Journal Mobile Options
Table of Contents
Vol. 16, No. 1, 2010
Issue release date: January 2010
Section title: Research Report
Eur Addict Res 2010;16:1–8
(DOI:10.1159/000253858)

Why Do the Clients of Georgian Needle Exchange Programmes Inject Buprenorphine?

Otiashvili D. · Zabransky T. · Kirtadze I. · Piralishvili G. · Chavchanidze M. · Miovsky M.
aDepartment of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic; bAddiction Research Center, Union Alternative Georgia, Tbilisi, Georgia; cCenter for Addictology, Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic

Do you have an account?

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger (new!)
  • Unrestricted printing, no saving restrictions for personal use
  • Reduced rates with a PPV account
read more

Direct: USD 38.00
Account: USD 26.50

Select

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restriction apply

Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

  • Automatic perpetual access to all articles of the subscribed year(s)
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select


Article / Publication Details

First-Page Preview
Abstract of Research Report

Published online: 11/2/2009

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 2

ISSN: 1022-6877 (Print)
eISSN: 1421-9891 (Online)

For additional information: http://www.karger.com/EAR

Abstract

Aim: The aim of the study was to understand the prevalence and patterns of the non-medical injecting use of buprenorphine among drug injectors in Georgia. Method: A self-administered questionnaire was distributed among injecting drug users enrolled in Georgian needle exchange programmes. The questions covered topics related to drug use career, patterns (frequency, history, dosage) and reasons for the use of buprenorphine. Results: Pharmaceutical buprenorphine in the form of Subutex® was the most commonly injected drug in terms of lifetime (95.5%) and last-month (75%) prevalence of use. 48% of those study participants who had injected Subutex at some point reported having used it to cope with withdrawal or to give up other opioids. 90.5% of Subutex injectors used 1–2 mg as a single dose, and the mean frequency of its injection was 6 times per month. 75% of Subutex injectors had used 3 or more types of illegal drugs during the last 30 days. Conclusion: While widely misused by Georgian drug injectors, Subutex is neither the principal nor the favourite drug, and it is rather used as self-treatment. The authors consider the introduction of buprenorphine maintenance treatment to be a promising effective measure to decrease its non-medical and illegal use.


Article / Publication Details

First-Page Preview
Abstract of Research Report

Published online: 11/2/2009

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 2

ISSN: 1022-6877 (Print)
eISSN: 1421-9891 (Online)

