Willingness to take buprenorphine/naloxone among people who use opioids in Vancouver, Canada

•We examined willingness to use buprenorphine/naloxone among people who use opioids.•A low level of willingness to take buprenorphine/naloxone (17.6%) was observed.•Lack of knowledge of buprenorphine/naloxone was commonly identified as a barrier.•Future research should examine effects of educational interventions on willingness. Opioid agonist therapy is the cornerstone of treatment of opioid use disorder. In Canada, buprenorphine/naloxone has recently been adopted as the first line agonist therapy given its comparable effectiveness to methadone and superior safety profile. This study examines factors associated with willingness to take buprenorphine/naloxone among opioid users. Data were derived from two prospective cohorts of high-risk individuals who use drugs in Vancouver, Canada. Multivariable logistic regression analyses were used to determine factors associated with willingness to use buprenorphine/naloxone among people who use opioids and were not currently accessing this treatment option. Participants who were unwilling to use buprenorphine/naloxone were invited to provide reason(s) and their responses were examined in a sub-analysis. Between December 2014 and May 2018, 1103 participants were interviewed. Overall, 194 (17.6%) respondents indicated that they would be willing to take buprenorphine/naloxone. Variables independently associated with willingness were previous buprenorphine/naloxone treatment (adjusted odds ratio [AOR] = 2.04), having ever used methadone treatment (AOR = 1.87), and age (AOR = 0.98, per year older) (all p