Many Patients Taking Buprenorphine Also Fill Opioid Prescriptions

In a recent study, more than two-fifths of individuals who were taking buprenorphine for the treatment of opioid addiction also fill prescriptions for opioids during treatment, and two-thirds filled opioid prescriptions following treatment.

Researchers from Johns Hopkins Bloomberg School of Public Health noted that non-buprenorphine prescription opioid use among patients taking buprenorphine for opioid use disorder is not well defined.
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In order to estimate the prevalence on non-buprenorphine opioid use among buprenorphine users, they conducted an analysis of pharmacy claims from a cohort of approximately 50 million patients who filled 2 or more prescriptions for any opioid from 2006 to 2013.

Among the 38,096 individuals who met inclusion criteria, median length of the first treatment episode was 55 days.

Four measures of non-buprenorphine use were calculated: the number of prescriptions; quantity dispensed; days of supply; and total morphine milligram equivalents (MME) before, during, and after the first treatment episode.

Overall, approximately two-fifths of buprenorphine recipients also filled an opioid prescription during the treatment episode, while two-thirds filled an opioid prescription following treatment. “The mean total of MME per opioid day supplied 12 months prior to treatment declined from 57 mg/per day to 54 mg/per day during the treatment episode, then remained constant at 55 mg/per day following the treatment episode,” the authors wrote.

“The use of buprenorphine for the treatment of opioid use disorder has increased markedly in the United States,” they concluded. “However, a substantial proportion of patients fill prescriptions for non-buprenorphine opioids during and following such treatment.”

—Michael Potts

Reference:

Daubresse M, Saloner B, Pollack HA, Alexander GC. Non-buprenorphine opioid utilization among patients using buprenorphine [published online February 23, 2017]. Addiction. doi:10.1111/add.13762.