ArticleJournal of medical toxicology : official journal of the American College of Medical Toxicology2021
Opioid Overdose Deaths with Buprenorphine Detected in Postmortem Toxicology: a Retrospective Analysis.
Article in Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- A Systematic Review of State Office-Based Buprenorphine Treatment Laws Effective During 2022: Counseling, Dosage, and Visit Frequency Requirements.Substance use & addiction journal · 2024Pooled it
- A wearable acoustofluidic patch for rapid reversal of opioid overdose.Nature communications · 2026Article
- Can Buprenorphine Be Overdosed? The Ceiling Effect and Its Clinical Implications.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Buprenorphine Microinduction Treatment in Tri-Diagnosis Patients with Opioid Use Disorder and Chronic Non-Cancerous Pain.Current pain and headache reports · 2026Review
- Article
- Buprenorphine deaths confirmed by toxicology reveal a low proportion of opioid agonist treatment before death in Finland.International journal of legal medicine · 2024Article
- Composition of buprenorphine prescribing networks in Medicaid and association with quality of care.Journal of substance use and addiction treatment · 2024Observational
- Quantifying a potential protective effect of buprenorphine on fatality risk during acute fentanyl exposures.Journal of substance use and addiction treatment · 2024Article
- A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use Disorder.Drugs in R&D · 2023Review
- An Examination of the Complex Pharmacological Properties of the Non-Selective Opioid Modulator Buprenorphine.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Buprenorphine involvement in opioid overdose deaths: A retrospective analysis of postmortem toxicology in Marion County, Indiana, 2015-2021.Drug and alcohol dependence reports · 2023Article
- Article
- Characterization of Unintentional Deaths Among Buprenorphine Users.Journal of studies on alcohol and drugs · 2023Article
- CommunityStat: A Public Health Intervention to Reduce Opioid Overdose Deaths in Burlington, Vermont, 2017-2020.Contemporary drug problems · 2022Article
- Alternative use of buprenorphine among people who use opioids in three U.S. Cities.Substance abuse · 2022Article
- Addressing racial & socioeconomic disparities in access to medications for opioid use disorder amid COVID-19.Journal of substance abuse treatment · 2021Article
- Benefit-Risk Analysis of Buprenorphine for Pain Management.Journal of pain research · 2021Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundBuprenorphine is a unique μ-opioid receptor partial agonist with avid receptor binding, nominal euphoric reward, and a ceiling effect on sedation and respiratory depression. Despite a pharmacologic profile that enhances safety, cases of fatal opioid overdose with buprenorphine on postmortem toxicology are reported, but details of these cases in the literature are limited.
methodsA retrospective review of opioid-involved drug overdose fatalities in Rhode Island (RI) from 2016 to 2018 using the RI Department of Health State Unintentional Drug Overdose Reporting System (SUDORS) database. Deaths with buprenorphine on toxicology testing versus opioid-involved overdose deaths without buprenorphine were compared to assess the type and number of co-exposures.
resultsOf 534 opioid-involved deaths, 29 (5.4%) included buprenorphine and/or norbuprenorphine on toxicology. Most frequent co-exposures are as follows: fentanyl (75.9%), norfentanyl (72.4%), cocaine (41.4%), benzoylecgonine (41.4%), cannabinoids (31.0%), ethanol (31.0%), levamisole (31.0%), and free morphine (31.0%). An average number of co-exposures for fatalities with buprenorphine were 9.24 versus 6.68 in those without buprenorphine. In one case buprenorphine was the only drug listed to cause death; all other fatalities with buprenorphine on toxicology reported additional drugs contributing to death.
conclusionDecedents with buprenorphine detected on toxicology testing commonly had documented polysubstance use. Although data are limited, buprenorphine may provide some risk mitigation against full agonist opioid overdose including fentanyl. Further work should explore the use of postmortem concentrations of buprenorphine, norbuprenorphine, and other opioid metabolites to determine the role of buprenorphine in fatal overdose pharmacology.
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