For additional information: http://www.karger.com/EAR


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Ling W, Charuvastra C, Collins JF, et al: Buprenorphine maintenance treatment of opiate dependence: a multicenter, randomized clinical trial. Addiction 1998;93:475–486.
  2. Lintzeris N, Bammer G, Rushworth L, Jolley DJ, Whelan G: Buprenorphine dosing regime for inpatient heroin withdrawal: a symptom-triggered dose titration study. Drug Alcohol Depend 2003;70:287–294.
  3. Jones HE: Science and practice perspectives, special focus – clinical use of buprenorphine. Rockville, NIDA, August 2004.
  4. Sporer KA: Buprenorphine: a primer for emergency physicians. Ann Emerg Med 2004;43:580–584.
  5. EMCDDA: Buprenorphine – treatment, misuse and prescription practices. Selected issue 3. 2004. http://issues05.emcdda.europa.eu/en/page038-en.html.
  6. Fatseas M, Auriacombe M: Why buprenorphine is so successful in treating opiate addiction in France. Curr Psychiatry Rep 2007;9:358–364.
  7. Zacny JP, Conley K, Galinkin J: Comparing the subjective, psychomotor and physiological effects of intravenous buprenorphine and morphine in healthy volunteers. J Pharmacol Exp Ther 1997;282:1187–1197.
  8. Comer SD, Collins ED, Fischman MW: Intravenous buprenorphine self-administration by detoxified heroin abusers. J Pharmacol Exp Ther 2002;301:266–276.
  9. Loo HW, Yam AKT, Tan TC, Peng YP, Teoh LC: Severe upper limb complications from parenteral abuse of Subutex. Ann Acad Med Singapore 2005;34:575–578.
  10. Pickworth WB, Johnson RE, Holicky BA, Cone EJ: Subjective and physiologic effects of intravenous buprenorphine in humans. Clin Pharmacol Ther 1993;53:570–576.
  11. Kintz P: Deaths involving buprenorphine: a compendium of French cases. Forensic Sci Int 2001;121:65–69.
  12. Singh RA, Mattoo SK, Malhotra A, Varma VK: Cases of buprenorphine abuse in India. Acta Psychiatr Scand 1992;86:46–48.
  13. Jenkinson RA, Clark NC, Fry CL, Dobbin M: Buprenorphine diversion and injection in Melbourne, Australia: an emerging issue? Addiction 2005;100:197–205.
  14. Auriacombe M, Fatseas M, Dubernet J, Daulouede JP, Tignol J: French field experience with buprenorphine. Am J Addict 2004;13(suppl 1):S17–S28.
  15. Carrieri MP, Rey D, Loundou A, Lepeu G, Sobel A, Obadia Y: Evaluation of buprenorphine maintenance treatment in a French cohort of HIV-infected injecting drug users, the MANIF-2000 Study Group. Drug Alcohol Depend 2003;72:13–21.
  16. Vidal-Trecan G, Varescon I, Nabet N, Boissonnas A: Intravenous use of prescribed sublingual buprenorphine tablets by drug users receiving maintenance therapy in France. Drug Alcohol Depend 2003;69:175–181.
  17. Guichard A, Lert F, Calderon C, Gaigi H, Maguet O, Soletti J, Brodeur JM, Richard L, Benigeri M, Zunzunegui MV: lllicit drug use and injection practices among drug users on methadone and buprenorphine maintenance treatment in France. Addiction 2003;98:1585–1597.
  18. Alho H, Sinclair D, Vuori E, Holopainen A: Abuse liability of buprenorphine-naloxone tablets in untreated IV drug users. Drug Alcohol Depend 2007;88:75–78.
  19. Winstock AR, Lea T, Sheridan J: Prevalence of diversion and injection of methadone and buprenorphine among clients receiving opioid treatment at community pharmacies in New South Wales, Australia. Int J Drug Policy 2008;19:450–458.
  20. Mravčík V, Chomynová P, Orlíková B, Škrdlantová E, Trojáčková A, Petroš O, Vopravil J, Vacek J: Výroční zpráva o stavu ve věcech drog v České republice v roce 2006 [The Czech Republic - Drug Situation 2006] (Vol. Annual Reports). Praha: Úřad vlády ČR [Office of the Czech Government], 2007.
  21. Cicero T, Surratt H, Inciardi J: Use and misuse of buprenorphine in the management of opioid addiction. J Opioid Manag 2007;3:302–308.

