ArticleThe International journal on drug policy2020
Unintentional drug overdose: Is more frequent use of non-prescribed buprenorphine associated with lower risk of overdose?
Article in The International journal on drug policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The impact of relaxing restrictions on take-home doses during the COVID-19 pandemic on program effectiveness and client experiences in opioid agonist treatment: a mixed methods systematic review.Substance abuse treatment, prevention, and policy · 2023Pooled it
- Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic review.Harm reduction journal · 2022Pooled it
- Retention in Telehealth-Delivered Buprenorphine Treatment for Opioid Use Disorder: Multistate Retrospective Cohort Study.Journal of medical Internet research · 2026Article
- Preparing Emergency Medical Services for Prehospital Buprenorphine: Examining a Train-the-Trainer Approach to Strengthening the Overdose Chain of Survival.Journal of the American College of Emergency Physicians open · 2026Article
- A qualitative study of the impacts of a government crackdown against revenue sharing between pharmacies and patients in Vancouver, Canada.Discover public health · 2026Article
- "I don't know how you can overdose smoking them:" Perceptions of overdose risks among persons who use illicit fentanyl-laced counterfeit pills.The International journal on drug policy · 2025Article
- Predicting Extent of Opioid Use Following Cardiac Surgery: A Pilot Study.Journal of cardiothoracic and vascular anesthesia · 2025Observational
- Non-Prescribed Use of Opioid Agonist Medications and Associations with Non-Fatal Overdoses: A Repeated Cross-Sectional Study across a Decade of Reduced Monitoring.European addiction research · 2025Article
- Buprenorphine/naloxone - one formulation that doesn't fit all: a case report.Harm reduction journal · 2024Article
- Article
- Fentanyl Exposure and Detection Strategies Utilized by Clinical Trial Participants Seeking Linkage to Opioid Use Disorder Treatment at a Syringe Service Program.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2024Article
- Buprenorphine use and setting type among reproductive-aged women self-reporting nonmedical prescription opioid use.Journal of substance use and addiction treatment · 2023Article
- Supervised on-site dosing in injectable opioid agonist treatment-considering the patient perspective. Findings from a cross-sectional interview study in two German cities.Harm reduction journal · 2023Article
- Examining buprenorphine diversion through a harm reduction lens: an agent-based modeling study.Harm reduction journal · 2023Article
- Research Priorities for Expansion of Opioid Use Disorder Treatment in the Community Pharmacy.Substance abuse · 2023Article
- Buprenorphine and opioid analgesics: Dispensation and discontinuity among accidental overdose fatalities in the Indianapolis metropolitan area, 2016-2021.Journal of substance use and addiction treatment · 2023Article
- Buprenorphine After Nonfatal Opioid Overdose: Reduced Mortality Risk in Medicare Disability Beneficiaries.American journal of preventive medicine · 2023Article
- Thematic Analysis of State Medicaid Buprenorphine Prior Authorization Requirements.JAMA network open · 2023Review
- Predictors of opioid overdose during the COVID-19 pandemic: The role of relapse, treatment access and nonprescribed buprenorphine/naloxone.Journal of substance use and addiction treatment · 2023Article
- Trajectories of non-prescribed buprenorphine and other opioid use: A multi-trajectory latent class growth analysis.Journal of substance use and addiction treatment · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundUnintentional drug overdoses have reached epidemic levels in the U.S. This study tests the hypothesis that people who have used non-prescribed buprenorphine more frequently in the past six months were less likely to experience a drug overdose during that same time period.
methodsParticipants age 18 years or older with opioid use disorder who reported use of non-prescribed buprenorphine in the last six months were recruited from the Dayton, Ohio, area using a combination of targeted and modified respondent-driven sampling. Participants completed a structured interview, including six-month timeline follow-back, after informed consent. Logistic regression was used to test the association between (log-transformed) frequency of non-prescribed buprenorphine use and overdose in the previous six months, adjusted for confounding due to sex, homelessness, incarceration, substance use treatment, previous overdose, heroin/fentanyl injection, psychiatric comorbidity, and (log-transformed) frequencies of other (non-opioid) drug use.
resultsAlmost 89% of 356 participants were white, 50.3% were male, and 78.1% had high school or greater education. Over 27% (n = 98) reported experiencing an overdose in the past six months. After adjusting for confounding, greater frequency of non-prescribed buprenorphine use was significantly associated with lower risk of overdose (AOR = 0.81, 95% CI = 0.66, 0.98; p = .0286). Experiencing an overdose more than six months ago (AOR = 2.19, 95% CI = 1.24, 3.97); injection as the most common route of administration of heroin/fentanyl (AOR = 2.49, 95% CI = 1.36, 4.71); and frequency of methamphetamine use (AOR = 1.13, 95% CI = 1.02, 1.27) were strongly associated with increased risk of recent overdose in multivariable analysis. DISCUSSION: The findings support our hypothesis that higher frequency of non-prescribed buprenorphine use is associated with lower risk of drug overdose, a potential harm reduction consequence of diversion. Improving the availability of buprenorphine though standard substance use disorder treatment, primary care, and other innovative methods is urgently needed.
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