BACKGROUND Illicit, medically unsupervised use of buprenorphine (i.e., "diverted use") among vulnerable and underserved populations, such as corrections-involved adults, remains underexplored. METHODS Survey data (2016-2017) collected as part of a clinical assessment of incarcerated adults entering corrections-based substance use treatment in Kentucky were analyzed. For years examined, 12,915 completed the survey. Removing cases for participants who did not reside in Kentucky for >6 months during the one-year pre-incarceration period (n = 908) resulted in a final sample size of 12,007. RESULTS Over a quarter of the sample reported past-year diverted buprenorphine use prior to incarceration and 21.8 % reported use during the 30-days prior to incarceration, using 6.5 months and 14.3 days on average, respectively. A greater proportion of participants who reported diverted buprenorphine use had previously been engaged with some substance use treatment (77.0 %) and reported greater perceived need for treatment (79.4 %) compared to those who did not report use. Use was more likely among participants who were younger, white, male, and who reported rural or Appalachian residence. Diverted buprenorphine users also evidenced extensive polydrug use and presented with greater substance use disorder severity. Non-medical prescription opioid, heroin, and diverted methadone use were associated with increased odds of diverted buprenorphine use while kratom was not. Diverted methadone use was associated with a 252.9 % increased likelihood of diverted buprenorphine use. CONCLUSIONS Diverted buprenorphine use among participants in this sample was associated with concerning high-risk behaviors and may indicate barriers to accessing opioid agonist therapies for corrections-involved Kentucky residents, particularly those in rural Appalachia.

中文翻译：

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肯塔基州接受矫正药物治疗的成年人中丁丙诺啡转移使用的特征。


背景技术在弱势和服务不足的人群（例如涉及惩教的成年人）中非法、在医疗上无人监督的情况下使用丁丙诺啡（即“转移使用”）仍然没有得到充分探索。方法 对肯塔基州接受基于惩教的药物使用治疗的被监禁成年人进行临床评估而收集的调查数据（2016-2017 年）进行了分析。在所调查的年份中，共有 12,915 人完成了调查。删除一年监禁前期间不在肯塔基州居住 >6 个月的参与者的案例 (n = 908)，最终样本量为 12,007。结果 超过四分之一的样本报告去年入狱前曾使用丁丙诺啡，21.8% 的样本报告在入狱前 30 天内使用过丁丙诺啡，平均分别使用 6.5 个月和 14.3 天。与未报告使用丁丙诺啡的参与者相比，报告转移丁丙诺啡使用的参与者之前曾接受过某种物质使用治疗（77.0%），并且报告认为需要更大的治疗需求（79.4%）。年轻、白人、男性以及居住在农村或阿巴拉契亚山脉的参与者更有可能使用该产品。转移的丁丙诺啡使用者还表现出广泛使用多种药物，并表现出更严重的物质使用障碍。非医疗处方阿片类药物、海洛因和转用美沙酮与转用丁丙诺啡的几率增加相关，而卡痛叶则不然。改用美沙酮与改用丁丙诺啡的可能性增加 252.9% 相关。 结论 该样本参与者中丁丙诺啡的转移使用与高风险行为有关，可能表明参与矫正的肯塔基州居民，特别是阿巴拉契亚农村地区的居民获得阿片类激动剂治疗存在障碍。