title: Buprenorphine infrequently found in fatal overdose in New York City.
abstract: BACKGROUND
  Buprenorphine is an opioid agonist medication that is both safe and effective in the treatment of opioid use disorders and the prevention of opioid overdoses. Despite this, media coverage has highlighted public concerns about the potential safety consequences of buprenorphine misuse and diversion. To address the possible contribution of buprenorphine to overdose mortality, we systematically tested post mortem blood specimens from decedents who had died of an unintentional drug overdoses in 2013.
  
  
  METHODS
  We retrospectively tested consecutive drug overdose cases that occurred from June through October 2013. Cases with available blood specimens were tested for buprenorphine and norbuprenorphine using liquid chromatography-tandem mass spectrometry. Toxicology results were linked to death certificates and case files from New York City Vital Statistics and New York City Office of the Chief Medical Examiner.
  
  
  RESULTS
  Of the 98 unintentional drug overdose fatalities tested, only 2 (2.0%) tested positive for buprenorphine metabolites. All 98 unintentional fatalities involved multiple substances.
  
  
  CONCLUSIONS
  Buprenorphine was infrequently found in drug overdose deaths in New York City. Since the safety and efficacy of buprenorphine are well documented, and overdoses resulting from buprenorphine treatment or diversion are very rare, facilitating access to buprenorphine treatment is strongly recommended.
authors: New York City Department of Health and Mental Hygiene, Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, 42-09 28th Street, Queens, NY 11101, United States. Electronic address: dpaone@health.nyc.gov.
authors: Denise
authors: D
authors: Paone
authors: New York City Department of Health and Mental Hygiene, Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, 42-09 28th Street, Queens, NY 11101, United States.
authors: Ellenie
authors: E
authors: Tuazon
authors: New York City Office of the Chief Medical Examiner, 520 First Avenue, New York, NY 10016, United States.
authors: Marina
authors: M
authors: Stajic
authors: New York City Office of the Chief Medical Examiner, 520 First Avenue, New York, NY 10016, United States.
authors: Barbara
authors: B
authors: Sampson
authors: New York City Department of Health and Mental Hygiene, Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, 42-09 28th Street, Queens, NY 11101, United States.
authors: Bennett
authors: B
authors: Allen
authors: New York City Department of Health and Mental Hygiene, Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, 42-09 28th Street, Queens, NY 11101, United States.
authors: Shivani
authors: S
authors: Mantha
authors: New York City Department of Health and Mental Hygiene, Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, 42-09 28th Street, Queens, NY 11101, United States.
authors: Hillary
authors: H
authors: Kunins
mesh_terms: D000701:Analgesics, Opioid / Q000097:blood; D002047:Buprenorphine / Q000031:analogs & derivatives / Q000097:blood*; D002423:Cause of Death; D062787:Drug Overdose / Q000097:blood* / Q000401:mortality*; D006801:Humans; D009519:New York City / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; C043585:norbuprenorphine
keywords: Buprenorphine; Overdose