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Published on: September 1, 2016
Buprenorphine use: the international experience.
Maria Patrizia Carrieri1, Leslie Amass, Gregory M Lucas
1INSERM U379, Marseilles, France. Pmcarrieri@aol.com
Summary
Buprenorphine and methadone offer effective treatment for heroin and human immunodeficiency virus (HIV) epidemics. Expanded access may reduce overdose deaths and HIV spread among injection drug users.
Area of Science:
- Addiction Medicine
- Infectious Disease Epidemiology
- Public Health Policy
Background:
- The co-occurrence of heroin injection and human immunodeficiency virus (HIV) epidemics necessitates expanded treatment access.
- Buprenorphine and methadone are recognized as essential medicines by the World Health Organization.
Purpose of the Study:
- To review the effectiveness and challenges of buprenorphine and methadone treatment models for opioid use disorder and HIV.
- To examine buprenorphine diversion factors and international treatment approaches.
Main Methods:
- Review of existing literature and treatment models from France, the United States, Australia, Germany, and Italy.
- Analysis of buprenorphine diversion factors, including dosage, social vulnerability, and prescribing practices.
Main Results:
- France's extensive buprenorphine program is linked to a significant reduction in overdose deaths.
- Buprenorphine diversion is associated with insufficient dosing, social challenges, and polypharmacy.
- International treatment models and specific population use are also discussed.
Conclusions:
- Buprenorphine and methadone are crucial tools for managing dual heroin and HIV epidemics.
- Expanding access to these medications can reduce HIV transmission and improve healthcare engagement for injection drug users.
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