Buprenorphine Diversion: Facts and Trends
Buprenorphine is used to treat opioid addiction and is popular with heroin addicts on the street and law enforcement is seeing it being sold like any other street drug. Some of you may know it by one of its brand names, Suboxone. It is prescribed by a physician and can be taken home for use at home or dispensed only at the doctor's office. It is a very popular drug to use to treat addiction. Buprenorphine differs from other opioids because it is a partial opioid agonist. This allows for less euphoria, lower potential for misuse, and a relatively mild withdrawal profile. If Buprenorphine is used properly, it will suppress symptoms of opioid withdrawal, decrease cravings for opioids, reduce illicit opioid use, block the effects of other opioids and can help patients stay in treatment.
Black Market for Buprenorphine
Cops and anyone else involved in dealing with our drug abuse problem will tell you about the black market for Buprenorphine. For myself, I would come across it on the street routinely during drug investigations. It was to the point of being routine. Like any good narcotics detective, I'd ask users why they possessed it and why they found it so attractive.
Now there is a study showing what narcs on the street have known all along. In the study, researchers surveyed current drug abusers. What they found was a good validation for narcs on the street.
Of 303 respondents, 58% reported a history of diverted buprenorphine use, 37% of whom reported never receiving a prescription. The most common reasons for illicit buprenorphine use were consistent with therapeutic use: to prevent withdrawal (79%), maintain abstinence (67%), or self-wean off drugs (53%). Approximately one-half (52%) reported using buprenorphine to get high or alter mood, but few (4%) indicated that it was their drug of choice. Among respondents who had used diverted buprenorphine, 33% reported that they had issues finding a doctor or getting buprenorphine on their own. Most (81%) of these participants indicated they would prefer using prescribed buprenorphine, if available.
Although a majority of addicts used Buprenorphine to stop using opioids, over half reported using it to get high. I interviewed a heroin addict many years ago that was also abusing Buprenorphine. She told me about the euphoric effects of the drug. To alleviate the abuse potential, one maker stopped making buprenorphine in pill form and made it into a strip placed on the tongue. This strip would dissolve, which would alleviate the abuse problem. However, there are still pill forms available.
Getting High on Buprenorphine
So, how powerful is buprenorphine if abused (at least in pill form)? First, users won't swallow the pill to get high necessarily. Most of the time they will crush the pill and then snort it or they will crush the pill and inject it. Sublingual Buprenorphine is 80 times more potent than morphine. I spoke with a heroin user on the street and relayed this information to her. She laughed and said I must be accurate because she overdosed on Buprenorphine (in pill form) on a dose she thought was small. She went on to tell me how small of doses she would take to avoid an overdose.
EDIT: Some experienced drug investigators are now seeing buprenorphine strips being abused. Users will dissolve the strip and then snort it or inject it.
Slang Names
Stop signs
Bupe
Sobos
Oranges
For more information on drug trends like this, you can take our online course Current Drug Trends or you can have this course presented to your group or agency by contacting us here.
