Public Needs Education On Buprenorphine Injectons To Avoid Complications: CDC

According to a new study, many users receiving buprenorphine as a treatment for opioid addiction are experiencing serious injection complications from the drug.

In findings published August 14 in the U.S. Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report, about two-thirds of all emergency room visits linked to non-medical buprenorphine are related to injection site complications.

Buprenorphine is an opioid used to help treat pain, but is also used to treat opioid use disorder. It can be injected, used under the tongue, placed in the cheek, or via skin patch.

CDC researchers say they believe buprenorphine is a critical component of treatment of opioid abuse, which is why they studied complications from the drug and how to prevent them.

“Complications of injecting transmucosal buprenorphine products represent a potentially preventable source of morbidity from nonmedical use of buprenorphine,” the researchers wrote. “Further description of complications related to buprenorphine injection can help prevent these complications while preserving access to this effective therapy for opioid use disorder.”

The CDC used data form the National Electronic Injury Surveillance System Cooperative Adverse Drug Event Surveillance project, a public health surveillance system to gather data on nonmedical opioid use-related visits to emergency departments (ED).

According to the findings, the CDC looked at data on emergency department visits from 2016-2018, and estimated there were about 47,437 visits per year for nonmedical injection of prescription opioids. Of those, about one third involved buprenorphine products.

The CDC researchers further estimated that two-thirds of those patients were men, and the mean age of the patient was 33. Most, 85%, of the buprenorphine-related ED visits involved the use of Suboxone, which is a combination of buprenorphine and naloxone, the opioid overdose reversal drug.

Two-thirds of those cases involved injection-specific complications and included reports of abscess, cellulitis, infective endocarditis, sepsis, septic arthritis, unspecified injection-site infections, and noninfection injection-specific complications such as injection site thrombosis or ischemia.

“The national estimates likely represent an undercount of the true number of visits for injection-related complications because patients might not disclose injections, and secondary chronic infections (e.g. human immunodeficiency virus or hepatitis C) might not be identified,” the CDC researchers noted. “Buprenorphine treatment is an important component of the public health response to the opioid overdose epidemic. Patients evaluated in EDs and other settings with injection-related complications might be referred to syringe services programs, where available, and educated on infection prevention practices.”