Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic review
Abstract Background and Aims Given the ongoing opioid crisis, novel interventions to treat severe opioid use disorder (OUD) are urgently needed. Injectable opioid agonist therapy (iOAT) with diacetylmorphine or hydromorphone is effective for the treatment of severe, treatment-refractory OUD, however...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12954-022-00695-5 |
| _version_ | 1798029831918583808 |
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| author | Nikki Bozinoff Vitor Tardelli Dafna Sara Rubin-Kahana Bernard Le Foll |
| author_facet | Nikki Bozinoff Vitor Tardelli Dafna Sara Rubin-Kahana Bernard Le Foll |
| author_sort | Nikki Bozinoff |
| collection | DOAJ |
| description | Abstract Background and Aims Given the ongoing opioid crisis, novel interventions to treat severe opioid use disorder (OUD) are urgently needed. Injectable opioid agonist therapy (iOAT) with diacetylmorphine or hydromorphone is effective for the treatment of severe, treatment-refractory OUD, however barriers to implementation persist. Intravenous buprenorphine for the treatment of OUD (BUP iOAT) has several possible advantages over traditional iOAT, including a safety profile that might enable take-home dosing. We aimed to characterize injecting practices among real-world populations of persons who regularly inject buprenorphine, as well as associated adverse events reported in order to inform a possible future BUP iOAT intervention. Methods We conducted a systematic review. We searched MEDLINE, EMBASE, and PsycINFO from inception through July 2020 and used backwards citation screening to search for publications reporting on dose, frequency among persons who regularly inject the drug, or adverse events associated with intravenous use of buprenorphine. The review was limited to English language publications and there was no limitation on study type. Study quality and risk of bias was assessed using the Mixed Methods Appraisal Tool. Narrative synthesis was used in reporting the results. Results Eighty-eight studies were included in our review. Regular injection of buprenorphine was identified across diverse settings world-wide. Daily dose of oral buprenorphine injected was < 1–12 mg. Frequency of injection was 0–10 times daily. Adverse events could be characterized as known side effects of opioids/buprenorphine or injection-related complications. Most studies were deemed to be of low quality. Conclusions Extramedical, intravenous use of buprenorphine, continues to be documented. BUP iOAT may be feasible and results may inform the development of a study to test the efficacy and safety of such an intervention. Future work should also examine acceptability among people with severe OUD in North America. Our review was limited by the quality of included studies. |
| first_indexed | 2024-04-11T19:30:41Z |
| format | Article |
| id | doaj.art-4120daaf19a84067b69bbbacd1731264 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-04-11T19:30:41Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-4120daaf19a84067b69bbbacd17312642022-12-22T04:06:59ZengBMCHarm Reduction Journal1477-75172022-10-0119111910.1186/s12954-022-00695-5Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic reviewNikki Bozinoff0Vitor Tardelli1Dafna Sara Rubin-Kahana2Bernard Le Foll3Campbell Family Mental Health Research Institute, Centre for Addiction and Mental HealthDepartamento de Psiquiatria, Universidade Federal de Sao PauloTranslational Addiction Research Laboratory, Centre for Addiction and Mental HealthDepartment of Family and Community Medicine, University of TorontoAbstract Background and Aims Given the ongoing opioid crisis, novel interventions to treat severe opioid use disorder (OUD) are urgently needed. Injectable opioid agonist therapy (iOAT) with diacetylmorphine or hydromorphone is effective for the treatment of severe, treatment-refractory OUD, however barriers to implementation persist. Intravenous buprenorphine for the treatment of OUD (BUP iOAT) has several possible advantages over traditional iOAT, including a safety profile that might enable take-home dosing. We aimed to characterize injecting practices among real-world populations of persons who regularly inject buprenorphine, as well as associated adverse events reported in order to inform a possible future BUP iOAT intervention. Methods We conducted a systematic review. We searched MEDLINE, EMBASE, and PsycINFO from inception through July 2020 and used backwards citation screening to search for publications reporting on dose, frequency among persons who regularly inject the drug, or adverse events associated with intravenous use of buprenorphine. The review was limited to English language publications and there was no limitation on study type. Study quality and risk of bias was assessed using the Mixed Methods Appraisal Tool. Narrative synthesis was used in reporting the results. Results Eighty-eight studies were included in our review. Regular injection of buprenorphine was identified across diverse settings world-wide. Daily dose of oral buprenorphine injected was < 1–12 mg. Frequency of injection was 0–10 times daily. Adverse events could be characterized as known side effects of opioids/buprenorphine or injection-related complications. Most studies were deemed to be of low quality. Conclusions Extramedical, intravenous use of buprenorphine, continues to be documented. BUP iOAT may be feasible and results may inform the development of a study to test the efficacy and safety of such an intervention. Future work should also examine acceptability among people with severe OUD in North America. Our review was limited by the quality of included studies.https://doi.org/10.1186/s12954-022-00695-5BuprenorphineOpioid use disorderOpioidsiOATOverdoseIntravenous |
| spellingShingle | Nikki Bozinoff Vitor Tardelli Dafna Sara Rubin-Kahana Bernard Le Foll Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic review Harm Reduction Journal Buprenorphine Opioid use disorder Opioids iOAT Overdose Intravenous |
| title | Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic review |
| title_full | Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic review |
| title_fullStr | Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic review |
| title_full_unstemmed | Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic review |
| title_short | Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic review |
| title_sort | patterns of use and adverse events reported among persons who regularly inject buprenorphine a systematic review |
| topic | Buprenorphine Opioid use disorder Opioids iOAT Overdose Intravenous |
| url | https://doi.org/10.1186/s12954-022-00695-5 |
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