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Buprenorphine abuse in India : an update
1YOGESH SHARMA, MBBS., Junior Resident, Department of Psychiatry, Post Graduate Institute of Medical Education & Research, Chandigarh-160 012.
Indian Journal of Psychiatry
|April 2, 2011
Summary
Indian literature review shows buprenorphine abuse peaked in 1994, often used as an opioid substitute. Despite initial symptom control, high dependence rates caution against its widespread use for opioid detoxification and maintenance.
Area of Science:
- Pharmacology
- Addiction Medicine
- Public Health
Background:
- Buprenorphine, introduced in India in 1986, saw a rapid increase in abuse starting in 1987.
- Abuse was often as a readily available, inexpensive substitute for opioids, initiated by other users and healthcare professionals.
Purpose of the Study:
- To review and analyze the available Indian literature on buprenorphine abuse patterns and clinical implications.
- To assess the efficacy and risks of buprenorphine in opioid detoxification and maintenance based on Indian data.
Main Methods:
- Systematic review of Indian scientific literature concerning buprenorphine abuse.
- Analysis of reported trends in abuse, user demographics, methods of administration, and associated complications.
Main Results:
- Buprenorphine abuse increased sharply until 1994, followed by a gradual decline.
- Abusers were typically young adult males using intravenous combinations for enhanced effects; withdrawal symptoms were opioid-like.
- Complications included pseudoaneurysm and recurrent koro; while effective for short-term opioid withdrawal symptom control, buprenorphine induction of dependence was noted.
Conclusions:
- Indian data suggests caution regarding the enthusiastic adoption of buprenorphine for opioid detoxification and maintenance, contrasting with Western perspectives.
- The potential for high dependence induction necessitates careful consideration of buprenorphine's role in addiction treatment in the Indian context.
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