Parenteral buprenorphine-naloxone abuse is a major cause of fatal buprenorphine-related poisoning

Autor: Margareeta Häkkinen, Ilkka Ojanperä, Pertti Heikman
Rok vydání: 2013
Předmět:
Adult
Male
Adolescent
Underlying cause of death
Drug abuser
Narcotic Antagonists
Administration
Sublingual
Opioid maintenance treatment
Poison control
01 natural sciences
Pathology and Forensic Medicine
03 medical and health sciences
chemistry.chemical_compound
Forensic Toxicology
Young Adult
0302 clinical medicine
Tandem Mass Spectrometry
Naloxone
Buprenorphine/naloxone
Administration
Inhalation
medicine
Opiate Substitution Treatment
Humans
030212 general & internal medicine
Norbuprenorphine
Substance Abuse
Intravenous
Aged
Ethanol
business.industry
010401 analytical chemistry
Central Nervous System Depressants
Middle Aged
Opioid-Related Disorders
0104 chemical sciences
3. Good health
Buprenorphine
Suicide
chemistry
Anesthesia
Female
business
Homicide
Law
medicine.drug
Chromatography
Liquid
Zdroj: Forensic science international. 232(1-3)
ISSN: 1872-6283
Popis: Buprenorphine (BPN) medication for opioid maintenance treatment in Finland consists predominantly of buprenorphine-naloxone (BNX). Both BPN and BNX are associated with diversion, abuse and non-medically supervised use worldwide. Our purpose was to estimate the proportion of BNX to all BPN-related fatalities. The material consisted of 225 deceased drug abusers in Finland from January 2010 to June 2011 with a positive BPN and/or norbuprenorphine (NOR) and/or naloxone (NX) finding in urine. The data were divided into three groups based on the urine NX and BPN concentrations. The "Parenteral BNX" group (>100 μg/l NX) was presumed to consist of injecting or snorting BNX abusers and the "Parenteral BPN" group (>50 μg/l BPN, 0 μg/l NX) of injecting or snorting BPN abusers, while the "Other BNX or BPN" group (≤100 μg/l NX, or ≤50 μg/l BPN combined with 0 μg/l NX) was presumed to consist of mainly sublingual BNX or BPN users. In 12.4% of cases the NX urine concentration was higher than the threshold 100 μg/l. In fatal BPN poisonings, the proportion of parenteral BNX was 28.4%. In the "Parenteral BNX", "Parenteral BPN" and "Other BNX or BPN" groups, the proportion of fatal BPN poisonings was 67.9, 31.0 and 22.6%, respectively. BNX abuse can be fatal. Among the 225 BPN-related fatalities, parenteral abuse of BNX was shown to be common (12.4%) and BNX poisoning was the underlying cause of death in 8.4%. Parenteral BNX caused fatal BPN poisoning proportionally more often than parenteral BPN.
Databáze: OpenAIRE
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