Abstract
BackgroundThe non-compliant use of opioid substitution treatment (OST) medicines is widespread and well-documented. However, less is known about characteristics of non-compliant OST medicine use and the factors that predict it. The two main goals of this study are to compare characteristics of non-compliant levomethadone, methadone, and buprenorphine use and to explore factors that may differentially predict it among opioid dependent persons in treatment.MethodsData from 595 opioid dependent patients with non-compliant OST medicine use were analyzed. Characteristics of use between substances were compared using chi-squared tests and predictive factors were explored through multinomial logistic regressions.ResultsNon-compliant levomethadone and methadone use was characterized by more frequent parallel consumption of other psychoactive substances and intravenous use, whereas buprenorphine was more often procured without a prescription. Regarding predictive factors, methadone was perceived to relieve withdrawal symptoms better than buprenorphine and levomethadone was perceived as being better at modulating the effects of other substances and worst at enhancing mood.ConclusionsPatterns of non-compliant use differ according to OST medicine. These patterns are considered with the reduction of non-compliant use and the improvement of treatment in mind.
Highlights
The non-compliant use of opioid substitution treatment (OST) medicines is widespread and well-documented
Sample A total of 595 cases of non-compliant OST medicine use was recorded. These cases corresponded to 79 cases of levomethadone use, 297 cases of methadone use, and 219 cases of buprenorphine use
Comparison of the characteristics of non-compliant OST medicine use Figure 1 provides an overview of the characteristics of non-compliant use for each of the three OST medicines
Summary
The non-compliant use of opioid substitution treatment (OST) medicines is widespread and well-documented. Less is known about characteristics of non-compliant OST medicine use and the factors that predict it. The two main goals of this study are to compare characteristics of non-compliant levomethadone, methadone, and buprenorphine use and to explore factors that may differentially predict it among opioid dependent persons in treatment. Opioid maintenance or substitution treatment (OST) has expanded to include buprenorphine in 2000 and diamorphine in 2009 [2] and is considered to be widespread and well-established [1]. The pharmacological effectiveness of levomethadone and methadone as OST medicines relies on the levorotary form found in both substances Their overall effects are not identical as the dextrorotary form in racemic methadone has been found to produce additional side effects [6]. Take-home methadone and levomethadone are dyed and made thicker before being handed out so as to be more difficult to inject [9]
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