    External Resources

  22. Tacke U: Abuse of buprenorphine by intravenous injection – the French connection. Addiction 2002;97:1355.
  23. Ahmadi J, Ahmadi K: Controlled trial of maintenance treatment of intravenous buprenorphine dependence. Ir J Med Sci 2003;172:171–173.
  24. Ahmadi J, Maany I, Ahmadi M: Treatment of intravenous buprenorphine dependence: a randomized open clinical trial. Ger J Psychiatry 2003;6:23–29.
  25. Roux P, Villes V, Blanche J, Bry D, Spire B, Feroni I, Carrieri MP: Buprenorphine in primary care: risk factors for treatment injection and implications for clinical management. Drug Alcohol Depend 2008;97:105–113.
  26. Obadia Y, Perrin V, Feroni I, Vlahov D, Moatti JP: Injecting misuse of buprenorphine among French drug users. Addiction 2001;96:267–272.
  27. NACD: Report to the National Advisory Committee on Drugs on ‘Use of buprenorphine as an intervention in the treatment of opiate dependence syndrome’. Dublin, National Advisory Committee on Drugs, 2002.
  28. EMCDDA: Reitox national reports. 2004. http://www.emcdda.europa.eu/?nnodeid= 435.
  29. Varescon I, Vidal-Trecan G, Nabet N, Boissonnas A: Buprenorphine deviated from normal use: the buprenorphine injection. Buprenorphine abuse: high dose intravenous administration of buprenorphine. Encephale 2002;28:397–402.
  30. Hakansson A, Medvedeo M, Andersson M, Berglund A: Buprenorphine misuse among heroin and amphetamine users in Malmo, Sweden: purpose of misuse and route of administration. Eur Addict Res 2007;13:207–215.
  31. Gamkrelidze A, Javakhishvili J, Kariauli D, Lejava G, Stvilia K, Todadze KH, Tsintsadze M: Drug Situation in Georgia – 2003. Tbilisi, Southern Caucasus Anti-Drug Programme, 2004.
  32. Javakhishvili J, Sturua L: Drug Situation in Georgia – 2007. Tbilisi, Southern Caucasus Anti-Drug Programme, 2009.
  33. Gamkrelidze A, Javakhishvili J, Kariauli D, Lejava G, Stvilia K, Todadze KH, Tsintsadze M: Drug Situation in Georgia – 2004. Tbilisi, Southern Caucasus Anti-Drug Programme, 2005.
  34. Otiashvili D, Balanchivadze N: The system of registration and follow-up of drug users in Georgia. Tbilisi, Addiction Research Center, Union Alternative Georgia, 2008.
  35. Javakhishvili J, Kariauli D, Lejava G, Stvilia K, Todadze KH, Tsintsadze M: Drug Situation in Georgia – 2005. Tbilisi, Southern Caucasus Anti-Drug Programme, 2006.
  36. Evaluation of drug treatment in Georgia. Tbilisi, Georgian Research Institute of Addiction and NGO New Way, OSGF Publication, February 2008.
  37. Otiashvili D, Jones HE, Chavchanidze M, Kirtadze I, Tuten M: First Republic of Georgia randomized controlled trial (RCT) for drug abuse treatment: the process and initial results of developing a couple’s treatment for drug abuse. Poster presentation, CPDD 69th Annual Conference, Quebec City, 2007.
  38. Davids E, Gastpar M: Buprenorphine in the treatment of opioid dependence 2003. Eur Neuropsychopharmacol 2004;14:209–216.
  39. Marsch L, Bickel W, Badger G, Jacobs E: Buprenorphine treatment for opioid dependence: the relative efficacy of daily, twice and thrice weekly dosing. Drug Alcohol Depend 2005;77:195–204.
  40. Otiashvili D, Zabransky T, Kirtadze I, Piralishvili G, Chavchanidze M, Miovsky M: ATS injection in the Republic of Georgia – a pilot study. Global Methamphetamine Conference, Prague, 2008, Addictologie, suppl 2, p 279.
  41. Kirtadze I, Otiashvili D, Chavchanidze M: Patterns of drug use and related risk behavior among participants of needle exchange programs in Georgia. NIDA International Forum Linking Drug Abuse and HIV/AIDS research abstract book. San Juan, NIDA, 2008, pp 57–58.
  42. Dershem L, Gurolla Bonilla S, Sirbiladze T, Todadze KH, Dallabetta D, Tsagareli T, Stvilia K: Characteristics, High-Risk Behaviors and Knowledge of STI/HIV/AIDS, and HIV and Syphilis Prevalence among Injection Drug Users in Tbilisi. Save the Children: Tbilisi, Georgia, 2004.
  43. Magura S, Kang S: Validity of self-reported drug use in high risk populations: a meta-analytical review. Subst Use Misuse 1996;31:1131–1153.
  44. Darke S: Self-report among injecting drug users: a review. Drug Alcohol Depend 1998;51:253–263.
  45. Escot S, Fahet G: Usages non substitutifs de la buprénorphine haut dosage, investigation menée en France en 2002–2003. Paris, Trend, 2004.
  46. Winslow M, Ng W, Mythily S, Song G, Yiong H: Socio-demographic profile and help-seeking behaviour of buprenorphine abusers in Singapore. Ann Acad Med Singapore 2006;35:451–456.
  47. Otiashvili D, Sarosi P, Somogyi G: Drug control in Georgia: drug testing and the reduction of drug use? Briefing paper 15. Witley, Beckley Foundation Drug Policy Programme, May 2008.
  48. Aitken C, Higgs P, Hellard M: Buprenorphine injection in Melbourne, Australia – an update. Drug Alcohol Rev 2008;27:197–199.
  49. Nielsen S, Dietze P, Lee N, Dunlop A, Taylor D: Concurrent buprenorphine and benzodiazepines use and self-reported opioid toxicity in opioid substitution treatment. Addiction 2006;102:616–622.

