Emergency Department Visits Involving Buprenorphine

Excerpt

Background: Buprenorphine is a medication used to treat opioid addiction. A properly prescribed dose of buprenorphine can help opioid-addicted individuals to stop misusing opioids without experiencing withdrawal symptoms. Although buprenorphine is itself an opioid, and can thus have the same effects as other opioids (e.g., heroin, oxycodone), its maximum effects are less than those of other opioids. Therefore, with buprenorphine there is a decreased risk of abuse, addiction, and side effects compared with other opioids. Buprenorphine was approved for use in the United States for the treatment of opioid dependence in 2002. Methods: National estimates of Emergency Department (ED) visits involving buprenorphine were analyzed using data from the 2005 to 2011 Drug Abuse Warning Network (DAWN). The ED visits analyzed included nonmedical use, seeking detoxification/treatment services and adverse reactions involving buprenorphine. Results: ED visits involving buprenorphine increased substantially from an estimated 3,161 in 2005 to 30,135 visits in 2010 as availability of the drug increased. Buprenorphine-related ED visits involving nonmedical use of pharmaceuticals increased 255% from 2006 to 2010, with 4,440 visits to 15,778 visits, respectively. In 2010, 52% (15,778 visits) of buprenorphine-related ED visits were classified as nonmedical use of pharmaceuticals, 24% (7,372 visits) were by patients seeking detoxification or substance abuse treatment, and 13% (4,017 visits) were attributed to adverse reactions. In 2010, additional drugs were involved in 59% of buprenorphine-related ED visits involving nonmedical use of pharmaceuticals. Conclusion: Findings in this report show significant growth in the number of ED visits involving buprenorphine at the same time that there was an increase in its availability for treatment of opioid dependence. These data show that buprenorphine is sometimes used nonmedically, resulting in health events that require acute treatment in the ED. Buprenorphine use can be risky for individuals who are not opioid dependent because its effects are similar to other opioids (although usually more mild), leading to injuries and other health consequences. Additionally, dangerous effects can occur if buprenorphine is combined with certain other drugs, including benzodiazepines.