/24740527.2022.2104699.

References

Dasgupta N, Bailey E, Cicero T, Inciardi J, Parrino M, Rosenblum A . Post-marketing surveillance of methadone and buprenorphine in the United States. Pain Med. 2010; 11(7):1078-91. DOI: 10.1111/j.1526-4637.2010.00877.x. View

Bailey J, Campagna E, Dart R . The underrecognized toll of prescription opioid abuse on young children. Ann Emerg Med. 2008; 53(4):419-24. DOI: 10.1016/j.annemergmed.2008.07.015. View

Schepis T, Krishnan-Sarin S . Sources of prescriptions for misuse by adolescents: differences in sex, ethnicity, and severity of misuse in a population-based study. J Am Acad Child Adolesc Psychiatry. 2009; 48(8):828-836. PMC: 3695610. DOI: 10.1097/CHI.0b013e3181a8130d. View

Rieckmann T, Daley M, Fuller B, Thomas C, McCarty D . Client and counselor attitudes toward the use of medications for treatment of opioid dependence. J Subst Abuse Treat. 2007; 32(2):207-15. PMC: 2847884. DOI: 10.1016/j.jsat.2006.09.002. View

Geib A, Babu K, Ewald M, Boyer E . Adverse effects in children after unintentional buprenorphine exposure. Pediatrics. 2006; 118(4):1746-51. DOI: 10.1542/peds.2006-0948. View

Hayes B, Klein-Schwartz W, Doyon S . Toxicity of buprenorphine overdoses in children. Pediatrics. 2008; 121(4):e782-6. DOI: 10.1542/peds.2007-1774. View

Bridge T, Fudala P, Herbert S, Leiderman D . Safety and health policy considerations related to the use of buprenorphine/naloxone as an office-based treatment for opiate dependence. Drug Alcohol Depend. 2003; 70(2 Suppl):S79-85. DOI: 10.1016/s0376-8716(03)00061-9. View

Mattick R, Kimber J, Breen C, Davoli M . Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev. 2008; (2):CD002207. DOI: 10.1002/14651858.CD002207.pub3. View

Duke A, Correia C, Walsh S, Bigelow G, Strain E . Acute effects of intramuscular and sublingual buprenorphine and buprenorphine/naloxone in non-dependent opioid abusers. Psychopharmacology (Berl). 2010; 211(3):303-12. PMC: 2941639. DOI: 10.1007/s00213-010-1898-4. View

10.

Cicero T, Surratt H, Inciardi J . Use and misuse of buprenorphine in the management of opioid addiction. J Opioid Manag. 2008; 3(6):302-8. DOI: 10.5055/jom.2007.0018. View

11.

Ferrant O, Papin F, Clin B, Lacroix C, Saussereau E, Remoue J . Fatal poisoning due to snorting buprenorphine and alcohol consumption. Forensic Sci Int. 2010; 204(1-3):e8-11. DOI: 10.1016/j.forsciint.2010.05.015. View

12.

Comer S, Walker E, Collins E . Buprenorphine/naloxone reduces the reinforcing and subjective effects of heroin in heroin-dependent volunteers. Psychopharmacology (Berl). 2005; 181(4):664-75. PMC: 4079466. DOI: 10.1007/s00213-005-0023-6. View

13.

Middleton L, Nuzzo P, Lofwall M, Moody D, Walsh S . The pharmacodynamic and pharmacokinetic profile of intranasal crushed buprenorphine and buprenorphine/naloxone tablets in opioid abusers. Addiction. 2011; 106(8):1460-73. PMC: 3776483. DOI: 10.1111/j.1360-0443.2011.03424.x. View

14.

Lofwall M, Havens J . Inability to access buprenorphine treatment as a risk factor for using diverted buprenorphine. Drug Alcohol Depend. 2012; 126(3):379-83. PMC: 3449053. DOI: 10.1016/j.drugalcdep.2012.05.025. View

15.

Pedapati E, Bateman S . Toddlers requiring pediatric intensive care unit admission following at-home exposure to buprenorphine/naloxone. Pediatr Crit Care Med. 2010; 12(2):e102-7. DOI: 10.1097/PCC.0b013e3181f3a118. View

16.

Ling W, Casadonte P, Bigelow G, Kampman K, Patkar A, Bailey G . Buprenorphine implants for treatment of opioid dependence: a randomized controlled trial. JAMA. 2010; 304(14):1576-83. DOI: 10.1001/jama.2010.1427. View

17.

Wallack S, Thomas C, Martin T, Chilingerian J, Reif S . Substance abuse treatment organizations as mediators of social policy: slowing the adoption of a congressionally approved medication. J Behav Health Serv Res. 2008; 37(1):64-78. DOI: 10.1007/s11414-008-9132-4. View

18.

Yokell M, Zaller N, Green T, Rich J . Buprenorphine and buprenorphine/naloxone diversion, misuse, and illicit use: an international review. Curr Drug Abuse Rev. 2011; 4(1):28-41. PMC: 3154701. DOI: 10.2174/1874473711104010028. View

19.

McCarty D, Rieckmann T, Green C, Gallon S, Knudsen J . Training rural practitioners to use buprenorphine; using The Change Book to facilitate technology transfer. J Subst Abuse Treat. 2004; 26(3):203-8. DOI: 10.1016/S0740-5472(03)00247-2. View

20.

Kleber H . Methadone maintenance 4 decades later: thousands of lives saved but still controversial. JAMA. 2008; 300(19):2303-5. DOI: 10.1001/jama.2008.648. View