Characterization of Unintentional Deaths Among Buprenorphine Users

Area of Science:

• Forensic Toxicology
• Public Health
• Pharmacology

Background:

• Medications for opioid use disorder (OUD) reduce overdose risk.
• Buprenorphine is a preferred OUD treatment due to its safety profile.
• Expanding buprenorphine use necessitates understanding its role in drug-related deaths.

Purpose of the Study:

• To examine buprenorphine-involved deaths (BIDs) in West Virginia.
• To compare the characteristics of BIDs with other drug-related deaths.

Main Methods:

• Analysis of West Virginia drug-related deaths (2005-2020).
• Inclusion of decedent demographics, toxicology, autopsy, and prescription data.
• Statistical comparison of BIDs and other drug-related deaths.

Main Results:

• Buprenorphine was involved in 4.8% of 11,764 drug-related deaths.
• Buprenorphine was the sole drug in 0.2% of deaths.
• BIDs frequently involved multiple drugs (e.g., benzodiazepines, methamphetamine, fentanyl) and comorbidities.

Conclusions:

• Buprenorphine-involved deaths are a small fraction of overall drug deaths.
• Buprenorphine is seldom the only substance involved in fatalities.
• Awareness of risks associated with co-intoxicants and comorbidities is crucial for safe buprenorphine use.