Awareness of, experience with, and attitudes toward buprenorphine among opioid users visiting a New York City syringe exchange program

Objective: To examine awareness of, experience with, and attitudes toward buprenorphine, to begin to understand why opioid users may not access buprenorphine treatment. Factors associated with attitudes toward buprenorphine were also explored. Design: Cross-sectional study. Setting: A community-based organization's syringe exchange program in mobile units at nine street-side outreach sites in New York City. Participants: One hundred eighty-six adult opioid users visiting a syringe exchange program. Main outcome measures: Awareness of, experiences with, and attitudes toward buprenorphine. Results: Most (68.5 percent) participants were aware of buprenorphine, 27.8 percent had taken buprenorphine, and 58.6 percent knew someone who had taken buprenorphine. Of the 98 who had taken or knew someone who had taken buprenorphine, 85.7 percent endorsed positive attitudinal statements about its effectiveness, and up to 31-6 percent endorsed statements about its limited access. Participants' attitudes about the need for formal buprenorphine treatment were mixed. Current heroin users were more likely than nonusers to have heard of buprenorphine (76.0 percent vs 61.5 percent, p < 0.05), have taken buprenorphine (46.8 percent vs 9.6 percent, p ≤ 0.01), endorse buprenorphine's effectiveness (96.3 percent vs 72.7 percent, p ≤ 0.01), and believe that illicit and prescribed buprenorphine have similar benefits (35.2 percent vs 13-6 percent, p < 0.02). Conclusions: Most opioid users visiting a syringe exchange program had positive attitudes about buprenorphine's effectiveness, and few believed that buprenorphine was difficult to access. Attitudes about the benefits of illicit versus prescribed buprenorphine use were inconsistent. Understanding awareness of experience with, and attitudes toward buprenorphine is important, as these factors are likely to influence opioid users' decisions about engaging in buprenorphine treatment.