High buprenorphine-related mortality is persistent in Finland
| Autor: | Ilkka Ojanperä, Pirkko Kriikku, Margareeta Häkkinen |
|---|---|
| Přispěvatelé: | Doctoral Programme in Population Health, Medicum, Forensic Medicine, Department of Forensic Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Pediatrics Poison control 01 natural sciences Mass Spectrometry chemistry.chemical_compound 0302 clinical medicine 030212 general & internal medicine Norbuprenorphine MAINTENANCE TREATMENT MEDICATIONS Substance Abuse Intravenous Finland Cause of death Aged 80 and over Naloxone 319 Forensic science and other medical sciences Fatal poisoning Middle Aged 3. Good health Buprenorphine Substance abuse NORDIC COUNTRIES Blood Alcohol Content Female DIVERSION medicine.drug Adult medicine.medical_specialty DEATHS Urinary system Overdose Drug abuse Pathology and Forensic Medicine 03 medical and health sciences Young Adult Age Distribution Injury prevention medicine Humans Sex Distribution ABUSE Aged DRUG-ADDICTS business.industry Opioid maintenance treatment NORBUPRENORPHINE 010401 analytical chemistry medicine.disease Opioid-Related Disorders 0104 chemical sciences chemistry RISK-FACTORS Drug Overdose INJECTION business Law OPIOID SUBSTITUTION TREATMENT Chromatography Liquid |
| Popis: | Sublingual buprenorphine is used in opioid maintenance treatment but buprenorphine is also widely abused and causes fatal poisonings. The aim of this study was to investigate buprenorphine-positive fatalities in order to gain novel information on the magnitude and nature of buprenorphine abuse. All post-mortem toxicology cases positive for urinary buprenorphine, including fatal poisonings caused by buprenorphine and fatalities in which the cause of death was unrelated to buprenorphine, in the five year period of 2010-2014 in Finland were characterized according to urine buprenorphine and naloxone concentrations (n = 775). Urine concentrations were used to assess which buprenorphine preparation had been used; mono-buprenorphine or a buprenorphine-naloxone combination, and whether they had been administered parenterally. In at least 28.8% of the buprenorphine-positive cases the drug had been administered parenterally. The majority of the parenteral users (68.6%) had taken mono-buprenorphine. Fatal poisoning was significantly more common among the identified parenteral users (65.5%) than among other users of buprenorphine products (45.3%). The proportion of buprenorphine-related poisoning was similar in identified parenteral users of mono-buprenorphine (68.6%) and buprenorphine-naloxone (64.1%). In nearly all of the fatal poisoningss the deceased had used other drugs and/or alcohol along with buprenorphine (98.7%). The median age of the deceased increased significantly over the study period, from 32 to 38 years. Our results show that there is ongoing parenteral abuse of both mono-buprenorphine and buprenorphine-naloxone combination. Parenteral users of buprenorphine put themselves into a great risk of fatal poisoning or other accidental injury death which is further exacerbated by the frequent polydrug use. (c) 2018 Elsevier B.V. All rights reserved. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|