High buprenorphine-related mortality is persistent in Finland
•In 28.8% of the fatalities, buprenorphine had been administered parenterally.•The proportion of parenteral use remained relatively constant over the study period.•The majority of the parenteral users had taken mono-buprenorphine.•Poly-substance use was evident in nearly all buprenorphine-positive f...
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| Veröffentlicht in: | Forensic science international 2018-10, Vol.291, p.76-82 |
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| creator | Kriikku, Pirkko Häkkinen, Margareeta Ojanperä, Ilkka |
| description | •In 28.8% of the fatalities, buprenorphine had been administered parenterally.•The proportion of parenteral use remained relatively constant over the study period.•The majority of the parenteral users had taken mono-buprenorphine.•Poly-substance use was evident in nearly all buprenorphine-positive fatalities.
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 poly-drug use. |
| doi_str_mv | 10.1016/j.forsciint.2018.08.010 |
| format | Article |
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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 poly-drug use.</description><identifier>ISSN: 0379-0738</identifier><identifier>EISSN: 1872-6283</identifier><identifier>DOI: 10.1016/j.forsciint.2018.08.010</identifier><identifier>PMID: 30170272</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Abuse ; Age ; Alcohol ; Alcoholic beverages ; Autopsy ; Buprenorphine ; Chromatography ; Drug abuse ; Drug overdose ; Drugs ; Fatal poisoning ; Fatalities ; Forensic pathology ; Forensic sciences ; Investigations ; Laboratories ; Legal medicine ; Mortality ; Naloxone ; Narcotics ; Nervous system ; Opioid maintenance treatment ; Opioids ; Overdose ; Poisoning ; Poisons ; Substance abuse treatment ; Toxicology ; Urine</subject><ispartof>Forensic science international, 2018-10, Vol.291, p.76-82</ispartof><rights>2018 Elsevier B.V.</rights><rights>Copyright © 2018 Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier Limited Oct 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-44f1641b6ae22d580781e17623793dcf204c8fe1a02b5c5023eafe7ad8c9afb43</citedby><cites>FETCH-LOGICAL-c474t-44f1641b6ae22d580781e17623793dcf204c8fe1a02b5c5023eafe7ad8c9afb43</cites><orcidid>0000-0002-5721-2827</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2116599337?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30170272$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kriikku, Pirkko</creatorcontrib><creatorcontrib>Häkkinen, Margareeta</creatorcontrib><creatorcontrib>Ojanperä, Ilkka</creatorcontrib><title>High buprenorphine-related mortality is persistent in Finland</title><title>Forensic science international</title><addtitle>Forensic Sci Int</addtitle><description>•In 28.8% of the fatalities, buprenorphine had been administered parenterally.•The proportion of parenteral use remained relatively constant over the study period.•The majority of the parenteral users had taken mono-buprenorphine.•Poly-substance use was evident in nearly all buprenorphine-positive fatalities.
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 poly-drug use.</description><subject>Abuse</subject><subject>Age</subject><subject>Alcohol</subject><subject>Alcoholic beverages</subject><subject>Autopsy</subject><subject>Buprenorphine</subject><subject>Chromatography</subject><subject>Drug abuse</subject><subject>Drug overdose</subject><subject>Drugs</subject><subject>Fatal poisoning</subject><subject>Fatalities</subject><subject>Forensic pathology</subject><subject>Forensic sciences</subject><subject>Investigations</subject><subject>Laboratories</subject><subject>Legal medicine</subject><subject>Mortality</subject><subject>Naloxone</subject><subject>Narcotics</subject><subject>Nervous system</subject><subject>Opioid maintenance treatment</subject><subject>Opioids</subject><subject>Overdose</subject><subject>Poisoning</subject><subject>Poisons</subject><subject>Substance abuse treatment</subject><subject>Toxicology</subject><subject>Urine</subject><issn>0379-0738</issn><issn>1872-6283</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkE1LxDAQhoMoun78BS148dJ1krRNevAgi18geNFzSNOpZummNUkF_71Zdt2DF2FgLs-88_IQckFhToFW18t5N_hgrHVxzoDKOaShsEdmVAqWV0zyfTIDLuocBJdH5DiEJQCUJasOyREHKoAJNiM3j_b9I2um0aMb_PhhHeYeex2xzVaDj7q38TuzIRvRBxsiuphZl91b12vXnpKDTvcBz7b7hLzd370uHvPnl4enxe1zbgpRxLwoOloVtKk0MtaWEoSkSEXFUj_emo5BYWSHVANrSlMC46g7FLqVptZdU_ATcrXJHf3wOWGIamWDwT51wGEKikEthWBS8oRe_kGXw-RdaqcYpVVZ15yLRIkNZfwQgsdOjd6utP9WFNTasFqqnWG1NqwgDYV0eb7Nn5oVtru7X6UJuN0AmIR8WfQqpaAz2FqPJqp2sP8--QFeCJBy</recordid><startdate>20181001</startdate><enddate>20181001</enddate><creator>Kriikku, Pirkko</creator><creator>Häkkinen, Margareeta</creator><creator>Ojanperä, Ilkka</creator><general>Elsevier B.V</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5721-2827</orcidid></search><sort><creationdate>20181001</creationdate><title>High buprenorphine-related mortality is persistent in Finland</title><author>Kriikku, Pirkko ; 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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 poly-drug use.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>30170272</pmid><doi>10.1016/j.forsciint.2018.08.010</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-5721-2827</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Abuse Age Alcohol Alcoholic beverages Autopsy Buprenorphine Chromatography Drug abuse Drug overdose Drugs Fatal poisoning Fatalities Forensic pathology Forensic sciences Investigations Laboratories Legal medicine Mortality Naloxone Narcotics Nervous system Opioid maintenance treatment Opioids Overdose Poisoning Poisons Substance abuse treatment Toxicology Urine |
| title | High buprenorphine-related mortality is persistent in Finland |
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