title: Comparative prices of diverted buprenorphine/naloxone and buprenorphine in a UK prison setting: a cross-sectional survey of drug using prisoners.
abstract: BACKGROUND
  There is evidence regarding the abuse potential of buprenorphine in prison settings. There is also emerging evidence from community settings that buprenorphine/naloxone is less amenable to abuse than the single preparation buprenorphine hydrochloride as evidenced by cost-differentials of diverted medication. This study sought to explore cost-differentials within a prison setting of diverted buprenorphine/naloxone medication relative to either single preparation buprenorphine hydrochloride or methadone.
  
  
  METHODS
  Cross-sectional survey in one remand prison.
  
  
  RESULTS
  A total of 85 prisoners participated in the survey. Prisoners estimated buprenorphine to have a significantly (p<0.001) higher cost than buprenorphine/naloxone both inside and outside of prison. This finding was supported when the analysis was restricted to both the prisoners with a longer-term experience of taking opioid substitution drugs during their current prison stay and those with a longer-term experience prior to reception.
  
  
  CONCLUSIONS
  Consideration should be given to the recommendation that buprenorphine/naloxone medication is the prescribed buprenorphine preparation of choice for clinicians offering opiate substitution therapy to prisoners, pending developments of buprenorphine preparations that have less abuse potential than sublingual preparations.
authors.affiliation: HMP Leeds, Healthcare Department, 2 Gloucester Terrace, Armley, Leeds, LS12 2TJ, United Kingdom; Leeds Community Healthcare NHS Trust, Leeds, LS6 1PF, United Kingdom. Electronic address: natwright@nhs.net.
authors.forename: Nat M J
authors.initials: NM
authors.lastname: Wright
authors.affiliation: HMP Leeds, Healthcare Department, 2 Gloucester Terrace, Armley, Leeds, LS12 2TJ, United Kingdom; Leeds Community Healthcare NHS Trust, Leeds, LS6 1PF, United Kingdom.
authors.forename: Zanib
authors.initials: Z
authors.lastname: Mohammed
authors.affiliation: Leeds Community Healthcare NHS Trust, Leeds, LS6 1PF, United Kingdom; Leeds Institute of Health Sciences, University of Leeds, LS2 9LJ, United Kingdom.
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Hughes
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002047:Buprenorphine / Q000008:administration & dosage / Q000191:economics*; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage / Q000191:economics*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D010865:Pilot Projects; D011329:Prisoners; D011330:Prisons / Q000191:economics*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D004338:Drug Combinations; D009270:Naloxone; D002047:Buprenorphine
keywords: Buprenorphine; Buprenorphine/naloxone; Opioid substitution treatment; Prescription drug abuse; Prisons