Examining buprenorphine diversion through a harm reduction lens: an agent-based modeling study

Original research
by
Adams, Joëlla W. et al

Release Date

2023

Geography

USA

Language of Resource

English

Full Text Available

Yes

Open Access / OK to Reproduce

Yes

Peer Reviewed

Yes

Objective

Our study aim was to estimate the impact of buprenorphine diversion on opioid overdose using an agent-based model calibrated to North Carolina.

Findings/Key points

Our status quo scenario predicted 10,658 fatal opioid overdoses. A scenario simulating controlled prescription only of buprenorphine (i.e., no diversion) resulted in 10,741 fatal opioid overdoses versus 10,301 within a scenario simulating increased diversion. Compared to the status quo, the controlled prescription only scenario resulted in a similar number of fatal overdoses, while the scenario with increased diversion of buprenorphine resulted in 357 (3.35%) fewer fatal overdoses. Even when increasing overdose risk while using diverted buprenorphine and incorporating use by opioid naïve individuals, increased diversion did not increase overdoses compared to a scenario with no buprenorphine diversion.

Design/methods

We simulated the progression of opioid misuse and opioid-related outcomes over a 5-year period.

Keywords

Diversion
Evidence base
Substitution/OAT
Mortality