Are patients' pejorative representations of buprenorphine associated with their level of addiction and of misuse?

Drug Alcohol Depend. 2018 Jul 1:188:10-15. doi: 10.1016/j.drugalcdep.2018.03.033. Epub 2018 Apr 27.

Abstract

Background: In France, buprenorphine is at once the most widely prescribed and the most commonly misused opioid maintenance treatment (OMT). Unlike other medicines, it is seldom prescribed as a generic drug. Several studies have underlined the influence of the patient's representations when choosing brand-name rather than generic forms. We aim to prove a link between these pejorative representations and misuse, a higher degree of addiction and a preference for brand-name products.

Methods: An observational study carried out at 11 sites in France using self-assessment questionnaires filled out in dispensing pharmacies by patients having come to them for buprenorphine delivery.

Results: Analysis was based on 806 usable questionnaires. There indeed exists a significant correlation between pejorative representations of OMT by means of buprenorphine, and a higher degree of addiction and misuse (p < .0001 for each). Preference for the brand-name product is correlated with the representation of OMT as a "trap" (p = .020).

Conclusion: Our results underscore the existence of a link between patients' negative representations of their OMT and their drug-taking behavior. Prescribing physicians should consequently take these representations into account to more precisely identify the relevant behaviors and help their patients to evolve positively.

Keywords: Buprenorphine; Generic; Opioid maintenance treatment; Substance abuse.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Analgesics, Opioid / administration & dosage*
  • Behavior, Addictive / drug therapy
  • Behavior, Addictive / epidemiology*
  • Behavior, Addictive / psychology*
  • Buprenorphine / administration & dosage*
  • Cross-Sectional Studies
  • Female
  • France / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Opiate Substitution Treatment / methods
  • Opiate Substitution Treatment / psychology
  • Opioid-Related Disorders / drug therapy
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / psychology*
  • Surveys and Questionnaires

Substances

  • Analgesics, Opioid
  • Buprenorphine