Understanding the Misuse of Buprenorphine in Addiction Treatment

Many substance abuse treatment centers use a medication called buprenorphine to alleviate the withdrawal symptoms of opioid dependent individuals who wish to discontinue use of opioids. While buprenorphine has been successfully used to assist opioid users in quitting, it is often misused.

A new study examines the misuse of buprenorphine. Schuman-Olivier and colleagues (2010) investigated whether opioid dependent individuals use buprenorphine improperly to achieve feelings of euphoria or if they are using it to alleviate the difficulties of opioid withdrawal.

The researchers also hoped to understand the pervasiveness of the use of buprenorphine as an illegal drug and how buprenorphine use is less common among opioid users who are enrolled in more comprehensive treatment for opioid dependence.

The study was conducted in an outpatient substance abuse treatment center in New England. The participants were all diagnosed as opioid dependent using DSM-IV criteria. The participants included 44 individuals who were interested in treatment using buprenorphine and 34 patients who were currently using buprenorphine.

The participants were asked to complete, along with other measures, the Buprenorphine Beliefs and Behaviors Questionnaire, to understand their motivation to use buprenorphine; and the Illicit Buprenorphine Use Questionnaire, to assess whether patients were using buprenorphine as an illicit drug. The questionnaires were completed again three months after the original administration by 42 of the participants.

Results determined that 49 percent of the participants who completed questionnaires in the first stage used buprenorphine illicitly. The remaining 61 percent of the illicit use was among new patients who did not yet have access to a doctor’s prescription.

The participants reported that they reduced distress by using buprenorphine, and did not use it as a way to get high. The participants used buprenorphine to self-treat opioid dependence, anxiety and pain. Illicit users were more likely to use buprenorphine to prevent withdrawal, ease pain and treat depression.

The study’s findings may be limited by its small sample size and its short duration. Three months may not be enough time to understand the use of buprenorphine over a long period of recovery from opioid addiction.
The illicit use of buprenorphine went down significantly after new patients were given access to buprenorphine by doctor prescription. Also, the study shows that the individuals who used illegal buprenorphine were using it to self-treat their opioid dependence, rather than using it to get high.
The study indicates that when given buprenorphine through a prescription, opioid users are reducing their illegal use of the medication. The information provided by this study may help policy makers understand use of buprenorphine in treatment for opioid addiction.