The experience of buprenorphine implant in patients with opioid use disorder: a series of narrative interviews

Abstract

Background: This study used narrative medicine (NM) to assess the point of view of patients with opioid use disorder (OUD) and the impact that addiction and a new treatment approach via buprenorphine implant had on their daily lives as compared with previous oral Opioid Agonist Therapy (OAT).

Methods: Five patients with OUD undergoing treatment with a buprenorphine subcutaneous implant participated voluntarily and provided their anonymity by self-describing, in response to questions prompted by the clinician, their experience with this innovative therapy. The narratives were analyzed according to standard NM methodology. Citations of patients' positive or negative experiences with traditional OAT and buprenorphine implant were classified according to five categories-patient's determination toward complete opioid abstinence, emotional impact, impact on life, smoothness of therapy, and therapy dependency-and quantified to obtain a picture of the overall therapy experience.

Results: The analysis revealed the extent of the burden not only of addiction but also of the traditional OAT on patients' life, including relationships with family, job management, and free time. Conversely, the therapy with buprenorphine implant revealed a significant improvement in the quality of life of the patients, who also largely reported a positive emotional outcome during this therapy, as well as a solid determination to achieve complete recovery.

Conclusions: This study illustrates the complex problems of living with OUD and provides insights into the added value of an innovative buprenorphine implant therapy that, due to its administration route and prolonged duration, allows patients to take an additional step toward total opioid abstinence and complete recovery of daily life.

Keywords: buprenorphine implant; narrative medicine; opioid agonist therapy; opioid use disorder; quality of life.

Figure 1

Narrative analysis of patients' reported experience with traditional OAT (A) and buprenorphine implant (B). (A) Statements concerning oral OAT were classified in one or more of the five identified topics located in the vertices of the pentagon. The number of positive (green line) and negative (red line) statements per topic are plotted along the direction of the corresponding vertex and connected by a 5-pointed closed line. The greater the distance from the center, the larger the number of iterations. (B) Statements concerning buprenorphine implant were classified in one or more of the five identified topics located in the vertices of the pentagon; examples of positive or negative statements are reported in the corresponding oval. The number of positive (green line) and negative (red line) statements per topic are plotted along the direction of the corresponding vertex and connected by a 5-pointed closed line. The greater the distance from the center, the higher the number of iterations. Please note that here the scale of the pentagon is different from the one reported in A.

Figure 2

Statement examples included in the narrative analysis. Statements in (A) concern traditional OAT; statements in (B) concern buprenorphine implant.