TY  - JOUR
PY  - 2013//
TI  - Parenteral buprenorphine-naloxone abuse is a major cause of fatal buprenorphine-related poisoning
JO  - Forensic science international
A1  - Häkkinen, Margareeta
A1  - Heikman, Pertti
A1  - Ojanperä, Ilkka
SP  - 11
EP  - 15
VL  - 232
IS  - 1-3
N2  - Buprenorphine (BPN) medication for opioid maintenance treatment in Finland consists predominantly of buprenorphine-naloxone (BNX). Both BPN and BNX are associated with diversion, abuse and non-medically supervised use worldwide. Our purpose was to estimate the proportion of BNX to all BPN-related fatalities. The material consisted of 225 deceased drug abusers in Finland from January 2010 to June 2011 with a positive BPN and/or norbuprenorphine (NOR) and/or naloxone (NX) finding in urine. The data were divided into three groups based on the urine NX and BPN concentrations. The "Parenteral BNX" group (>100μg/l NX) was presumed to consist of injecting or snorting BNX abusers and the "Parenteral BPN" group (>50μg/l BPN, 0μg/l NX) of injecting or snorting BPN abusers, while the "Other BNX or BPN" group (≤100μg/l NX, or ≤50μg/l BPN combined with 0μg/l NX) was presumed to consist of mainly sublingual BNX or BPN users. In 12.4% of cases the NX urine concentration was higher than the threshold 100μg/l. In fatal BPN poisonings, the proportion of parenteral BNX was 28.4%. In the "Parenteral BNX", "Parenteral BPN" and "Other BNX or BPN" groups, the proportion of fatal BPN poisonings was 67.9, 31.0 and 22.6%, respectively. BNX abuse can be fatal. Among the 225 BPN-related fatalities, parenteral abuse of BNX was shown to be common (12.4%) and BNX poisoning was the underlying cause of death in 8.4%. Parenteral BNX caused fatal BPN poisoning proportionally more often than parenteral BPN.<p />  <p>Language: en</p>
LA  - en
SN  - 0379-0738
UR  - http://dx.doi.org/10.1016/j.forsciint.2013.06.017
ID  - ref1
ER  -