Sub is a Weird Drug: A Web-Based Study of Lay Attitudes About Use of Buprenorphine to Self-Treat Opioid Withdrawal Symptoms

TitleSub is a Weird Drug: A Web-Based Study of Lay Attitudes About Use of Buprenorphine to Self-Treat Opioid Withdrawal Symptoms
Publication TypeJournal Article
Year of Publication2015
AuthorsRaminta Daniulaityte, Robert Carlson, Gregory Brigham, Delroy Cameron, Amit Sheth
JournalThe American Journal on Addictions
Date Published08/2015

Buprenorphine, a semi-synthetic opioid, has very high affinity, but low intrinsic activity at mu receptors, which makes it an effective medication in the treatment of opioid dependence. Buprenorphine' use in substance abuse treatment in the U.S. has expanded substantially since its approval in 2002. Simultaneously, U.S.-based reports about its illicit use have also increased. Research suggests that the use of illicit buprenorphine in the U.S. seldom represents an attempt to attain euphoria but is more commonly linked to self- treatment of opioid withdrawal symptoms. For example, a study conducted with individuals entering opioid addiction treatment programs in New England found that out of 51 interviewees, the majority (96%) had used buprenorphine illicitly to modulate opiate withdrawal symptoms. A study conducted in Providence, Rhode Island, with a community- recruited sample of 100 opioid users found that 74% reported lifetime use of diverted buprenorphine. Self-medication of withdrawal symptoms and inability to access treatment services were cited as common motives for illicit buprenorphine use, especially among injection drug users. To design effective intervention and policy measures, more research is needed to understand lay attitudes about buprenorphine self-treatment practices. There is a growing recognition that the Web provides unprecedented opportunities for drug abuse research. Increasing numbers of users rely on the Web to share their experiences and opinions about different drugs. Such user-generated content provides a rich source of data about lay knowledge, attitudes and behaviors related to illicit drugs. Prior studies have utilized such sources to explore emerging trends of illicit drug use, including mega-dosing with loperamide (Imodium) and using Kratom to self-treat opioid withdrawal. The study builds on PREDOSE (PREscription Drug abuse Online Surveillance and Epidemiology) platform, a novel Semantic Web tool that was developed by our interdisciplinary research team to facilitate information extraction from Web-forums on illicit drugs. The study aims to explore Web-forum discussions about the use of buprenorphine to self-treat opioid withdrawal. First, we describe trends in the frequency of buprenorphine mentions on a Web-forum and compare them to two of the most commonly abused pharmaceutical opioids-oxycodone and hydrocodone. Next, we conduct content analysis of Web-forum posts to describe user attitudes about buprenorphine's effectiveness in self-treatment, dosing practices, and concomitant drug use.

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Daniulaityte, R., Carlson, R., Brigham, G., Cameron, D., & Sheth, A. (2015). “Sub is a weird drug:” A web‐based study of lay attitudes about use of buprenorphine to self‐treat opioid withdrawal symptoms. The American Journal on Addictions, 24(5), 403-409.