Nalbuphine (Nubain): Non-Prescribed Use, Injecting, and Risk Behaviors for Blood-Borne Viruses

Abstract

Nalbuphine hydrochloride is a synthetic opiate with agonist-antagonist properties that has been prescribed for pain relief in several countries in North and Central America, Europe, and elsewhere. Marketed for several years under the tradename Nubain®, the drug was believed to have low potential for dependence. Research into nalbuphine misuse is limited but studies have documented misuse among some bodybuilders, weightlifters, and users of anabolic steroids. This study examines patterns of nalbuphine misuse and injecting behaviors that pose risk for blood-borne viruses among ten respondents residing largely in one community in Ireland. Contrary to other research findings, most individuals had no history of weightlifting and no experience with the use of anabolic steroids. Most of the respondents had injected nalbuphine several times per day, and reported frequent injection of stimulants. Tampered bottle caps had been observed by respondents who also reported that needles and syringes were scarce. At least some of the nalbuphine in the region has been found to be “counterfeit.” Implications of the findings are discussed.