Understanding the use of diverted buprenorphine

Drug Alcohol Depend. 2018 Dec 1;193:117-123. doi: 10.1016/j.drugalcdep.2018.09.007. Epub 2018 Oct 12.


Background: Buprenorphine is approved in many countries for the treatment of opioid use disorder (OUD), but problems with diversion and abuse exist. There is a need to understand how and why patients use diverted buprenorphine, and whether barriers to access contribute to illicit use.

Methods: Adults >18 years with DSM-IV criteria for substance use disorder and primarily using an opioid completed the online Survey of Key Informants' Patients (SKIP) between August and September 2016. The survey included closed- and open-ended questions regarding reasons for buprenorphine use with and without a prescription, sources of buprenorphine, route of administration, and barriers to treatment.

Results: Of 303 respondents, 175 (58%) reported a history of diverted buprenorphine use, 65 (37%) of whom reported never receiving a prescription. The most common reasons for illicit buprenorphine use were consistent with therapeutic use: to prevent withdrawal (79%), maintain abstinence (67%), or self-wean off drugs (53%). Approximately one-half (52%) reported using buprenorphine to get high or alter mood, but few (4%) indicated that it was their drug of choice. Among respondents who had used diverted buprenorphine, 33% reported that they had issues finding a doctor or obtaining buprenorphine on their own. Most (81%) of these participants indicated they would prefer using prescribed buprenorphine, if available.

Conclusions: Although 58% of survey respondents reported a history of using diverted buprenorphine, the most frequently cited reasons for non-prescription use were consistent with therapeutic use. Diversion was partially driven by barriers to access, and an unmet need for OUD treatment persists.

Keywords: Barriers to treatment; Buprenorphine; Diversion; Opioid use disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Analgesics, Opioid / therapeutic use*
  • Buprenorphine / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Opioid-Related Disorders / drug therapy*
  • Prescription Drug Diversion*
  • Surveys and Questionnaires
  • Young Adult


  • Analgesics, Opioid
  • Buprenorphine