According to a new Substance Abuse Mental Health Administration (SAMHSA) Drug Abuse Warning Network (DAWN) report, Emergency Department (ED) visits involving buprenorphine increased substantially from 3,161 in 2005 to 30,135 visits in 2010 (Figure 1). This trend likely reflects the increased availability of buprenorphine after the Food and Drug Administration approved its use for treatment of opioid dependence in 2002, and the increasing number of physicians who subsequently became certified to prescribe it.

Figure 1. Emergency Department (ED) Visits Involving Buprenorphine: 2005 to 2010

Most buprenorphine-related ED visits fell into one of three types of visits: patients seeking detoxification or substance abuse treatment, adverse reactions to medications, or nonmedical use of pharmaceuticals. Nonmedical use includes taking more than the prescribed dose of a prescription medication or more than the recommended dose of an over-the-counter (OTC) medication or supplement, taking a prescription medication prescribed for another individual, being deliberately poisoned with a pharmaceutical by another person, or misusing or abusing a prescription medication, an OTC medication, or a dietary supplement.

In 2010, 52 percent of buprenorphine-related ED visits involved nonmedical use of pharmaceuticals, 24 percent involved patients seeking detoxification or substance abuse treatment, and 13 percent involved adverse reactions to medications (Figure 2).

Figure 2. Emergency Department (ED) Visits Involving Buprenorphine, by Type of Visit: 2010

Demographic Characteristics

In 2010, most buprenorphine-related ED visits involving nonmedical use of pharmaceuticals involved male patients (66 percent). Patients aged 26 to 34 accounted for the highest proportion of visits for nonmedical use (38 percent), followed by patients aged 18 to 25 (24 percent), aged 35 to 44 (15 percent), and aged 45 to 54 (13 percent).

Drug Combinations with Buprenorphine

In 2010, 41 percent of buprenorphine-related ED visits involving nonmedical use of pharmaceuticals involved buprenorphine only (Figure 3). In the remaining 59 percent of these visits, another drug was involved. More specifically, pharmaceuticals were combined with buprenorphine in 43 percent of visits The most common types of pharmaceuticals were benzodiazepines, which are commonly prescribed to treat anxiety and insomnia (27 percent of visits). A specific benzodiazepine, alprazolam (Xanax^®), was combined with buprenorphine in 12 percent of visits. Narcotic pain relievers other than buprenorphine were involved in 12 percent of visits; more specifically, 6 percent of visits involved the narcotic pain reliever oxycodone and 3 percent of visits involved an unspecified opiate.

Figure 3. Drug Combinations among Emergency Department (ED) Visits Involving Buprenorphine,
by Type of Visit: 2010

The report can be accessed at: http://www.samhsa.gov/data/2k13/DAWN106/sr106-buprenorphine.htm

Source: Substance Abuse Mental Health Administration (SAMHSA) Drug Abuse Warning Network (DAWN) – January 29, 2013