'Diversion’ of methadone or buprenorphine: 'harm’ versus 'helping’

Harm Reduction Journal

Anne-Lise Middelthon¹  Thomas Clausen²  Ingrid Amalia Havnes² 

[1] Institute of Health and Society, University of Oslo, Blindern, PO Box 1130, Oslo 0318, Norway;SERAF - Norwegian Centre for Addiction Research, University of Oslo, PO Box 1039, Oslo 0315, Norway

关键词: Reciprocity;    Buprenorphine;    Methadone;    Opioid maintenance treatment;    Diversion;   

Others  :  809836
DOI  :  10.1186/1477-7517-10-24

 received in 2013-08-06, accepted in 2013-10-12,  发布年份 2013

【 摘 要 】

Background

'Non-compliant’ individuals in opioid maintenance treatment, OMT, are often met with tight control regimes to reduce the risk of 'diversion’, which may lead to harm or death among persons outside of OMT. This article explores reported practices of, and motivations for, diversion of methadone and buprenorphine, in a group of imprisoned individuals in OMT.

Findings

28 in-depths interviews were conducted among 12 OMT-enrolled, imprisoned individuals, most of whom were remand prisoners. All had experienced tight control regimes prior to imprisonment due to varying degrees of 'non-compliance’ and illicit drug use during treatment. Their acquired norm of sharing with others in a drug using community was maintained when entering OMT. Giving one’s prescription opioids to an individual in withdrawal was indeed seen as an act of helping, something that takes on particular significance for couples in which only one partner is included in OMT and the other is using illicit heroin. Individuals enrolled in OMT might thus be trapped between practicing norms of helping and sharing and adhering to treatment regulations. ’Diversion’, as this term is conventionally used, is not typically understood as practices of giving and helping, but may nevertheless be perceived as such by those who undertake them.

Conclusions

As we see it, the need to sustain oneself as a decent person in one’s own eyes and those of others through practices such as sharing and helping should be recognized. Treatment providers should consider including couples in which both individuals are motivated for starting OMT.

【 授权许可】

   
2013 Havnes et al.; licensee BioMed Central Ltd.

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