@article{ref1,
title="Characteristics and circumstances of death related to buprenorphine toxicity in  Australia",
journal="Drug and alcohol dependence",
year="2020",
author="Darke, Shane and Duflou, Johan and Larance, Briony and Farrell, Michael and Lappin, Julia",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Buprenorphine is a semi-synthetic opioid used in the treatment of opioid  dependence and chronic pain. The current study aimed to determine the  characteristics and circumstances of all recorded cases of buprenorphine-related  toxicity death in Australia; determine toxicology and organ pathology; and compare  these profiles to cases of death due to buprenorphine-related traumatic injury. <br><br>METHODS: All cases of buprenorphine-related drug toxicity death were retrieved from  the National Coronial Information System (2000-2019), as were all cases of  buprenorphine-related traumatic injury. Information was collected on cause of death,  case characteristics, toxicology and major organ pathology. <br><br>RESULTS: A total of 314  cases of drug toxicity and 55 of traumatic injury were identified. Toxicity cases  were significantly older (40.5 v 36.1 years), more likely to have a history of  chronic pain (OR 2.95), less likely to have a history of injecting drug use (OR  0.09), but more likely to have injected buprenorphine proximal to death (OR 4.90). There were no group differences in buprenorphine or norbuprenorphine toxicology. Toxicity cases were more likely to have hypnosedatives (OR 2.08) and other opioids  (OR 4.69) present, but less likely to have psychostimulants (OR 0.26) and THC (OR  0.45). Toxicity cases were more likely to be obese (OR 4.05), have pre-existing  cardiovascular disease (OR 4.02) and heavier hearts (412.1 v 355.2 g). <br><br>CONCLUSIONS:  Buprenorphine-related toxicity death cases differed from trauma deaths in their  characteristics, toxicology and disease. Fatal buprenorphine toxicity is associated  with older age, concurrent use of depressants and cardiovascular disease.<p /> <p>Language: en</p>",
language="en",
issn="0376-8716",
doi="10.1016/j.drugalcdep.2020.108360",
url="http://dx.doi.org/10.1016/j.drugalcdep.2020.108360"
}