title: Prior Experience with Non-Prescribed Buprenorphine: Role in Treatment Entry and Retention.
abstract: Buprenorphine availability continues to expand as an effective treatment for opioid dependence, but increases in availability have also been accompanied by increases in non-prescribed use of the medication. Utilizing data from a randomized clinical trial, this mixed-method study examines associations between use of non-prescribed buprenorphine and subsequent treatment entry and retention. Quantitative analyses (N = 300 African American buprenorphine patients) found that patients with prior use of non-prescribed buprenorphine had significantly higher odds of remaining in treatment through 6 months than patients who were naïve to the medication upon treatment entry. Qualitative data, collected from a subsample of participants (n = 20), identified three thematic explanations for this phenomenon: 1) perceived effectiveness of the medication; 2) cost of obtaining prescription buprenorphine compared to purchasing non-prescribed medication; and 3) convenience of obtaining the medication via daily-dosing or by prescription compared to non-prescribed buprenorphine. These findings suggest a dynamic relationship between non-prescribed buprenorphine use and treatment that indicates potential directions for future research into positive and negative consequences of buprenorphine diversion.
authors.affiliation: Friends Research Institute, 1040 Park Ave., Suite 103, Baltimore, MD, 21201, USA. Electronic address: lmonico@friendsresearch.org.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Monico
authors.affiliation: Friends Research Institute, 1040 Park Ave., Suite 103, Baltimore, MD, 21201, USA. Electronic address: smitchell@friendsresearch.org.
authors.forename: Shannon Gwin
authors.initials: SG
authors.lastname: Mitchell
authors.affiliation: Friends Research Institute, 1040 Park Ave., Suite 103, Baltimore, MD, 21201, USA. Electronic address: jgryczynski@friendsresearch.org.
authors.forename: Jan
authors.initials: J
authors.lastname: Gryczynski
authors.affiliation: Friends Research Institute, 1040 Park Ave., Suite 103, Baltimore, MD, 21201, USA. Electronic address: rschwartz@friendsresearch.org.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Schwartz
authors.affiliation: Department of Psychology, University of Maryland, Biology/Psychology Building, College Park, MD, 20742, USA. Electronic address: keogradyfri@gmail.com.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: O'Grady
authors.affiliation: Institute for Behavior Resources REACH Health Services, 2104 Maryland Ave., Baltimore, MD, 21218, USA. Electronic address: yolsen@gmail.com.
authors.forename: Yngvild K
authors.initials: YK
authors.lastname: Olsen
authors.affiliation: Friends Research Institute, 1040 Park Ave., Suite 103, Baltimore, MD, 21201, USA; University of Maryland School of Medicine, Department of Psychiatry, 110 South Paca St. 4th floor, Baltimore, MD, USA. Electronic address: jhjaffe@aol.com.
authors.forename: Jerome H
authors.initials: JH
authors.lastname: Jaffe
mesh_terms: D000328:Adult; D001741:Black or African American; D002047:Buprenorphine / Q000627:therapeutic use*; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine
keywords: Buprenorphine; Buprenorphine diversion; Opioid dependence; Treatment retention