Tracing the affordances of long-acting injectable depot buprenorphine: A qualitative study of patients' experiences in Australia

Anthony Barnett; Michael Savic; Nicholas Lintzeris; Ramez Bathish; Shalini Arunogiri; Adrian J Dunlop; Paul Haber; Robert Graham; Vicky Hayes; Dan I Lubman

doi:10.1016/j.drugalcdep.2021.108959

Tracing the affordances of long-acting injectable depot buprenorphine: A qualitative study of patients' experiences in Australia

Drug Alcohol Depend. 2021 Oct 1:227:108959. doi: 10.1016/j.drugalcdep.2021.108959. Epub 2021 Aug 11.

Authors

Affiliations

¹ Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, VIC, Australia; Turning Point, Eastern Health, Richmond, VIC, Australia.
² South Eastern Sydney Local Heath District Drug and Alcohol Service, NSW, Australia; Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
³ Turning Point, Eastern Health, Richmond, VIC, Australia; Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University, Melbourne, VIC, Australia.
⁴ Drug & Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW, Australia; University of Newcastle, Callaghan, NSW, Australia.
⁵ Drug Health Services, Royal Prince Alfred Hospital, and Sydney Medical School, Camperdown, NSW, Australia.
⁶ Drug Health, Western Sydney Local Health District, Sydney, Australia; School of Medicine, Western Sydney University, Sydney, Australia.
⁷ South Eastern Sydney Local Heath District Drug and Alcohol Service, NSW, Australia; School of Public Health and Community Medicine, University of New South Wales, NSW, Australia.
⁸ Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, VIC, Australia; Turning Point, Eastern Health, Richmond, VIC, Australia. Electronic address: dan.lubman@monash.edu.

PMID: 34450472
DOI: 10.1016/j.drugalcdep.2021.108959

Abstract

Background: Long-acting injectable depot buprenorphine is an important new treatment option for the management of opioid dependence, delivering therapeutic doses in weekly or monthly formulations. Depot buprenorphine aims to overcome challenges associated with traditional opioid agonist therapy (OAT), including: poor patient adherence; inconvenience of regular attendance for dosing; and, risk of non-medical use of takeaway doses. However, little is known about patients' experiences of depot buprenorphine. This qualitative study aimed to explore patients' experiences of the practical and social affordances of depot buprenorphine.

Methods: Participants were recruited from sites in Sydney, regional New South Wales, and Melbourne, Victoria, Australia. Thirty participants (16 men, 14 women; mean age 47.3 years) participated in semi-structured interviews. Participants had histories of both heroin and prescription opioid use, and previous OAT including daily dosing of buprenorphine and methadone.

Findings: Depot buprenorphine afforded positive benefits for many participants, including: opportunities to avoid stigma experienced at pharmacies/clinics; time to engage in activities (e.g., travel, work) by releasing participants from previous OAT treatment regimens; and, cost savings by not having to pay pharmacy fees associated with daily dosing. However, for some participants, moving to depot buprenorphine: disrupted engagements with important social/practical supports available at pharmacies/clinics; constrained their control over dosing; and, constrained their ability to generate income via the sale of takeaway doses.

Conclusions: While generally experienced as affording benefits, depot buprenorphine can have differing social and practical impacts. Clinicians should monitor patients receiving depot buprenorphine to reduce the risk of unintended consequences including disruption to clinical supports.

Keywords: Australia; Buprenorphine; Depot injections; Opioid dependence; Opioid pharmacotherapy; Qualitative study.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Analgesics, Opioid / therapeutic use
Buprenorphine* / therapeutic use
Female
Humans
Male
Methadone / therapeutic use
Middle Aged
Narcotic Antagonists / therapeutic use
Opiate Substitution Treatment
Opioid-Related Disorders* / drug therapy
Victoria

Substances

Analgesics, Opioid
Narcotic Antagonists
Buprenorphine
Methadone