Motivations for and perspectives of medication diversion among clients of a safer opioid supply program in Toronto, Canada

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-01-01 DOI:10.1016/j.drugpo.2024.104665

Lucas Martignetti , Rod Knight , Frishta Nafeh , Kate Atkinson , Gab Laurence , Colin H Johnson , Dan Werb , Mohammad Karamouzian

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Abstract

Background

Safer opioid supply programs in Canada have come under intense scrutiny related to the perceived risk of diversion of safer opioid supply medications. We sought to explore the experiences and perspectives of safer opioid supply medication diversion with clients of a safer opioid supply program in Toronto, Canada.

Methods

From December 2022 to August 2023, we conducted in-depth, semi-structured interviews with 25 adult clients of a safer opioid supply program in Toronto, Canada. We analyzed the data using deductive and inductive approaches via thematic analysis.

Results

Our analysis identified five themes regarding clients’ perceptions and experiences with safer opioid supply diversion: (i) Compassionate sharing with others to address withdrawal symptoms; (ii) Selling or sharing due to unmet medication or survival needs of program clients; (iii) High demand for safer alternatives to those that are available in unregulated drug markets; (iv) Price of safer opioid supply medications in the unregulated drug markets as a diversion deterrent; and (v) Coerced diversion through harassment or violence.

Conclusions

These findings document experiences of medication diversion and the multifaceted and complex interplay of various individual and contextual factors that motivate safer opioid supply clients to engage in it. Future policy and safer opioid supply practice should address root causes of diversion, particularly barriers to service access and the diverse medication needs of clients.

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在加拿大多伦多的一个更安全的阿片类药物供应项目的客户之间的药物转移的动机和观点。

背景：加拿大更安全的阿片类药物供应计划受到严格审查，这与转移更安全的阿片类药物供应的感知风险有关。我们试图与加拿大多伦多的一个更安全的阿片类药物供应项目的客户探讨更安全的阿片类药物供应转移的经验和观点。方法：从2022年12月到2023年8月，我们对加拿大多伦多一个更安全的阿片类药物供应项目的25名成年客户进行了深入的半结构化访谈。我们通过主题分析使用演绎和归纳的方法来分析数据。结果：我们的分析确定了关于客户对更安全的阿片类药物供应转移的看法和经验的五个主题：(i)与他人富有同情心地分享以解决戒断症状；（ii）由于药物未得到满足或项目客户的生存需要而出售或分享；对较安全替代品的高需求，以取代不受管制的药物市场上的替代品；（四）在不受管制的药品市场上更安全的类阿片供应药物的价格，作为转移的威慑力量；（五）通过骚扰或暴力强迫转移。结论：这些发现记录了药物转移的经历，以及各种个人和环境因素的多方面和复杂的相互作用，这些因素促使更安全的阿片类药物供应客户参与其中。未来的政策和更安全的阿片类药物供应做法应解决转移的根本原因，特别是获得服务的障碍和客户的不同药物需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.