Non-buprenorphine opioid utilization among patients using buprenorphine

Area of Science:

• Pharmacology
• Public Health
• Addiction Medicine

Background:

• Buprenorphine is a key medication for treating opioid use disorder (OUD).
• Patterns of non-buprenorphine opioid use among buprenorphine-treated patients are not well understood.
• Understanding these patterns is crucial for effective OUD management.

Purpose of the Study:

• To estimate the prevalence of non-buprenorphine opioid use in incident buprenorphine users.
• To quantify opioid use levels before, during, and after the initial buprenorphine treatment episode.
• To analyze prescription data for insights into treatment adherence and potential misuse.

Main Methods:

• Utilized anonymized pharmacy claims data from QuintilesIMS (2010-2012).
• Identified incident buprenorphine users from a large cohort (approx. 50 million patients) across 11 US states.
• Measured non-buprenorphine opioid use via prescription counts, dispensed quantity, days of supply, and morphine milligram equivalents (MME).

Main Results:

• 43% of buprenorphine recipients filled non-buprenorphine opioid prescriptions during treatment.
• 67% filled non-buprenorphine opioid prescriptions after treatment completion.
• Mean MME per opioid day decreased slightly from 57 mg prior to treatment to 54 mg during treatment, remaining at 55 mg post-treatment.

Conclusions:

• Despite increased buprenorphine use for OUD in the US, significant non-buprenorphine opioid prescribing persists.
• A substantial number of patients continue non-buprenorphine opioid use during and after buprenorphine treatment.
• Further research and clinical strategies are needed to address concurrent opioid use in OUD patients.