title: Adverse effects in children after unintentional buprenorphine exposure.
abstract: Buprenorphine in sublingual formulation was recently introduced to the American market for treatment of opioid dependence. We report a series of 5 toddlers with respiratory and mental-status depression after unintentional buprenorphine exposure. Despite buprenorphine's partial agonist activity and ceiling effect on respiratory depression, all children required hospital admission and either opioid-antagonist therapy or mechanical ventilation. Results of routine urine toxicology screening for opioids were negative in all cases. Confirmatory testing was sent for 1 child and returned with a positive result. The increasing use of buprenorphine as a home-based therapy for opioid addiction in the United States raises public health concerns for the pediatric population.
authors.affiliation: Program in Medical Toxicology, Division of Emergency Medicine, Children's Hospital Boston, Boston, Massachusetts, USA. ajgeib@hotmail.com
authors.forename: Ann-Jeannette
authors.initials: AJ
authors.lastname: Geib
authors.forename: Kavita
authors.initials: K
authors.lastname: Babu
authors.forename: Michele Burns
authors.initials: MB
authors.lastname: Ewald
authors.forename: Edward W
authors.initials: EW
authors.lastname: Boyer
mesh_terms: D000701:Analgesics, Opioid / Q000506:poisoning*; D002047:Buprenorphine / Q000506:poisoning*; D003244:Consciousness Disorders / Q000139:chemically induced; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009270:Naloxone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D011041:Poisoning / Q000175:diagnosis / Q000188:drug therapy; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000139:chemically induced*
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine