Perceptions of extended-release buprenorphine injections for opioid use disorder among people who regularly use opioids in Australia

Aims: To examine perceptions of extended-release (XR) buprenorphine injections among people who regularly use opioids in Australia.

Design: Cross-sectional survey prior to implementation. XR-buprenorphine was registered in Australia in November 2018. Setting Sydney, Melbourne and Hobart.

Participants: A total of 402 people who regularly use opioids interviewed December 2017 to March 2018.

Measurements: Primary outcome concerned the proportion of participants who believed XR-buprenorphine would be a good treatment option for them, preferred weekly versus monthly injections and perceived advantages/disadvantages of XR-buprenorphine. Independent variables concerned the demographic characteristics and features of current opioid agonist treatment (OAT; medication-type, dose, prescriber/dosing setting, unsupervised doses, out-of-pocket expenses and travel distance).

Findings: Sixty-eight per cent [95% confidence interval (CI) = 63–73%] believed XR-buprenorphine was a good treatment option for them. They were more likely to report being younger [26–35 versus > 55 years; odds ratio (OR) = 3.16, 95% CI = 1.12–8.89; P = 0.029], being female (OR = 1.67, 95% CI = 1.04–2.69; P = 0.034), < 10 years school education (OR = 1.87, 95% CI = 1.12–3.12; P = 0.016) and past-month heroin (OR = 1.81, 95% CI = 1.15–2.85; P = 0.006) and methamphetamine use (OR = 1.90, 95% CI = 1.20–3.01; P = 0.006). Fifty-four per cent reported no preference for weekly versus monthly injections, 7% preferred weekly and 39% preferred monthly. Among OAT recipients (n = 255), believing XR-buprenorphine was a good treatment option was associated with shorter treatment episodes (1–2 versus ≥ 2 years; OR = 3.93, 95% CI = 1.26– 12.22; P = 0.018), fewer unsupervised doses (≤ 8 doses past-month versus no take-aways; OR = 0.50; 95% CI = 0.27– 0.93; P = 0.028) and longer travel distance (≥ 5 versus < 5 km; OR = 2.10, 95% CI = 1.20–3.65; P = 0.009). Sixtynine per cent reported ‘no problems or concerns’ with potential differences in availability, flexibility and location of XRbuprenorphine.

Conclusions: Among regular opioid users in Australia, perceptions of extended-release buprenorphine as a good treatment option are associated with being female, recent illicit drug use and factors relating to the (in)convenience of current opioid agonist treatment.