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Addiction Science & Clinical Practice
Published in: Addiction Science & Clinical Practice 1/2019

Open Access 01-12-2019 | Addiction | Research

Buprenorphine unobserved “home” induction: a survey of Ontario’s addiction physicians

Authors: Anita Srivastava, Meldon Kahan, Pamela Leece, Alison McAndrew

Published in: Addiction Science & Clinical Practice | Issue 1/2019

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Abstract

Background

Ontario patients on opioid agonist treatment (OAT) are often prescribed methadone instead of buprenorphine, despite the latter’s superior safety profile. Ontario OAT providers were surveyed to better understand their attitudes towards buprenorphine and potential barriers to its use, including the induction process.

Methods

We used a convenience sample from an annual provincial conference to which Ontario physicians who are involved with OAT are invited.

Results

Based on 85 survey respondents (out of 215 attendees), only 4% of Ontario addiction physicians involved in OAT routinely used unobserved “home” buprenorphine induction: 59% of physicians felt that unobserved induction was risky because it was against “the guidelines” and 66% and 61% respectively believed that unobserved “home” induction increased the risk of diversion and of precipitated withdrawal.

Conclusions

Ontario addiction physicians largely report following the traditional method of bringing in patients for observed in-office buprenorphine induction: they expressed fear of precipitated withdrawal, diversion, and going against clinical guidelines. The hesitance in using unobserved induction may explain, in part, Ontario’s reliance on methadone.
Appendix
Available only for authorised users
Footnotes
1
Ontario Drug Benefits cover drug costs for all Ontario residents under age 25, over age 64, and anyone receiving social assistance, disability support, long-term care, or prescription drug coverage assistance if they spend a large part of their income on prescription medications.
 
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Metadata
Title
Buprenorphine unobserved “home” induction: a survey of Ontario’s addiction physicians
Authors
Anita Srivastava
Meldon Kahan
Pamela Leece
Alison McAndrew
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Addiction Science & Clinical Practice / Issue 1/2019
Electronic ISSN: 1940-0640
DOI
https://doi.org/10.1186/s13722-019-0146-4

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