Abstract

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: 402 people who regularly use opioids interviewed December 2017 to March 2018. MEASUREMENTS: Primary outcome: proportion of participants who believed XR-buprenorphine would be a good treatment option for them, preferred weekly vs. monthly injections and perceived advantages/disadvantages of XR-buprenorphine. INDEPENDENT VARIABLES: 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 percent (95% CI: 63%-73%) believed XR-buprenorphine was a good treatment option for them. They were more likely to report being younger (26-35 years vs. >55 years; 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 percent reported no preference for weekly vs. 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 years vs. >/= 2 years; OR 3.93, 95% CI: 1.26-12.22; p=0.018), fewer unsupervised doses (</=8 doses past month vs. no takeaways; OR 0.50; 95% CI: 0.27-0.93; p=0.028), and longer travel distance (>/=5km vs. <5km; OR 2.10, 95% CI: 1.20-3.65; p=0.009). Sixty-nine percent reported ‘no problems or concerns’ with potential differences in availability, flexibility and location of XR-buprenorphine. 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.

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