Indicators of buprenorphine and methadone use and abuse: what do we know?

Abstract

Abuse of prescription opioids is a growing problem. The number of methadone pain pills distributed now exceeds liquid methadone used in opioid treatment, and the increases in buprenorphine indicators provide evidence of the need to monitor and intervene to decrease the abuse of this drug. The need for additional and improved data to track trends is discussed, along with findings as to the characteristics of the users and combinations of drugs. Data on toxicities related to methadone or buprenorphine, particularly in combination with other prescribed drugs, are presented and clinical implications and considerations are offered. These findings underscore the need for physicians to be aware of potential toxicities and to educate their patients regarding these issues.

FIGURE 1

Age groups of buprenorphine and methadone ED visits: DAWN 2007.

FIGURE 2

U.S. treatment admissions by primary substance: TEDS 1992–2007.

FIGURE 3

U.S. narcotic substances mentioned in poisoning deaths: NCHS 1999–2006. Source: Warner et al., Methadone Deaths, 1999–2005, Findings from the National Vital Statistics, PowerPoint presentation.

FIGURE 4

Texas deaths with a mention of methadone: 2000–2007.

FIGURE 5

Buprenorphine and methadone items as proportion of all NFLIS items submitted to federal, state, and local laboratories: 2000–2008.

FIGURE 6

Distribution of methadone in the United States by formulation: ARCOS 2000–2008.

FIGURE 7

Dosage units of buprenorphine per 100,000 population: ARCOS 2003–2008.