학술논문
Buprenorphine and opioid analgesics: Dispensation and discontinuity among accidental overdose fatalities in the Indianapolis metropolitan area, 2016-2021.
Document Type
Academic Journal
Author
Victor G; School of Social Work, Rutgers, The State University of New Jersey, 120 Albany St, New Brunswick, NJ 08901, United States of America. Electronic address: gv220@ssw.rutgers.edu.; Ray B; RTI International, Division for Applied Justice Research, 3040 Cornwallis Road, Research Triangle Park, NC 27709, United States of America.; Del Pozo B; Miriam Hospital/Warren Alpert Medical School of Brown University, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, United States of America.; Jaffe K; Center for Bioethics and Social Sciences in Medicine, University of Michigan, 2800 Plymouth Road Bldg. 14, G016, Ann Arbor, MI 48109, United States of America.; King A; School of Emergency Medicine, Wayne State University, 4201 St. Antoine, University Health Center - 6G, Detroit, MI 48201, United States of America.; Huynh P; Center for Behavioral Health and Justice, Wayne State University, Detroit, MI 48208, United States of America.
Source
Publisher: Elsevier Inc Country of Publication: United States NLM ID: 9918541186406676 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2949-8759 (Electronic) Linking ISSN: 29498759 NLM ISO Abbreviation: J Subst Use Addict Treat Subsets: MEDLINE
Subject
Language
English
Abstract
Background: This study describes overall trends and sociodemographic disparities in buprenorphine and opioid analgesic uptake and prescribing patterns prior to fatal overdose events.
Methods: We examined toxicology data from all accidental overdose deaths from 2016 to 2021 (N = 2682) in a large metropolitan area. These data were linked at the individual-level with a prescription drug monitoring program (PDMP).
Results: Fewer than half of all deaths had any kind of PDMP record (39.9 %, n = 1070). Among those with a buprenorphine prescription, 10.6 % (n = 35) of decedents had a buprenorphine dispensation within 7 days of their death, while the majority (64.7 %, n = 214) were dispensed buprenorphine more than 30 days prior to death. Evidence existed of racial disparities among those with any buprenorphine uptake, whereby Black individuals (7.3 %, n = 24) had significantly fewer any dispensations compared to White individuals (92.7 %, n = 307). Among those with an opioid analgesic prescription, about 12.2 % (n = 90) were dispensed within 7 days of death, with the majority (68.5 %, n = 506) occurring more than 30 days prior to death. Like buprenorphine dispensations, Black individuals were prescribed a significantly smaller proportion of opioid analgesics (21.9 %, n = 162) versus White individuals (77.7 %, n = 574). Buprenorphine was detected in 78.5 % of deaths where fentanyl was present in the toxicology record, significantly greater when compared to opioid analgesics (57.5 %).
Conclusion: Consistent with prior research, our findings suggest prescription opioid analgesics may protect against fatal overdoses. Access to buprenorphine treatment did not keep pace with the rising lethality of the overdose crisis, and in recent years, a smaller percentage of the people at risk of fatal overdose availed themselves of MOUD preceding their death.
Competing Interests: Declaration of competing interest The authors have no disclosures to declare.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Methods: We examined toxicology data from all accidental overdose deaths from 2016 to 2021 (N = 2682) in a large metropolitan area. These data were linked at the individual-level with a prescription drug monitoring program (PDMP).
Results: Fewer than half of all deaths had any kind of PDMP record (39.9 %, n = 1070). Among those with a buprenorphine prescription, 10.6 % (n = 35) of decedents had a buprenorphine dispensation within 7 days of their death, while the majority (64.7 %, n = 214) were dispensed buprenorphine more than 30 days prior to death. Evidence existed of racial disparities among those with any buprenorphine uptake, whereby Black individuals (7.3 %, n = 24) had significantly fewer any dispensations compared to White individuals (92.7 %, n = 307). Among those with an opioid analgesic prescription, about 12.2 % (n = 90) were dispensed within 7 days of death, with the majority (68.5 %, n = 506) occurring more than 30 days prior to death. Like buprenorphine dispensations, Black individuals were prescribed a significantly smaller proportion of opioid analgesics (21.9 %, n = 162) versus White individuals (77.7 %, n = 574). Buprenorphine was detected in 78.5 % of deaths where fentanyl was present in the toxicology record, significantly greater when compared to opioid analgesics (57.5 %).
Conclusion: Consistent with prior research, our findings suggest prescription opioid analgesics may protect against fatal overdoses. Access to buprenorphine treatment did not keep pace with the rising lethality of the overdose crisis, and in recent years, a smaller percentage of the people at risk of fatal overdose availed themselves of MOUD preceding their death.
Competing Interests: Declaration of competing interest The authors have no disclosures to declare.
(Copyright © 2023 Elsevier Inc. All rights reserved.)