The extent of misuse and diversion of medication for agonist opioid treatment: A review and expert opinions

Hannu Alho, Oscar D’Agnone, Peter Krajci, Neil McKeganey, Icro Maremmani, Jens Reimer, Carlos Roncero, Lorenzo Somaini, Nat Wright, Richard Littlewood

Research output: Contribution to journalReview articleResearchpeer-review

6 Citations (Scopus)


© 2015 Pacini Editore S.p.A. All rights reserved. Introduction: Opioid dependence is a major global problem associated with negative health, social and economic outcomes. Agonist opioid treatment (AOT) is the prescription of opioid-containing medicines as a medication for illicit opioid drugs. AOT, as an intervention for opioid dependence, reduces illicit drug use and is proven to improve outcomes by preventing harm and mortality. Provision of access to AOT is associated with the misuse and diversion of opioidcontaining medications. This misuse and diversion is a serious public health problem; it results in worsening outcomes with an increased risk to the individual’s health, a lack of progression in recovery and an increase in criminal activity. Aim: The aim of this paper is to describe the extent of misuse and diversion of AOT medication. Methods: An assessment of the scale of the problem was made based on a defined process including analysis of evidence from a systematic review of published literature and experts’ practice. Results: Results describe rates of misuse of AOT medication ranging from 18 to 81%; diversion occurs in 23 to 39% of cases. Misuse and diversion of AOT is common and is associated with negative outcomes for individuals and society. Conclusion: Greater understanding of the extent and impact of misuse and diversion will assist in the development of strategies to reduce this problem and its significant consequences. As part of ensuring appropriate care for those with opioid dependence, addressing misuse and diversion must be considered an important priority.
Original languageEnglish
Pages (from-to)25-34
JournalHeroin Addiction and Related Clinical Problems
Issue number2-3
Publication statusPublished - 1 Jan 2015


  • Agonist opioid treatment (AOT)
  • Extent
  • Misuse and diversion


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