Intravenous use of prescribed sublingual buprenorphine tablets by drug users receiving maintenance therapy in France

Background In 1996, sublingual buprenorphine was authorized for prescription in France for maintenance therapy (MT). MT should facilitate the rehabilitation of opioid-dependent drug users and reduce the risks associated with injection. However, misuse and side effects have been reported. Objectives: To assess the frequency of buprenorphine injection in 404 subjects on buprenorphine NIT and to determine the factors associated with the injection of buprenorphine. Methods: A cross-sectional survey was used to collect data from subjects on buprenorphine MT seeking treatment from health care networks, specialized structures, a prison and a hostel in three different regions of France (1998-1999). Information was collected by trained interviewers using a structured questionnaire. Results: About half (46.5%) of the subjects on NIT (188/404) had ever injected buprenorphine; 67.2% of this subgroup had since used both injected and sublingual buprenorphine. Variables associated with buprenorphine injection were having injected a substance other than buprenorphine (odds ratio (OR): 13.18; 95% CI: 5.36-32.42), cannabis use (OR: 2.34; 95% CI: 1.51-3.63) and having a source of income other than a salary (OR: 1.58; 95% CI: 1.02-2.45) and heroin use (OR: 0.23; 95% CI: 0.09-0.61). Conclusions: To decrease buprenorphine injection, prescribers of buprenorphine should participate in networks with specialized centers, and social and professional rehabilitation programs should be implemented for subjects on buprenorphine MT. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.