Twelve-year trend in treatment seeking for buprenorphine abuse in Finland

Background: Buprenorphine abuse is becoming increasingly common worldwide. However, large-scale long-term studies of buprenorphine abuse are lacking. The objective of this study was to examine the trend in characteristics of clients seeking treatment for buprenorphine abuse and compare them to those seeking treatment for heroin and amphetamine abuse. Methods: A 12-year descriptive study was conducted at the Helsinki Deaconess Institute (HDI), a public utility foundation responsible for providing treatment for substance abuse in the greater Helsinki area. All clients seeking treatment between 31 January 1997 and 31 August 2008 received a structured clinical interview concerning demographic characteristics and abuse patterns. Characteristics of clients who reported that their primary drug of abuse was buprenorphine (n= 780) were compared to those whose primary drug of abuse was either heroin (n= 598) or amphetamine (n= 1249). Results: The annual proportion of buprenorphine clients increased from 3.0 in 1998 to 38.4 in 2008. Daily abuse (73.8 ) and intravenous administration (80.6 ) were common among buprenorphine clients. Concurrent abuse of prescription medications (p<0.001), stimulants (p= 0.001) and alcohol (p<0.001) increased from 1997 to 2008. Treatment seeking for heroin abuse declined to approximately 1 of clients annually after 2002. Buprenorphine clients were more likely to be daily users of their primary drug (p<0.001), abuse prescription medications (p<0.001) and administer drugs intravenously (p= 0.001 from 1997 to 2001) compared to heroin and amphetamine clients. Conclusions: Our results highlight the increasing abuse of buprenorphine in Finland. Buprenorphine clients had risky abuse patterns in terms of daily use and intravenous administration. Concurrent substance abuse increased during the study period.