Suboxone misuse along the opiate maintenance treatment pathway

Area of Science:

• Addiction Medicine
• Clinical Psychology
• Public Health

Background:

• Suboxone (buprenorphine/naloxone) is a common treatment for opioid use disorder.
• Patient adherence and treatment strategies can significantly impact outcomes.
• Understanding patient-driven coping mechanisms is crucial for effective addiction treatment.

Purpose of the Study:

• To explore the strategies employed by individuals misusing Suboxone while undergoing drug treatment.
• To identify how patients manage opioid/opiate dependency intermittently during Suboxone therapy.

Main Methods:

• Qualitative study utilizing ethnographic interviews.
• Conducted with 14 patients with a history of cycling in and out of Suboxone treatment.
• Focus on understanding patient-reported strategies in a Harm Reduction setting.

Main Results:

• Some patients intentionally stop and restart Suboxone treatment.
• Patients reported a sequential use of Suboxone and heroin to avoid withdrawal.
• This pattern was observed as a method to sustain opioid/opiate misuse during treatment.

Conclusions:

• Patient strategies for managing opioid use disorder can be complex and counterintuitive.
• Harm Reduction settings may inadvertently facilitate continued misuse for some patients.
• Treatment approaches need to adapt to address these patient-driven strategies for improved efficacy.