Lucas Martignetti , Rod Knight , Frishta Nafeh , Kate Atkinson , Gab Laurence , Colin H Johnson , Dan Werb , Mohammad Karamouzian
{"title":"在加拿大多伦多的一个更安全的阿片类药物供应项目的客户之间的药物转移的动机和观点。","authors":"Lucas Martignetti , Rod Knight , Frishta Nafeh , Kate Atkinson , Gab Laurence , Colin H Johnson , Dan Werb , Mohammad Karamouzian","doi":"10.1016/j.drugpo.2024.104665","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Safer opioid supply programs in Canada have come under intense scrutiny related to the perceived risk of diversion of safer opioid supply medications. We sought to explore the experiences and perspectives of safer opioid supply medication diversion with clients of a safer opioid supply program in Toronto, Canada.</div></div><div><h3>Methods</h3><div>From December 2022 to August 2023, we conducted in-depth, semi-structured interviews with 25 adult clients of a safer opioid supply program in Toronto, Canada. We analyzed the data using deductive and inductive approaches via thematic analysis.</div></div><div><h3>Results</h3><div>Our analysis identified five themes regarding clients’ perceptions and experiences with safer opioid supply diversion: (i) Compassionate sharing with others to address withdrawal symptoms; (ii) Selling or sharing due to unmet medication or survival needs of program clients; (iii) High demand for safer alternatives to those that are available in unregulated drug markets; (iv) Price of safer opioid supply medications in the unregulated drug markets as a diversion deterrent; and (v) Coerced diversion through harassment or violence.</div></div><div><h3>Conclusions</h3><div>These findings document experiences of medication diversion and the multifaceted and complex interplay of various individual and contextual factors that motivate safer opioid supply clients to engage in it. Future policy and safer opioid supply practice should address root causes of diversion, particularly barriers to service access and the diverse medication needs of clients.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"135 ","pages":"Article 104665"},"PeriodicalIF":4.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Motivations for and perspectives of medication diversion among clients of a safer opioid supply program in Toronto, Canada\",\"authors\":\"Lucas Martignetti , Rod Knight , Frishta Nafeh , Kate Atkinson , Gab Laurence , Colin H Johnson , Dan Werb , Mohammad Karamouzian\",\"doi\":\"10.1016/j.drugpo.2024.104665\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Safer opioid supply programs in Canada have come under intense scrutiny related to the perceived risk of diversion of safer opioid supply medications. We sought to explore the experiences and perspectives of safer opioid supply medication diversion with clients of a safer opioid supply program in Toronto, Canada.</div></div><div><h3>Methods</h3><div>From December 2022 to August 2023, we conducted in-depth, semi-structured interviews with 25 adult clients of a safer opioid supply program in Toronto, Canada. We analyzed the data using deductive and inductive approaches via thematic analysis.</div></div><div><h3>Results</h3><div>Our analysis identified five themes regarding clients’ perceptions and experiences with safer opioid supply diversion: (i) Compassionate sharing with others to address withdrawal symptoms; (ii) Selling or sharing due to unmet medication or survival needs of program clients; (iii) High demand for safer alternatives to those that are available in unregulated drug markets; (iv) Price of safer opioid supply medications in the unregulated drug markets as a diversion deterrent; and (v) Coerced diversion through harassment or violence.</div></div><div><h3>Conclusions</h3><div>These findings document experiences of medication diversion and the multifaceted and complex interplay of various individual and contextual factors that motivate safer opioid supply clients to engage in it. Future policy and safer opioid supply practice should address root causes of diversion, particularly barriers to service access and the diverse medication needs of clients.</div></div>\",\"PeriodicalId\":48364,\"journal\":{\"name\":\"International Journal of Drug Policy\",\"volume\":\"135 \",\"pages\":\"Article 104665\"},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Drug Policy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0955395924003499\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SUBSTANCE ABUSE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Drug Policy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0955395924003499","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SUBSTANCE ABUSE","Score":null,"Total":0}
Motivations for and perspectives of medication diversion among clients of a safer opioid supply program in Toronto, Canada
Background
Safer opioid supply programs in Canada have come under intense scrutiny related to the perceived risk of diversion of safer opioid supply medications. We sought to explore the experiences and perspectives of safer opioid supply medication diversion with clients of a safer opioid supply program in Toronto, Canada.
Methods
From December 2022 to August 2023, we conducted in-depth, semi-structured interviews with 25 adult clients of a safer opioid supply program in Toronto, Canada. We analyzed the data using deductive and inductive approaches via thematic analysis.
Results
Our analysis identified five themes regarding clients’ perceptions and experiences with safer opioid supply diversion: (i) Compassionate sharing with others to address withdrawal symptoms; (ii) Selling or sharing due to unmet medication or survival needs of program clients; (iii) High demand for safer alternatives to those that are available in unregulated drug markets; (iv) Price of safer opioid supply medications in the unregulated drug markets as a diversion deterrent; and (v) Coerced diversion through harassment or violence.
Conclusions
These findings document experiences of medication diversion and the multifaceted and complex interplay of various individual and contextual factors that motivate safer opioid supply clients to engage in it. Future policy and safer opioid supply practice should address root causes of diversion, particularly barriers to service access and the diverse medication needs of clients.
期刊介绍：
The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.
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