A self-reported survey of past use found that buprenorphine misuse was trending downward between 2015 and 2019 among American adults with an opioid use disorder (OUD). These findings were published in JAMA Network Open.

Data were sourced from the 2015-2019 National Survey on Drug Use and Health (NSDUH). A total of 214,505 adults reported their past-year opioid use, misuse, and OUD.

The study population was 51.7% women, 13.9% were aged 18-25 years, 40.6% 26-49 years, 45.5% >50 years, 63.9% were White, 16.0% Hispanic, and 11.9% Black.


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In 2019, the study authors projected that 4.9 million people misused hydrocodone, 3.0 million oxycodone, 2.3 million codeine, and 1.3 million tramadol. For buprenorphine, 2.4 million were estimated to use buprenorphine, 0.7 million of whom misused it during the previous year.

Compared with data from 2015-2018, buprenorphine misuse remained relatively stable among individuals without OUD (P =.08) while those with OUD decreased misuse (>20.0% in 2015 to 15.9% in 2019; P =.04).

In 2019, individuals who misused buprenorphine were more likely to not have a prescription compared with misusers of other opioids among the population with OUD (71.8% vs 53.2%; P <.001) and without OUD (74.7% vs 60.0%; P <.001), respectively.

Motivation for buprenorphine or non-buprenorphine misuse among individuals with OUD differed, specifically for the motivations ‘I am hooked’ (27.3% vs 7.8%), ‘to alter effects of other drug(s)’ (15.1% vs 1.2%), ‘to relieve physical pain’ (20.5% vs 52.5%), ‘to relax or relive tension’ (3.7% vs 8.9%), and ‘to get high’ (9.4% vs 17.1%), respectively.

Among individuals with OUD, misuse of buprenorphine associated (all P <.05) with past-year use disorder (adjusted odds ratio [aOR], 3.9), aged 24-34 years (aOR, 2.9), aged 35-49 years (aOR, 2.3), past-year cocaine use or disorder (aOR, 2.3), lifetime use but no past-year cocaine use (aOR, 1.9), and past-year oxycodone misuse (aOR, 1.9).

Among individuals without OUD, misuse of buprenorphine associated (all P <.05) with past-year hydrocodone misuse (aOR, 4.3), planning suicide (aOR, 4.1), past-year cocaine use or disorder (aOR, 4.0), past-year oxycodone misuse (aOR, 3.9), age 24-34 years (aOR, 2.1), lifetime use but no past-year cocaine use (aOR, 2.1), family income <$20,000 (aOR, 1.9), past-year alcohol use disorder (aOR, 1.8), past-year alcohol use without disorder (aOR, 1.7), and past-year cannabis use without disorder (aOR, 1.5).

These data did not include individuals who had insecure housing or who were incarcerated.

The study authors concluded that buprenorphine misuse among individuals with OUD has been decreasing in the United States, however, there remains a need for buprenorphine-based OUD treatment programs.

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Han B, Jones CM, Einstein EB, Compton WM. Trends in and characteristics of buprenorphine misuse among adults in the US. JAMA Netw Open. 2021;4(10):e2129409. doi:10.1001/jamanetworkopen.2021.29409