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Concomitant drugs with buprenorphine user deaths
Claudia Mariottini1, Pirkko Kriikku1, Ilkka Ojanperä1
1Department of Forensic Medicine, University of Helsinki, P.O. Box 40, 00014 Helsinki, Finland; Forensic Toxicology Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland.
Drug and Alcohol Dependence
|October 31, 2020
Summary
Buprenorphine deaths frequently involved benzodiazepines, illicit drugs, and gabapentinoids, especially in younger individuals. Polydrug use is a significant factor in buprenorphine-related fatalities, highlighting urgent prevention needs.
Area of Science:
- Forensic Toxicology
- Pharmacology
- Public Health
Background:
- Buprenorphine, a vital analgesic and opioid agonist treatment, is subject to abuse.
- Previous research linked benzodiazepines and alcohol to buprenorphine toxicity.
- This study investigates emerging concomitant drug roles in buprenorphine user deaths.
Purpose of the Study:
- To elucidate the role of emerging concomitant drugs in buprenorphine user deaths.
- To identify patterns of polydrug use associated with buprenorphine fatalities.
- To inform prevention strategies for buprenorphine-related mortality.
Main Methods:
- Analysis of the Finnish national post-mortem toxicology database (2016-2019).
- Inclusion of deaths with buprenorphine or norbuprenorphine findings in individuals aged 15-64.
- Investigation of cause of death, concurrent drug/alcohol findings, age, and gender.
Main Results:
- Buprenorphine was implicated in 271 (34%) of 792 deaths without other opioids.
- In these cases, 94% involved benzodiazepines, 63% illicit drugs, and 50% gabapentinoids.
- Younger individuals (15-24 years) showed higher prevalence of benzodiazepine and illicit drug co-use.
Conclusions:
- High rates of benzodiazepine co-use in buprenorphine deaths obscure other risk factors.
- Polydrug use is prevalent across all buprenorphine-related fatalities.
- Targeted interventions are needed for younger populations with unsafe drug use patterns.
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