Addiction Medication, Buprenorphine, Linked to Increased ER Visits

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Buprenorphine, used to treat opioid addiction, has been linked to an increase in hospital emergency room (ER) department visits, according to recent research. Opioids are linked with serious risks of overuse, abuse, misuse, and death and the numbers continue to rise. Physician prescribing practices are among the contributing factors in the ongoing and growing opioid epidemic being seen in America and worldwide.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA) ER visits over buprenorphine rose from 3,151 in 2005 to 30,135 in 2010, said Medical News Today. In 2002, buprenorphine was approved by the U.S. Food & Drug Administration to treat opioid addiction. Since, there has been a marked increased in the number of physicians prescribing the drug to their patients. Medical News Today noted that, in 2005, some 5,656 physicians prescribed buprenorphine to 100,000 patients; in 2010, those figures rose significantly to 18,582 doctors and 800,000 patients.

A weak opiod, buprenorphine helps opioid-addicted patients from suffering withdrawal effects. According to the study’s authors, “Harmful consequences can occur even when buprenorphine is taken as prescribed by a physician. If used by an individual who is dependent on large doses of opioids, buprenorphine can block the effect of other opioids and bring on withdrawal symptoms. Although these symptoms are not usually severe, emergency medical care may be required to relieve symptoms.”

Of the reported visits in 2010, half—15,778—were not medically related and more than half—59 percent—involved other drugs such as benzodiazepine, pain medications, and illicit drugs, said Medical News Today. In all, 66 percent  of the reports involved men; most patients were 24-34 years of age and took the drug non-medically.

When not taken correctly, buprenorphine can be dangerous. For example, in 2010, some 2.3 million emergency visits were reported over health complications associated with the incorrect use of buprenorphine. In fact, said Medical News Today, some branches of the federal government have implemented steps to lower buprenorphine abuse using physician education and medication guidance. Also, SAMHSA just announced it intends to monitor buprenorphine for abuse and to work to ensure physicians understand the drug’s potential addictive nature, said Medical News Today.

For the research, the Drug Abuse Warning Network (DAWN) data was used from reports conducted 2005-2011, which published the complete incidence of buprenorphine-related morbidity and mortality.

Last week, an FDA Panel voted 19 to 10 in favor of making hydrocodone-containing drugs Schedule II controlled substances, as are other narcotic painkillers, including oxycodone. The FDA Drug Safety and Risk Management Advisory Committee commented on the alarming increase in addiction and overdose deaths related to these medications and also previously approved a Risk Evaluation and Mitigation Strategy (REMS) for both extended-release (ER) and long-acting (LA) opioids. The REMS measure is part of a larger federal initiative and introduces new safety measures that were created to reduce risks and improve the safe use of ER/LA opioids, while also ensuring appropriate access to these medications for patients who are in pain.

Also last month, New York City Mayor Michael Bloomberg, announced new ER guidelines to prevent prescription painkiller abuse, explaining that in 2004-2010 the number of painkiller-related ER visits nearly tripled annually, said Medical News Today.

When the opioid, OxyContin (oxycodone), began to be touted for all types of chronic pain—back pain, arthritis—and advertised as a non-addictive alternative to other painkillers, the situation began escalating. In 2007, the maker of OxyContin, pleaded guilty to misbranding the drug “with intent to defraud and mislead the public,” paying $635 million in penalties. By that time, the truth about the drug was being seen—that it caused serious side effects, did not last the 12 hours advertised, was addictive, and caused serious withdrawal symptoms when stopped.

Sadly, many doctors falsely believe opioids are safe and efficacious for long-term, non-cancer pain, adding to the growing problem.