Flexibility in prescribing buprenorphine does not increase overdose deaths: New study

Mar 14, 2023

According to the results of a new study, the proportion of opioid-linked overdose deaths involving buprenorphine, a medication used to treat opioid use disorder, did not significantly increase after prescribing flexibilities were introduced in the U.S. during the COVID-19 pandemic.

The research was carried out as a collaboration between the U.S. National Institute on Drug Abuse (NIDA), which is part of the National Institutes of Health, and the Center for Disease Control and Prevention (CDC).

Specifically, the study found that buprenorphine was involved in a very small proportion of drug overdose deaths over the period spanning July 2019 and June 2021. During the period examined by the study, there were 1,955 buprenorphine-involved overdose deaths, which represented 2.2% of the 89,111 total overdose deaths and 2.6% of the 74,474 opioid-involved overdose deaths recorded in the dataset. Furthermore, between April 2020 and June 2021, when buprenorphine prescribing regulations were relaxed in the U.S. during the COVID-19 pandemic, researchers determined that the proportion of opioid-related overdose deaths involving buprenorphine did not increase.

“Research has shown beyond a doubt that medications for opioid use disorder are overwhelmingly beneficial and can be lifesaving, yet they continue to be vastly underused,” said NIDA Director and senior author, Dr. Nora Volkow in her interview with NIH. “Expanding more equitable access to these medications for people with substance use disorders is a critical part of our nation’s response to the overdose crisis. The findings from this study strengthen existing evidence suggesting that greater flexibility in prescribing may be one safe method for working toward this goal.”

Finally, the study results demonstrate that the majority of individuals who died of an overdose involving any opioid, including buprenorphine were not receiving treatment for substance use disorders at the time of the overdose.

Importantly, the results of this research correspond to the findings of another recent study showing that increasing access to methadone for the treatment of opioid use disorder was not associated with an augmentation in methadone-involved overdose deaths.

Data reported by the CDC shows that in 2021, approximately 107,000 people died of a drug overdose in the U.S., with 75% of overdose deaths linked to opioid use. Moreover, CBC attributes the increase in overdose deaths to the increasing appearance of fentanyl in the illicit drug supply, in the drug supply of illicit fentanyl, a highly potent synthetic opioid.

Despite the benefits of medications used to treat opioid use disorder, a report by the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that in 2021, only less than one-quarter of individuals with the disorder receive these medications. Specifically, buprenorphine, is prescribed to reduce opioid misuse, reduce the risk of injection-related infectious diseases, and decrease the risk of fatal and non-fatal overdoses.