Hospital emergency department visits linked to buprenorphine, a medication to treat opioid addiction, increased substantially – from 3,161 visits in 2005 to 30,135 visits in 2010 with 52 percent (15, 778) in 2010 involving non-medical use – according to a new report by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Of the buprenorphine-related, non-medical use related visits in 2010, 41 percent involved just the use of buprenorphine. The remaining 59 percent of these non-medical visits involved the use of other substances such as pharmaceuticals including benzodiazepine (27 percent), narcotic pain relievers (12 percent), and illicit drugs like marijuana (11 percent), heroin (9 percent) and cocaine (8 percent). In 2010, most buprenorphone-related emergency department visits for non-medical use involved males (66 percent). Patients aged 26 to 34 years old represented the largest proportion of visits for non-medical use of the medication.
Buprenophine was approved as a treatment for opioid addiction in 2002 and is usually prescribed to patients by certified physicians, mostly in office-based treatment settings. Since its introduction the use and availability of the partial opioid medication has significantly increased. In 2005 5,656 certified physicians were prescribing buprenorphine to 100,000 patients. By 2010, 18,582 certified physicians were prescribing the medication to more than 800,000 patients
Although its overdose risk and abuse potential is thought to be lower than other treatments for opioid addiction such as methadone, buprenorphine, like any prescription medication, may cause serious harmful health consequences. This is particularly true when the drug is taken improperly or for non-medical uses. In 2010, there were 2.3 million emergency department visits related to the misuse of all drugs.
Federal, state, and other entities have taken steps to reduce the risk of buprenorphine diversion and abuse. For example, FDA has required a Risk Evaluation and Mitigation Strategy for certain buprenorphine products that will include physician education and medication guides. SAMHSA announced recently that the agency will monitor for buprenorphine abuse and diversion, and provide resources for physician education. The Federation of State Medical Boards is updating its guidelines for buprenorphine use in Office Based Treatment settings.