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Buprenorphine-Involved Overdose Deaths Before and During the COVID-19 Pandemic

Buprenorphine-based treatment for opioid use disorder during the COVID-19 pandemic was not associated with an increased proportion of overdose deaths involving buprenorphine, according to results of a cross-sectional study. “Efforts are needed to expand more equitable and culturally competent access to and provision of buprenorphine-based treatment,” the authors conclude.

Data on overdose deaths came from the State Unintentional Drug Overdose Reporting System (SUDORS) and included 46 states and the District of Columbia from July 2019 to June 2021. Based on outcomes related to buprenorphine- and other opioid-involved overdose deaths, the study shows: “During July 2019 to June 2021, 32 jurisdictions reported 89,111 total overdose deaths and 74,474 opioid-involved overdose deaths, including 1,955 buprenorphine-involved overdose deaths, accounting for 2.2% of all drug overdose deaths and 2.6% of opioid-involved overdose deaths. Median (IQR) age was similar for buprenorphine-involved overdose deaths (41 [34-55] years) and other opioid–involved overdose deaths (40 [31-52] years). A higher proportion of buprenorphine-involved overdose decedents, compared with other opioid–involved decedents, were female (36.1% [95% CI, 34.2%-38.2%] vs 29.1% [95% CI, 28.8%-29.4%]), non-Hispanic White (86.1% [95% CI, 84.6%-87.6%] vs 69.4% [95% CI, 69.1%-69.7%]), and residing in rural areas (20.8% [95% CI, 19.1%-22.5%] vs 11.4% [95% CI, 11.2%-11.7%]). Although monthly opioid-involved overdose deaths increased, the proportion involving buprenorphine fluctuated but did not increase during July 2019 to June 2021. Nearly all (92.7% [95% CI, 91.5%-93.7%]) buprenorphine-involved overdose deaths involved at least 1 other drug; higher proportions involved other prescription medications compared with other opioid-involved overdose deaths (eg, anticonvulsants: 18.6% [95% CI, 17.0%-20.3%] vs 5.4% [95% CI, 5.2%-5.5%]) and a lower proportion involved illicitly manufactured fentanyls (50.2% [95% CI, 48.1%-52.3%] vs 85.3% [95% CI, 85.1%-85.5%]). Buprenorphine decedents were more likely to be receiving mental health treatment than other opioid–involved overdose decedents (31.4% [95% CI, 29.3%-33.5%] vs 13.3% [95% CI, 13.1%-13.6%]).”

Source: JAMA Network Open