| Popis: |
The study mapped various aspects of buprenorfine (Subutex \regm{}, herein S) abuse among opiate-dependent community. It analyses three sources of data, questionnaires distributed in general problem drug-users community ({\clq}non-substitution sample{\crq}, n = 64), questionnaires distributed among patients of buprenorphine substitution treatment ({\clq}substitution sample{\crq}, n = 42), and semi-structured moderated interviews conducted with S users attending low-threshold contact centre in Ceske Budejovice (n = 15). Prevalence of non-commissioned S abuse was 57% of the non-substitution sample and 21% of the sample claimed S as their primary drug. Illicit market prices range from prescription price to its multiple of eight, are higher in small towns and during weekends, and lower in case of close relationships between the seller and buyer. There are no regular big dealers in the community, and the contracts are rather based on close acquaintance among baseline users. The user view S price and availability as worse/higher than in case of marihuana, comparable with hallucinogens and ecstasy, and better/cheaper than metamphetamine and heroin. The main driver for buying was occasional abuse over the prescription dose, the main incentive to sell was to help a friend. Illicit S users view substitution treatment as a chance how to reduce their drugrelated expenses and stabilise their life, but some are repelled by strict treatment rules. Both licit and illicit users displayed comparably high (over 90%) prevalence of injection use; they typically understand the risks, but explain the injection use by their psychological attachment to the injection ritual. An indisputably positive aspect of substitution treatment is lower total number of drugs abused by individual patients, compared to general drug-abusing population. Illicit S market bears only marginal societal risks and its existence is rather positive with respect to harm reduction philosophy, as it supplies the community of illicit drug users with cheaper and safer alternative to street opiates. |
