title: Notes from the Field: Pediatric Emergency Department Visits for Buprenorphine/Naloxone Ingestion - United States, 2008-2015.
abstract: Expanding access to office-based medication-assisted treatment with buprenorphine/naloxone for opioid dependence is a key part of the national strategy to address the opioid abuse epidemic (1). However, as buprenorphine/naloxone prescribing increased, emergency department (ED) visits and hospitalizations for unsupervised ingestions by young children began to increase, with buprenorphine/naloxone ingestions becoming the most common cause of hospitalization for medication ingestions by young children during 2010-2011 (2). Buprenorphine ingestions might be asymptomatic or can cause drowsiness, vomiting, or respiratory depression, which if untreated can result in death (3). Buprenorphine/naloxone was available only as tablets in multidose child-resistant bottles (Suboxone) until late 2010, when film strips packaged in unit-dose, child-resistant pouches were introduced. In 2013, tablets became available in unit-dose packaging (Zubsolv). Because unit-dose, child-resistant packaging encloses each dose until opened, it might limit unintended ingestions by young children compared with traditional child-resistant bottles that must be resecured after every use (4). This study compared ED visits for pediatric buprenorphine/naloxone ingestions before and after these product packaging/formulation changes.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Budnitz
authors.forename: Maribeth C
authors.initials: MC
authors.lastname: Lovegrove
authors.forename: Mathew R P
authors.initials: MR
authors.lastname: Sapiano
authors.forename: Justin
authors.initials: J
authors.lastname: Mathew
authors.forename: Scott R
authors.initials: SR
authors.lastname: Kegler
authors.forename: Andrew I
authors.initials: AI
authors.lastname: Geller
authors.forename: Christian
authors.initials: C
authors.lastname: Hampp
mesh_terms: D002047:Buprenorphine / Q000633:toxicity*; D000069479:Buprenorphine, Naloxone Drug Combination; D002675:Child, Preschool; D004349:Drug Packaging; D004435:Eating; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D009270:Naloxone / Q000633:toxicity*; D010372:Pediatrics; D014481:United States
chemical_list: D000069479:Buprenorphine, Naloxone Drug Combination; D009270:Naloxone; D002047:Buprenorphine