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Perceptions of extended‐release buprenorphine injections for opioid use disorder among people who regularly use opioids in Australia

journal contribution
posted on 10.11.2020, 00:05 by Briony Larance, Louisa Degenhardt, Jason Grebely, Suzanne Nielsen, Raimondo Bruno, Paul Dietze, Kari Lancaster, Sarah Larney, Thomas Santo, Marian Shanahan, Sonja Memedovic, Robert Ali, Michael Farrell
© 2019 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction Aims: To examine perceptions of extended-release (XR) buprenorphine injections among people who regularly use opioids in Australia. Design: Cross-sectional survey prior to implementation. XR-buprenorphine was registered in Australia in November 2018. Setting: Sydney, Melbourne and Hobart. Participants. A total of 402 people who regularly use opioids interviewed December 2017 to March 2018. Measurements: Primary outcome concerned the proportion of participants who believed XR-buprenorphine would be a good treatment option for them, preferred weekly versus monthly injections and perceived advantages/disadvantages of XR-buprenorphine. Independent variables concerned the demographic characteristics and features of current opioid agonist treatment (OAT; medication-type, dose, prescriber/dosing setting, unsupervised doses, out-of-pocket expenses and travel distance). Findings: Sixty-eight per cent [95% confidence interval (CI) = 63–73%] believed XR-buprenorphine was a good treatment option for them. They were more likely to report being younger [26–35 versus > 55 years; odds ratio (OR) = 3.16, 95% CI = 1.12–8.89; P = 0.029], being female (OR = 1.67, 95% CI = 1.04–2.69; P = 0.034), < 10 years school education (OR = 1.87, 95% CI = 1.12–3.12; P = 0.016) and past-month heroin (OR = 1.81, 95% CI = 1.15–2.85; P = 0.006) and methamphetamine use (OR = 1.90, 95% CI = 1.20–3.01; P = 0.006). Fifty-four per cent reported no preference for weekly versus monthly injections, 7% preferred weekly and 39% preferred monthly. Among OAT recipients (n = 255), believing XR-buprenorphine was a good treatment option was associated with shorter treatment episodes (1–2 versus ≥ 2 years; OR = 3.93, 95% CI = 1.26–12.22; P = 0.018), fewer unsupervised doses (≤ 8 doses past-month versus no take-aways; OR = 0.50; 95% CI = 0.27–0.93; P = 0.028) and longer travel distance (≥ 5 versus < 5 km; OR = 2.10, 95% CI = 1.20–3.65; P = 0.009). Sixty-nine per cent reported ‘no problems or concerns’ with potential differences in availability, flexibility and location of XR-buprenorphine. Conclusions: Among regular opioid users in Australia, perceptions of extended-release buprenorphine as a good treatment option are associated with being female, recent illicit drug use and factors relating to the (in)convenience of current opioid agonist treatment.

Funding

This study was sponsored by UNSW and supported by an Externally Sponsored Collaborative Research grant from Indivior. Indivior contributed to the study design and analysis plan; Indivior had no role in collection, analysis and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. L.D. (#1135991), S.N. (#1132433 and #1163961) and S.L. (#1140938) are supported by NHMRC research fellowships. LD is also supported by NIH grant NIDA R01DA1104470. S.L. receives additional support from a UNSW Sydney Scientia Fellowship. The National Drug and Alcohol Research Centre at UNSW Sydney is supported by funding from the Australian Government Department of Health under the Drug and Alcohol Program. The authors thank the study participants for generously sharing their views and experiences, Alexander Saeri, who coordinated the project and helped design the questionnaire and Nima Dorkian, Rakin Rahman, Oliver de Angelis, Jessica Forward, Thomas Norman, Jane Akhurst, Luke Ney, Daisy Gibbs, Teleri Moore, Isaac Addo and Kelly Kershaw, who assisted with interviewing participants. Thanks also go to Nick Lintzeris, who made comments on an earlier manuscript draft.

NHMRC | 1135991

NHMRC | 1132433

NHMRC | 1163961

NHMRC | 1140938

NIH | NIDA R01DA1104470

UNSW Sydney Scientia Fellowship

Australian Government Department of Health under the Drug and Alcohol Program

UNSW

Indivior

History

Publication Date

01/07/2020

Journal

Addiction

Volume

115

Issue

7

Pagination

11p. (p. 1295-1305)

Publisher

Wiley

ISSN

0965-2140

Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

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