Illicit market

Information on the availability of buprenorphine on the black market is also very limited. Diversion of buprenorphine to the illegal market is reported in Austria (where it is very rare), the Czech Republic, Estonia, France and Finland. In the last four countries there seems to be an inverse relation between the legal availability of the drug, which depends on the nature of national regulations, and diversion to the illegal market.

A tightening up of national regulations in the Czech Republic and national importing regulations of pharmaceuticals in Finland resulted in a decrease in the availability of buprenorphine on the legal market; as demand for buprenorphine remained stable or even increased (e.g. Finland), this appears to have contributed to an increase in availability of the substance on the black market.

In contrast, in Estonia and France, ease of access to buprenorphine through doctors’ prescriptions or pharmacies has contributed to a generally increased availability on the legal and illegal market. In France, clients can obtain several prescriptions by going from one doctor to another (so-called ’doctor shopping’), while Estonian users supply the Finnish illegal market. In Estonia specific measures have now been adopted, and political agreements with Finland negotiated, to prevent the diversion of buprenorphine.

In addition, in Finland a decrease in the availability of heroin, resulting from a reduction in heroin production in Afghanistan, is reported to be a crucial factor in the increase in buprenorphine availability in the illegal market (Nordic Studies on Alcohol and Drugs, 2004).

Another element which has contributed to the increase in buprenorphine demand and availability is the low cost of the drug in the illegal market. In Finland an 8 mg tablet of buprenorphine costs EUR 30–35, whereas the price of heroin is around EUR 60–350 per gram; in France the price of an 8 mg buprenorphine tablet varies from EUR 1 to 4. Indications of a current decrease in the price of buprenorphine on the illegal market are also reported.