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Long-acting injectable depot buprenorphine from a harm reduction perspective in patients with ongoing substance use and multiple psychiatric comorbidities: a qualitative interview study
School of Social Work, Lund University, Lund, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Department of Social Work. Department of Psychiatry, County Hospital Jönköping, Jönköping, Sweden.ORCID iD: 0000-0002-1749-4727
Department of Psychiatry in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
2024 (English)In: Harm Reduction Journal, E-ISSN 1477-7517, Vol. 21, no 1, article id 68Article in journal (Refereed) Published
Abstract [en]

Background: Long-acting injectable depot buprenorphine may increase access to opioid agonist treatment (OAT) for patients with opioid use disorder in different treatment phases. The aim of this study was to explore the experiences of depot buprenorphine among Swedish patients with ongoing substance use and multiple psychiatric comorbidities.

Method: Semi-structured qualitative interviews were conducted with OAT patients with experience of depot buprenorphine. Recruitment took place at two OAT clinics with a harm reduction focus, specializing in the treatment of patients with ongoing substance use and multiple comorbidities. Nineteen participants were included, 12 men and seven women, with a mean age of 41 years (range 24–56 years), and a mean of 21 years (5–35 years) of experience with illicit substance use. All participants had ongoing substance use and psychiatric comorbidities such as ADHD, anxiety, mood, psychotic and eating disorders. Interviews were transcribed verbatim. Thematic content analysis was conducted both manually and using qualitative data analysis software.

Results: Participants reported social benefits and positive changes in self-perception and identity. In particular, depot buprenorphine contributed to a realization that it was possible to make life changes and engage in activities not related to substance use. Another positive aspect that emerged from the interviews was a noticeable relief from perceived pressure to divert OAT medication, while some expressed the lack of income from diverted oral/sublingual OAT medication as a negative, but still acceptable, consequence of the depot buprenorphine. Many participants considered that the information provided prior to starting depot buprenorphine was insufficient. Also, not all patients found depot buprenorphine suitable, and those who experienced coercion exhibited particularly negative attitudes towards the medication.

Conclusions: OAT patients with ongoing substance use and multiple psychiatric comorbidities reported clear benefits of depot buprenorphine, including changes in self-perception which has been theorized to play an important role in recovery. Clinicians should consider the specific information needs of this population and the extensive diversion of traditional OAT medications in this population to improve the treatment experience and outcomes. Overall, depot buprenorphine is a valuable treatment option for a population in need of harm reduction and may also contribute to psychological changes that may facilitate recovery in those with the greatest need.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024. Vol. 21, no 1, article id 68
Keywords [en]
Long-acting injectable depot buprenorphine, Opioid use disorder, Polydrug use, Psychiatric comorbidity, Qualitative interviews, Treatment, buprenorphine, adult, age distribution, anxiety disorder, Article, attention deficit hyperactivity disorder, clinical article, comorbidity, eating disorder, female, harm reduction, human, male, medication compliance, mental disease, mood disorder, opiate addiction, patient attitude, personal experience, psychosis, sex difference, substance abuse, Sweden, thematic analysis, treatment outcome, treatment response
National Category
Drug Abuse and Addiction
Identifiers
URN: urn:nbn:se:hj:diva-63921DOI: 10.1186/s12954-024-00984-1ISI: 001190938600001PubMedID: 38528531Scopus ID: 2-s2.0-85188521017Local ID: GOA;;944426OAI: oai:DiVA.org:hj-63921DiVA, id: diva2:1848224
Available from: 2024-04-02 Created: 2024-04-02 Last updated: 2025-02-11Bibliographically approved

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