Opioid-related mortality and filled prescriptions for buprenorphine and methadone

Introduction and Aims To assess opioid‐related mortality and correlation with filled prescriptions for buprenorphine and methadone. Design and Methods A register study, including data from the Swedish Forensic Pathology and Forensic Toxicology databases 2003–2010, the Prescribed Drug Register and th...

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Bibliographic Details
Published in:	Drug and alcohol review Vol. 33; no. 5; pp. 491 - 498
Main Authors:	Wikner, Birgitta N., Öhman, Inger, Seldén, Tor, Druid, Henrik, Brandt, Lena, Kieler, Helle
Format:	Journal Article
Language:	English
Published:	Australia Blackwell Publishing Ltd 01-09-2014
Subjects:	Adolescent Adult Aged buprenorphine Buprenorphine - administration & dosage Buprenorphine - adverse effects Databases, Factual Female Heroin Dependence - mortality Heroin Dependence - rehabilitation Humans Male Medicin och hälsovetenskap methadone Methadone - administration & dosage Methadone - adverse effects Middle Aged mortality Opiate Substitution Treatment - adverse effects opioid dependence Opioid-Related Disorders - mortality Opioid-Related Disorders - rehabilitation overdose Registries Sweden - epidemiology Young Adult Sweden mortality overdose buprenorphine methadone opioid dependence
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Summary:	Introduction and Aims To assess opioid‐related mortality and correlation with filled prescriptions for buprenorphine and methadone. Design and Methods A register study, including data from the Swedish Forensic Pathology and Forensic Toxicology databases 2003–2010, the Prescribed Drug Register and the National Patient Register. Results A total of 1301 deaths, assessed as related to buprenorphine, methadone or heroin, or a combination of them, were studied. The largest number of fatalities was related to intake of heroin (n = 776), followed by methadone (n = 342) and buprenorphine (n = 168). The total annual number of fatal cases related to the studied drugs more than doubled (116 to 255) during the study period. There were increases in mortality related to both buprenorphine and methadone: from 1 to 49 cases for buprenorphine, and from 19 to 81 cases for methadone. Only one‐fifth of the fatal cases had a filled prescription for the maintenance drug assessed as the cause of death. Discussion and Conclusion This study showed that most fatalities were not related to filled prescriptions of maintenance drugs, and a substantial illicit use of buprenorphine and methadone resulting in deaths was revealed. To prevent opioid toxicity deaths it is important to make efforts not only to reduce drug diversion from maintenance programs, but also to improve the control of drug trafficking and other illegal sources. [Wikner BN, Öhman I, Seldén T, Druid H, Brandt L, Kieler H. Opioid‐related mortality and filled prescriptions for buprenorphine and methadone. Drug Alcohol Rev 2014;33:491–498]
Bibliography:	istex:26D00D59064212714D822323C875A08286A3C7C4 ark:/67375/WNG-Z7K31JGL-H ArticleID:DAR12143
ISSN:	0959-5236 1465-3362 1465-3362
DOI:	10.1111/dar.12143