    External Resources

  50. Ng WL, Mythily S, Song G, Chan YH, Winslow M: Concomitant use of midazolam and buprenorphine and its implications among drug users in Singapore. Ann Acad Med Singapore 2007;36:774–777.
  51. De Ducla M, Gagnon A, Mucchielli A, Robinet S, Vellay A: Comparison of high dose buprenorphine treatments of opiate dependent outpatients in four healthcare networks. Ann Med Interne (Paris) 2000;151(suppl B):B9–B15.

    External Resources

  52. Carrieri MP, Amass L, Lucas GM, Vlahov D, Wodak A, George E, Woody GE: Buprenorphine use: the international experience. Clin Infect Dis 2006;43:S197–S215.
  53. Booth R, Lehman W, Kwiatkowski C, Brewster J, Sinitsyna L, Dvoryak S: Stimulant injectors in Ukraine: the next wave of the epidemic? AIDS Behav 2008;12:652–661.
  54. Kozlov A, Shaboltas A, Toussova O, Verevochkin S, Masse B, Perdue T, Beauchamp G, Sheldon W, Miller W, Heimer R, Ryder R, Hoffman I: HIV incidence and factors associated with HIV acquisition among injection drug users in St Petersburg, Russia. AIDS 2006;20:901–906.
  55. Gabelia N, Nelson K, del Rio C, Stivilia K, Chitale R, Aladashvili M, Tsertsvadze T: Prevalence and Risk Factors for Hepatitis C Virus, and HIV Infection among Injection Drug Users in the Republic of Georgia. Tbilisi, Georgian Infectious Diseases, AIDS and Clinical Immunology Research Center, 1998.
  56. de Jong W, Tsegarelli T, Schouten E: Rapid assessment of injection drug use and HIV in the Republic of Georgia. J Drug Issues 1999;29:843–860.
  57. Shapatava E, Nelson K, Tsertsvadze T, del Rio C: Risk Behaviors and the Transmission of HIV, Hepatitis B and Hepatitis C among Injecting Drug Users in Georgia. Tbilisi, Georgian Infectious Diseases, AIDS and Clinical Immunology Research Center, 2001.
  58. Tkeshelashvili-Kessler A, del Rio C, Nelson K, Tsertsvadze T: The emerging HIV/AIDS epidemic in Georgia. Int J STD AIDS 2005;16:61–67.
  59. Otiashvili D, Gambashidze N, Kapanadze E, Lomidze G, Usharidze D: Effectiveness of needle/syringe exchange program in Tbilisi. Georgian Med News 2006;11:62–65.
  60. United Nations General Assembly Special Session on HIV/AIDS, monitoring the declaration of commitment on HIV/AIDS, Georgia country report 2008, reporting period January 1 to December 31, 2006. 2008. http://data.unaids.org/pub/Report/2008/georgia_2008_country_progress_report_en.pdf.
  61. Durell T, Kroutil L, Crits-Christoph P, Barchha N, Van Brunt D: Prevalence of nonmedical methamphetamine use in the United States. Subst Abuse Treat Prev Policy 2008;3:19.
  62. Wu LT, Pilowsky D, Wechsberg W, Schlenger W: Injection drug use among stimulant users in a national sample. Am J Drug Alcohol Abuse 2004;30:61–83.