title: Comparison of abuse, suspected suicidal intent, and fatalities related to the 7-day buprenorphine transdermal patch versus other opioid analgesics in the National Poison Data System.
abstract: OBJECTIVE
  Prescription opioid related abuse, suicide and death are significant public health problems. This study compares rates of poison center calls categorized as intentional abuse, suspected suicidal intent or fatality for the 7-day buprenorphine transdermal system/patch (BTDS) with other extended-release and long-acting (ER/LA) opioids indicated for chronic pain.
  
  
  METHODS
  Retrospective 24-month cohort study using National Poison Data System data from July 2012 through June 2014. BTDS was introduced in the United States in January 2011. Numbers and rates of calls of intentional abuse, suspected suicidal intent and fatalities were evaluated for BTDS, ER morphine, ER oxycodone, fentanyl patch, ER oxymorphone and methadone tablets/capsules, using prescription adjustment to account for community availability. Rate ratios (RR) and 95% confidence intervals (CI) were calculated.
  
  
  RESULTS
  Absolute numbers and prescription-adjusted rates of intentional abuse and suspected suicidal intent with BTDS were significantly lower (p < .0001) than for all other ER/LA opioid analgesics examined. No fatalities associated with BTDS exposure were reported.
  
  
  CONCLUSIONS
  This post-marketing evaluation of BTDS indicates infrequent poison center calls for intentional abuse and suspected suicidal intent events, suggesting lower rates of these risks with BTDS compared to other ER/LA opioids.
authors.affiliation: a Purdue Pharma L.P ., Stamford , CT , USA.|b University of Pennsylvania , Philadelphia , PA , USA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Coplan
authors.affiliation: a Purdue Pharma L.P ., Stamford , CT , USA.
authors.forename: Nelson E
authors.initials: NE
authors.lastname: Sessler
authors.affiliation: a Purdue Pharma L.P ., Stamford , CT , USA.
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Harikrishnan
authors.affiliation: a Purdue Pharma L.P ., Stamford , CT , USA.
authors.forename: Richa
authors.initials: R
authors.lastname: Singh
authors.affiliation: c Mount Sinai Beth Israel, Bernstein Pavilion , New York , NY , USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Perkel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002047:Buprenorphine / Q000009:adverse effects* / Q000627:therapeutic use*; D002423:Cause of Death; D059350:Chronic Pain / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011039:Poison Control Centers / Q000706:statistics & numerical data*; D063487:Prescription Drug Misuse / Q000401:mortality* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data; D057968:Transdermal Patch; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine
keywords: Buprenorphine transdermal patch; National Poison Data System (NPDS); intentional abuse; suspected suicidal intent