Wiegand Timothy J, Le Lait Marie-Claire, Bartelson Becki Bucher, Dart Richard C, Green Jody L
Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York.
Research Department, Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado.
J Pain. 2016 Jun;17(6):745-52. doi: 10.1016/j.jpain.2016.02.015. Epub 2016 Mar 18.
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.
在美国,处方阿片类药物滥用和转移是发病和死亡的主要原因。丁丙诺啡透皮给药系统(BTDS)适用于治疗中度至重度慢性疼痛,可连续7天提供5、7.5、10、15或20μg/小时的丁丙诺啡剂量。将BTDS的季度滥用和转移率与4个对照群组进行比较:1)其他丁丙诺啡产品,2)芬太尼透皮贴剂,3)缓释(ER)阿片类片剂/胶囊,以及4)ER曲马多。数据来自研究性滥用、转移和成瘾相关监测(RADARS)系统中毒控制中心、药物转移、治疗项目综合(阿片类药物治疗和关键信息提供者患者项目调查)以及大学调查项目。率的计算使用每人群的病例数和每填充处方的提及数。在考虑药物组特定的离散参数后,使用泊松回归分析比较各药物组随时间的平均率。与其他对照群组相比,在所有RADARS系统项目中,BTDS的人群调整滥用率都很低。处方调整率的结果类似,在所有项目中BTDS的报告率最低。根据项目不同,BTDS和对照群组的滥用途径略有差异。在RADARS系统的5个项目中,使用基于人群的率或处方配发率,与其他阿片类药物组相比,BTDS的滥用和转移率较低。
RADARS系统的数据显示,与其他阿片类药物组(包括其他形式的丁丙诺啡、芬太尼透皮贴剂、ER阿片类制剂和ER曲马多)相比,BTDS的滥用和转移率较低。