Lebanon has faced problems arising from buprenorphine abuse in recent years as people who use drugs have chosen different routes of administration, such as snorting or injecting, which increased the harms caused by the OST drug. Buprenorphine sublingual tablets contain corn starch and other active ingredients which can cause blood clots, and are designed to be taken orally, by placing them under your tongue. People have been experimenting with buprenorphine in an attempt to create produce a high associated with opioids and this has, rather alarmingly, led to buprenorphine now being sold on the black market. Youth RISE, along with other national NGOs in Lebanon such as SIDC, OM el NOUR, SKOON, and many others started working on ways to solve these problems. Youth RISE team member Bachaar Kawach was working in this group as a social and medical worker, and experienced activist, concluded that the best strategy would be to convince the Ministry of Public Health to implement new strategies, such as adapting the formula of the tablets.
The main points of his suggestion were:
- Maintain the current plan of out-patient rehabilitation
- To use an OST drug that cannot easily be exchanged for goods on the black market, as was an issue with buprenorphine being exchanged for heroin, trapping those on OST in addiction still.
- To help people who inject drugs simply because they have needle fixation by using suboxone which has naloxone in it, unlike the generic “Buprenorphine Arrow”.
- Discouraging the sale and use of suboxone on the black market.
After 8 years of generic buprenorphine being used in OST, in the beginning of this year suboxone has finally been registered and is now available to be distributed as OST. Feedback from people using the new suboxone formula has been positive and we hope to continue education about the harms associated with the misuse of OST drugs throughout the year.