Opioid Substitution Treatment and Opioid Replacement Therapy
Opioid Substitution Treatment (OST)
Opioid Replacement Therapy (ORT)
use of e-pill Electronic Medicine Dispensers (EMD) in Unobserved Opioid Substitution Treatment
(take-home doses)
Providing unobserved opioid substitution treatment (OST) safely is a major challenge. This study examined
whether electronicmedicine dispensers (EMDs) can reduce diversion of take-home buprenorphine–naloxone
(BNX) in a medium-sized Finnish city [suboxone]. All BNX treated OST patients in Kuopio received their take-home BNX
in EMDs for 4 months. EMDs' effect on diversion was investigated using questionnaires completed by patients
(n=37) and treatment staff (n=19), by survey at the local needle exchange service and by systematic review
of drug screen data from the Kuopio University Hospital. The majority of patients (n=21, 68%) and treatment
staff (n=11, 58%) preferred to use EMDs for the safe storage of tablets. Five patients (16%) declared that
EMDs had prevented them from diverting BNX. However, EMDs had no detectable effect on the availability or
origin of illegal BNX or on the hospital-treated buprenorphine-related health problems. EMDs may improve
the safety of storage of take-home BNX, but their ability to prevent diversion needs further research.Interim Buprenorphine Treatment using state-of-the-art, computerized portable device (e-pill Med-O-Wheel SECURE) that dispenses each day's dose at a predetermined time, after which all medication is inaccessible.
SUBOXONE® (buprenorphine and naloxone)(CIII) is a prescription medicine and is a registered trademark of Reckitt Benckiser Pharmaceuticals Inc.
Keywords: Buprenorphine, Naloxone, Diversion, Electronic monitoring, Opiate substitution treatment
