The perceived and actual consequences of intranasal administration of buprenorphine or burprenorphine-naloxone by prisoners

Aims: Previous research has highlighted that intranasal administration of buprenorphine is common amongst the UK prison population. However, there is a scarcity of research exploring the effects of intranasal administration of buprenorphine–naloxone. We sought to explore the experiences and perceptions of intranasal administration of buprenorphine–naloxone with different opioid drugs. Methods: A cross-sectional survey in a male remand prison in the North of England. Findings: A total of 85 prisoners completed the survey (mean age 35 years). Compared to buprenorphine, prisoners perceived that they were significantly less likely to experience euphoria after intranasal administration of buprenorphine–naloxone alone (χ2 = 4, p < 0.05). No statistically significant differences were found for actual experiences of intranasal administration of drugs, but this was limited by reduced statistical power due to the small numbers of prisoners with experience. Conclusions: This study is the first to assess the relative consequences of intranasal misuse of buprenorphine and buprenorphine–naloxone within a prison setting. Prisoners perceived a reduced euphoric effect following intranasal administration of buprenorphine–naloxone compared to buprenorphine alone. Since intranasal administration of illicit buprenorphine is common in prison settings, buprenorphine–naloxone should be used as the first line buprenorphine product for those engaged in the criminal justice system. However, since the research was conducted in just one prison, findings should be interpreted with caution as they might not be representative of the wider prison population.