Lack of reduction in buprenorphine injection after introduction of co-formulated buprenorphine/naloxone to the Malaysian market
Background: Diversion of buprenorphine (BPN) has been described in settings where it is legally prescribed and has resulted in increasing concern. To address this concern, co-formulation of buprenorphine/naloxone (BPN/NLX) replaced buprenorphine alone in Malaysia in December 2006. Methods: To assess...
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| Format: | Article |
| Language: | English |
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2009
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| Online Access: | http://eprints.um.edu.my/4596/1/Lack_of_Reduction_in_Buprenorphine_Injection_After_Introduction_of_Co-Formulated_Buprenorphine-Naloxone_to_the_Malaysian_Market.pdf |
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| author | Bruce, R.D. Govindasamy, S. Sylla, L. Kamarulzaman, A. Altice, F.L. |
| author_facet | Bruce, R.D. Govindasamy, S. Sylla, L. Kamarulzaman, A. Altice, F.L. |
| author_sort | Bruce, R.D. |
| collection | UM |
| description | Background: Diversion of buprenorphine (BPN) has been described in settings where it is legally prescribed and has resulted in increasing concern. To address this concern, co-formulation of buprenorphine/naloxone (BPN/NLX) replaced buprenorphine alone in Malaysia in December 2006. Methods: To assess the significance of BPN/NLX introduction, 41 BPN/NLX injectors in Kuala Lumpur, Malaysia were recruited using a modified snowball recruitment technique. Results: In January 2007, all subjects had previously injected BPN alone. During the transition from injecting BPN alone to co-formulated BPN/NLX, the mean daily BPN injection dose increased from 1.88 mg (range 1.0-4.0 mg) to 2.49 mg/day (p .001). Overall, 18 (44) subjects increased their daily amount of injection while 22 (54) had no change in dose; only one subject reduced the amount of injection. Development of opioid withdrawal symptoms was the primary outcome, however the only symptom that was significantly associated with BPN/NLX dosage was the report of stomach pains (p = .01). In logistic regression analysis, the development of opioid withdrawal symptoms was associated with increased benzodiazepine injection and increased syringe sharing. Conclusion and Scientific Significance: These data suggests that the introduction of BPN/NLX did not reduce injection related risk behaviors such as syringe sharing and was associated with increased benzodiazepine use. Evidence-based approaches to treat BPN injection are urgently needed. |
| first_indexed | 2024-03-06T05:12:21Z |
| format | Article |
| id | um.eprints-4596 |
| institution | Universiti Malaya |
| language | English |
| last_indexed | 2024-03-06T05:12:21Z |
| publishDate | 2009 |
| record_format | dspace |
| spelling | um.eprints-45962013-01-29T01:57:06Z http://eprints.um.edu.my/4596/ Lack of reduction in buprenorphine injection after introduction of co-formulated buprenorphine/naloxone to the Malaysian market Bruce, R.D. Govindasamy, S. Sylla, L. Kamarulzaman, A. Altice, F.L. R Medicine Background: Diversion of buprenorphine (BPN) has been described in settings where it is legally prescribed and has resulted in increasing concern. To address this concern, co-formulation of buprenorphine/naloxone (BPN/NLX) replaced buprenorphine alone in Malaysia in December 2006. Methods: To assess the significance of BPN/NLX introduction, 41 BPN/NLX injectors in Kuala Lumpur, Malaysia were recruited using a modified snowball recruitment technique. Results: In January 2007, all subjects had previously injected BPN alone. During the transition from injecting BPN alone to co-formulated BPN/NLX, the mean daily BPN injection dose increased from 1.88 mg (range 1.0-4.0 mg) to 2.49 mg/day (p .001). Overall, 18 (44) subjects increased their daily amount of injection while 22 (54) had no change in dose; only one subject reduced the amount of injection. Development of opioid withdrawal symptoms was the primary outcome, however the only symptom that was significantly associated with BPN/NLX dosage was the report of stomach pains (p = .01). In logistic regression analysis, the development of opioid withdrawal symptoms was associated with increased benzodiazepine injection and increased syringe sharing. Conclusion and Scientific Significance: These data suggests that the introduction of BPN/NLX did not reduce injection related risk behaviors such as syringe sharing and was associated with increased benzodiazepine use. Evidence-based approaches to treat BPN injection are urgently needed. 2009 Article PeerReviewed application/pdf en http://eprints.um.edu.my/4596/1/Lack_of_Reduction_in_Buprenorphine_Injection_After_Introduction_of_Co-Formulated_Buprenorphine-Naloxone_to_the_Malaysian_Market.pdf Bruce, R.D. and Govindasamy, S. and Sylla, L. and Kamarulzaman, A. and Altice, F.L. (2009) Lack of reduction in buprenorphine injection after introduction of co-formulated buprenorphine/naloxone to the Malaysian market. American Journal of Drug and Alcohol Abuse, 35 (2). pp. 68-72. ISSN 0095-2990, |
| spellingShingle | R Medicine Bruce, R.D. Govindasamy, S. Sylla, L. Kamarulzaman, A. Altice, F.L. Lack of reduction in buprenorphine injection after introduction of co-formulated buprenorphine/naloxone to the Malaysian market |
| title | Lack of reduction in buprenorphine injection after introduction of co-formulated buprenorphine/naloxone to the Malaysian market |
| title_full | Lack of reduction in buprenorphine injection after introduction of co-formulated buprenorphine/naloxone to the Malaysian market |
| title_fullStr | Lack of reduction in buprenorphine injection after introduction of co-formulated buprenorphine/naloxone to the Malaysian market |
| title_full_unstemmed | Lack of reduction in buprenorphine injection after introduction of co-formulated buprenorphine/naloxone to the Malaysian market |
| title_short | Lack of reduction in buprenorphine injection after introduction of co-formulated buprenorphine/naloxone to the Malaysian market |
| title_sort | lack of reduction in buprenorphine injection after introduction of co formulated buprenorphine naloxone to the malaysian market |
| topic | R Medicine |
| url | http://eprints.um.edu.my/4596/1/Lack_of_Reduction_in_Buprenorphine_Injection_After_Introduction_of_Co-Formulated_Buprenorphine-Naloxone_to_the_Malaysian_Market.pdf |
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