title: Analysis of the Abuse and Diversion of the Buprenorphine Transdermal Delivery System.
abstract: Prescription opioid abuse and diversion are major causes of morbidity and mortality in the United States. The buprenorphine transdermal delivery system (BTDS) is indicated for the treatment of moderate to severe chronic pain and provides a continuous dose of 5, 7.5, 10, 15, or 20 μg/h buprenorphine for 7 days. Quarterly rates of abuse and diversion of BTDS were compared with 4 comparator groups: 1) other buprenorphine products, 2) fentanyl patches, 3) extended-release (ER) opioid tablets/capsules, and 4) ER tramadol. Data were obtained from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System Poison Center, Drug Diversion, Treatment Programs Combined (Opioid Treatment and Survey of Key Informants' Patients Programs), and College Survey Programs. Rates were calculated using case counts per population and mentions per prescriptions filled. Poisson regression analysis was used to compare mean rates over time across drug groups after allowing for drug group-specific dispersion parameters. Population adjusted abuse rates were low for BTDS in all of the RADARS System programs compared with the other comparator groups. Findings were similar for the prescription adjusted rates, with BTDS reported at the lowest rates in all programs. Route of abuse differed slightly for BTDS and the comparator groups depending on the program. BTDS was abused and diverted at low rates compared with the other opioid groups in 5 programs of the RADARS System using either population-based rates or prescription dispensed rates.
  
  
  
  Data from the RADARS System show the BTDS is abused and diverted at low rates compared with other opioid groups including other forms of buprenorphine, fentanyl patches, ER opioid formulations, and ER tramadol.
authors.affiliation: Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York. Electronic address: Timothy_Wiegand@URMC.Rochester.edu.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Wiegand
authors.affiliation: Research Department, Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado.
authors.forename: Marie-Claire
authors.initials: MC
authors.lastname: Le Lait
authors.affiliation: Research Department, Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado.
authors.forename: Becki Bucher
authors.initials: BB
authors.lastname: Bartelson
authors.affiliation: Research Department, Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Dart
authors.affiliation: Research Department, Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado.
authors.forename: Jody L
authors.initials: JL
authors.lastname: Green
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage*; D059350:Chronic Pain / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage*; D058850:Opiate Substitution Treatment / Q000379:methods* / Q000706:statistics & numerical data; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology; D064226:Prescription Drug Diversion; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D009294:Narcotics; D002047:Buprenorphine; D005283:Fentanyl
keywords: Buprenorphine; Butrans; RADARS; opioid abuse; opioid diversion