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Published on: November 11, 2013
Homelessness and high-dosage buprenorphine misuse
T Blanchon1, A Boissonnas, I Vareseon
1Départment de Santé Publique, CHU Cochin-Port Royal, Assistance Publique Hôpitaux de Paris, Université René Descartes, Paris, France.
Substance Use & Misuse
|May 16, 2003
Summary
Homeless individuals who use intravenous drugs are more likely to misuse high dosage buprenorphine (HDB). This suggests HDB maintenance therapy may not be suitable for this vulnerable population.
Area of Science:
- Addiction medicine
- Public health
- Sociomedical sciences
Background:
- High dosage buprenorphine (HDB) is used in treating opioid dependence.
- Homelessness is a significant social determinant of health, potentially impacting treatment outcomes.
- Understanding the specific risks associated with HDB misuse in homeless populations is crucial for harm reduction.
Purpose of the Study:
- To investigate the association between homelessness and the misuse of high dosage buprenorphine (HDB) among intravenous drug users (IDUs).
- To identify if homeless IDUs exhibit different patterns of HDB misuse compared to non-homeless IDUs.
Main Methods:
- Cross-sectional study conducted between 1998 and 1999.
- Data collected via structured questionnaires from 779 intravenous drug users (IDUs).
- Participants recruited from diverse settings including treatment centers, healthcare networks, and support services.
Main Results:
- Homeless IDUs were significantly more likely to inject HDB (67% vs. 47%) and engage in unsafe injection practices.
- The initial HDB injection led to medical complications more frequently in homeless individuals (58% vs. 38%).
- Homeless IDUs reported less medical follow-up and poorer understanding of correct HDB usage.
Conclusions:
- Homelessness is a significant risk factor for high dosage buprenorphine (HDB) misuse among intravenous drug users (IDUs).
- Current HDB maintenance therapy may not be the most appropriate treatment strategy for homeless IDUs due to higher misuse rates and associated risks.
- Targeted interventions and alternative therapeutic approaches are warranted for homeless populations undergoing opioid dependence treatment.
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