"Whatever it is, it Works" Understanding of Buprenorphine/Naloxone and Sources of Information: A Qualitative Study Among People Who Use Fentanyl and Clinicians.

OBJECTIVES

Most persons with opioid use disorder (OUD) are not receiving effective treatment with medications. A lack of understanding and misinformation may impede an individual's decision to begin or continue medications for OUD (MOUD). This study explored the understanding of the role of naloxone, and sources of information related to buprenorphine/naloxone products among people who use fentanyl (PWUF) and clinicians.

METHODS

Qualitative study utilizing semi-structured interviews with PWUF and clinicians providing buprenorphine care. Participants were recruited via flyers and word of mouth (PWUF), and direct emails (clinicians). Interviews were audio recorded, transcribed, and analyzed using a rapid qualitative analysis process, which consists of creating templated summaries separated by domains to formulate themes.

RESULTS

Forty-three adults (28 PWUF and 15 clinicians) from Seattle, WA, participated in interviews between April and November 2024. The analyses identified 3 themes: (1) PWUF and clinicians both acknowledge confusion around how buprenorphine and naloxone work; (2) misconceptions may lead to adverse events, anxiety, and/or lack of interest in starting buprenorphine, especially in the setting of fentanyl use; (3) while PWUF had high regards for clinicians, the primary and most trusted source of information is people with lived experience taking buprenorphine/naloxone.

CONCLUSIONS

Findings suggest confusion and lack of information about the role of naloxone in buprenorphine/naloxone, potentially limiting medication uptake. The finding that patients mainly hear about buprenorphine/naloxone from people with lived experience should be incorporated into outreach strategies. Future efforts should increase involvement from people with lived experience taking buprenorphine in disseminating accurate information regarding MOUD.