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Self-management of buprenorphinealoxone among online discussion board users

机译：在线讨论区用户对丁丙诺啡/纳洛酮的自我管理

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Background: Buprenorphinealoxone is an effective medication used to treat opioid dependence. Patients in treatment and those using it illegally without prescriptions have discussed using buprenorphinealoxone anonymously on Internet discussion boards. Their beliefs about self-treatment and efforts to self-treat are not well known. Objectives: To identify facilitators of self-treatment by online buprenorphinealoxone users. Methods: A qualitative, retrospective study of discussion board postings from September 2010 to November 2012 analyzed 121 threads from 13 discussion boards using grounded theory. Results: Facilitators of self-management themes that emerged included: (1) a ready supply of buprenorphinealoxone from a variety of sources; (2) distrust of buprenorphine prescribers and pharmaceutical companies; (3) the declaration that buprenorphinealoxone is a "bad-tasting" medicine; (4) the desire to adopt a different delivery method other than sublingually; and (5) a desire to become completely "substance-free." The sublingual film formulation appears to be an important facilitator in self-treatment because it can more easily be apportioned to extend the medication because of limited supply, cost, or to taper. Conclusions/Importance: The findings indicate a range of self-management activities ranging from altering the amount taken to modifying the physical medication composition or changing the administration route; some of these behaviors constitute problematic extra-medical use. Contributors to discussion boards seem to trust each other more than they trust pharmacists and prescribing physicians. The shared knowledge and behaviors of this understudied online community are important to healthcare providers because of the previously unknown precautions and risks taken to self-treat.
机译：背景：丁丙诺啡/纳洛酮是用于治疗阿片类药物依赖的有效药物。在互联网讨论板上，匿名使用丁丙诺啡/纳洛酮的患者以及未经处方就非法使用该药物的患者已经进行了讨论。他们关于自我治疗和自我治疗的信念并不广为人知。目的：确定丁丙诺啡/纳洛酮在线使用者自我治疗的促进因素。方法：2010年9月至2012年11月对讨论板发布进行的定性，回顾性研究使用扎根理论分析了13个讨论板的121条线索。结果：出现了自我管理主题的促进者包括：（1）各种来源的丁丙诺啡/纳洛酮的现成供应; （2）不信任丁丙诺啡处方药和制药公司; （3）声明丁丙诺啡/纳洛酮是“不良品”药物; （4）希望采用除舌下以外的其他交付方式; （5）成为完全“无物质”的愿望。舌下膜制剂似乎是自我治疗中的重要促进剂，因为由于供应，成本或锥度的限制，可以更容易地分配它以扩展药物。结论/重要性：研究结果表明一系列自我管理活动，包括改变服用量，改变物理药物成分或改变给药途径。其中一些行为构成了有问题的非医疗用途。讨论板的参与者似乎彼此信任，而不是他们信任药剂师和处方医生。由于以前未知的预防措施和自我治疗的风险，因此这个未被充分研究的在线社区的共享知识和行为对于医疗保健提供者非常重要。

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