Abstract:
AIMS:Methadone and buprenorphine diversion by patients in opioid substitution treatment (OST) is a poorly understood phenomenon. We study the norms and attitudes on diversion among OST patients, including the role these norms and attitudes play as diversion risk factors. We also study whether perceived quality of care, social bonds to treatment staff, and deterrence can be associated with diversion. METHODS:Structured interviews were conducted with 411 patients from eleven OST programs. In total, 280 interviews were done on site by the researchers, while 131 interviews were conducted through peer interviewing by specially trained patients. The data was analyzed through frequency- and averages-calculations, cross-tabulations, and logistic regression analysis. RESULTS:Most patients consider diversion as mostly positive (83.7%), morally right (76.8%), and without any significant risk of detection (66.9%). Individual differences in norms and risk perceptions may play a role in explaining variations in diversion; patients who consider it right to share medication with friends report higher treatment-episode diversion than other patients (OR 1.455, p = 0.016). Patients who perceive control measures as effective report lower diversion than other patients (OR = 0.655, p = 0.013). Furthermore, data indicate that patients who are satisfied with the care and service are less prone to engage in diversion. Social bonds with treatment staff seem to be less importance. CONCLUSIONS:The norm system described by patients resemble Bourgois' 'moral economy of sharing' concept-not sharing drugs with friends in withdrawal is considered unethical. Efforts to decrease diversion may focus on lifestyle-changing interventions, and reducing black market demand for illicit medications by expanding access to treatment.
journal_name
J Subst Abuse Treatjournal_title
Journal of substance abuse treatmentauthors
Johnson B,Richert Tdoi
10.1016/j.jsat.2015.01.013subject
Has Abstractpub_date
2015-07-01 00:00:00pages
50-5eissn
0740-5472issn
1873-6483pii
S0740-5472(15)00038-0journal_volume
54pub_type
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journal_title:Journal of substance abuse treatment
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journal_title:Journal of substance abuse treatment
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
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