Factors contributing to the rise of buprenorphine misuse: 2008-2013

Theodore J. Cicero, Matthew S. Ellis, Hilary L. Surratt, Steven P. Kurtz

Research output: Contribution to journalArticlepeer-review

72 Scopus citations


Objective: The purpose of the present study was to examine the motivations underlying the use of buprenorphine outside of therapeutic channels and the factors that might account for the reported rapid increase in buprenorphine misuse in recent years. Methods: This study used: (1) a mixed methods approach consisting of a structured, self-administered survey (N= 10,568) and reflexive, qualitative interviews (N= 208) among patients entering substance abuse treatment programs for opioid dependence across the country, centered on opioid misuse patterns and related behaviors; and (2) interviews with 30 law enforcement agencies nationwide about primary diverted drugs in their jurisdictions. Results: Our results demonstrate that the misuse of buprenorphine has increased substantially in the last 5 years, particularly amongst past month heroin users. Our quantitative and qualitative data suggest that the recent increases in buprenorphine misuse are due primarily to the fact that it serves a variety of functions for the opioid-abusing population: to get high, manage withdrawal sickness, as a substitute for more preferred drugs, to treat pain, manage psychiatric issues and as a self-directed effort to wean themselves off opioids. Conclusion: The non-therapeutic use of buprenorphinehas risen dramatically in the past five years, particularly in those who also use heroin. However, it appears that buprenorphine is rarely preferred for its inherent euphorigenic properties, but rather serves as a substitute for other drugs, particularly heroin, or as a drug used, preferable to methadone, to self-medicate withdrawal sickness or wean off opioids.

Original languageEnglish
Pages (from-to)98-104
Number of pages7
JournalDrug and Alcohol Dependence
StatePublished - Sep 1 2014

Bibliographical note

Funding Information:
The national data were collected as part of the Survey of Key Informants’ Patients (SKIP) Program, a component of the RADARS ® (Researched Misuse, Diversion and Addiction-Related Surveillance) System, funded through an unrestricted research grant sponsored by Denver Health and Hospital Authority (DHHA) , which collects subscription fees from 14 pharmaceutical firms. The interview-driven Research and Patients Interacting Directly (RAPID) Program received support from both DHHA and private university funds.


  • Buprenorphine misuse
  • Heroin
  • Opioid misuse
  • Self-treatment of opioid dependence

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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