Information from a nationally consultant survey point out that in 2019, practically three-fourths of U.S. adults reporting buprenorphine use didn’t misuse the treatment previously 12 months. As well as, buprenorphine misuse amongst individuals with opioid use dysfunction trended downward between 2015-2019, regardless of will increase within the variety of individuals receiving buprenorphine therapy. The research, revealed right this moment in JAMA Community Open, was carried out by the Nationwide Institute on Drug Abuse (NIDA), a part of the Nationwide Institutes of Well being, and the Facilities for Illness Management and Prevention.
Buprenorphine is an FDA-approved treatment to deal with opioid use dysfunction and to alleviate extreme ache. Buprenorphine used to deal with opioid use dysfunction works by partially activating opioid receptors within the mind, which might help cut back opioid cravings, withdrawal, and general use of different opioids.
In 2020, greater than 93,000 individuals misplaced their lives resulting from drug overdoses, with 75% of these deaths involving an opioid. Nevertheless, in 2019, lower than 18% of individuals with a past-year opioid use dysfunction acquired drugs to deal with their dependancy, partially resulting from stigma and obstacles to accessing these drugs. To prescribe buprenorphine for therapy of opioid use dysfunction, clinicians should achieve this inside a licensed Opioid Therapy Program, or submit a discover of intent to the federal authorities, and are restricted in what number of sufferers they will deal with at one time. Solely a small proportion of clinicians are eligible to deal with opioid use dysfunction with buprenorphine, and even fewer prescribe the treatment.
Top quality medical apply requires supply of protected and efficient remedies for well being situations, together with substance use problems. This consists of offering lifesaving drugs to individuals affected by an opioid use dysfunction. This research gives additional proof to help the necessity for expanded entry to confirmed therapy approaches, comparable to buprenorphine remedy, regardless of the remaining stigma and prejudice that continues to be for individuals with dependancy and the drugs used to deal with it.”
Nora D. Volkow, M.D., NIDA Director
In April 2021, the U.S. Division of Well being and Human Companies launched up to date buprenorphine apply pointers to broaden entry to therapy for opioid use dysfunction. Nevertheless, obstacles to using this therapy stay, together with supplier unease with managing sufferers with opioid use dysfunction, lack of enough insurance coverage reimbursement, and issues about dangers for diversion, misuse, and overdose. Misuse is outlined as sufferers taking drugs in a means not beneficial by a doctor, and might embrace consuming another person’s prescription treatment, or taking one’s personal prescription in bigger quantities, extra frequent doses, or for an extended length than directed.
To raised perceive buprenorphine use and misuse, researchers analyzed information on use and misuse of prescription opioids, together with buprenorphine, from the 2015-2019 Nationwide Surveys on Drug Use and Well being (NSDUH). The NSDUH is carried out yearly by the Substance Abuse and Psychological Well being Companies Administration. It gives nationally consultant information on prescription opioid use, misuse, opioid use dysfunction, and motivation for the latest misuse amongst U.S. civilian, noninstitutionalized populations.
The researchers discovered that nearly three-fourths of U.S. adults who reported buprenorphine use in 2019 didn’t misuse buprenorphine previously 12 months. General, an estimated 1.7 million individuals reported utilizing buprenorphine as prescribed previously yr, in contrast with 700,000 individuals who reported misusing the treatment. Furthermore, the proportion of individuals with opioid use dysfunction who misused buprenorphine trended downward over the research interval, regardless of latest will increase within the variety of sufferers receiving buprenorphine therapy.
Importantly, for adults with opioid use dysfunction, the commonest motivations for the latest buprenorphine misuse have been “as a result of I’m hooked” on opioids (27.3%), indicating that individuals could also be taking buprenorphine with out a prescription to self-treat craving and withdrawal signs related to opioid use dysfunction, and “to alleviate bodily ache” (20.5%). Furthermore, amongst adults with buprenorphine use, these receiving drug use therapy have been much less prone to misuse buprenorphine than these not receiving drug use therapy. Collectively, these findings spotlight the pressing have to broaden entry to buprenorphine therapy, as a result of receipt of therapy might assist cut back buprenorphine misuse. Moreover, it’s essential to develop methods to proceed to observe and cut back buprenorphine misuse.
The research additionally discovered that individuals who acquired no drug use therapy and those that lived in rural areas have been extra prone to misuse the treatment. Nevertheless, different elements, comparable to being a racial/ethnic minority or residing in poverty, had no impact on buprenorphine misuse. The research authors urged that to deal with the present opioid disaster, each entry to and high quality of buprenorphine therapy for individuals with opioid use dysfunction must be improved.
“Three-quarters of adults taking buprenorphine don’t misuse the drug,” mentioned Wilson Compton, M.D., M.P.E., Deputy Director of NIDA and senior writer of the research. “Many individuals with opioid use dysfunction need assist, and as clinicians, we should deal with their sickness. This research additionally underscores the urgency of addressing racial and ethnic, medical insurance, financial, and geographic disparities in therapy entry, to make sure that everybody with opioid use dysfunction can entry this lifesaving treatment.”
Nationwide Institutes of Well being
Han, B., et al. (2021) Traits in and Traits of Buprenorphine Misuse Amongst Adults within the US. JAMA Community Open. doi.org/10.1001/jamanetworkopen.2021.29409.
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