title: Injecting buprenorphine-naloxone film: Findings from an explorative qualitative study.
abstract: OBJECTIVE
  Experiences of buprenorphine-naloxone (BNX) sublingual film injection are not well documented or understood. We examined how people who inject BNX film seek and share information about this practice, document the methods used to prepare BNX film for injection, and report participants' experiences of this practice.
  
  
  METHODS
  Interviews were (n = 16) conducted with people who indicated that they had injected BNX film since its introduction onto the Australian market. Semistructured interviews were recorded and transcribed. NVivo10 program (QSR International) was used to analyse the data using qualitative description methodology.
  
  
  RESULTS
  Participants largely reported similar BNX film preparation techniques, although the texture of BNX film during preparation to inject was reported to be unusual (gluggy), and there were many varied accounts associated with the amount of water used. Physical harms reported as associated with injecting BNX film were described (including local and systemic issues); participants reported injecting the film to enhance its immediate effects, yet generally reported that sublingual administration provided longer-lasting effects.
  
  
  CONCLUSIONS
  Understanding knowledge acquisition about injecting new formulations of opioid substitution therapy is crucial in developing more effective harm-reduction strategies. Dissemination by peer networks to those who are currently or planning to inject BNX film regarding the 'gelatine like' texture when mixing, using only cold water and double filtering is important to ensure safer injecting practices. Findings from this study highlight the importance of peer networks for the dissemination of harm-reduction information. Introduction of new formulations internationally requires more qualitative studies to inform safer practices.
authors.affiliation: Discipline of Pharmacology, School of Medical Sciences, University of Adelaide, Adelaide, Australia.
authors.forename: Nancy
authors.identifier: http://orcid.org/0000-0002-2301-8778
authors.initials: N
authors.lastname: White
authors.affiliation: Department of Sociology and Social Policy, Sydney University, Sydney, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Flaherty
authors.affiliation: National Drug Research Institute, Faculty of Health Sciences, Curtin University, Melbourne, Australia.|Centre for Population Health, The Burnet Institute, Melbourne, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Higgs
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
authors.forename: Briony
authors.initials: B
authors.lastname: Larance
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Nielsen
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
authors.affiliation: Discipline of Pharmacology, School of Medical Sciences, University of Adelaide, Adelaide, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Ali
authors.affiliation: The Langton Centre, South Eastern Sydney Local Health District Drug and Alcohol Services, NSW Health, Sydney, Australia.|The Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lintzeris
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D001315:Australia; D000069479:Buprenorphine, Naloxone Drug Combination / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000523:psychology*; D063487:Prescription Drug Misuse / Q000523:psychology*; D036301:Qualitative Research; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D055815:Young Adult
chemical_list: D000069479:Buprenorphine, Naloxone Drug Combination
keywords: buprenorphine-naloxone; harm reduction; intravenous drug abuse; patient non-adherence; qualitative research