Buprenorphine Transdermal System Abused Less than Other Opioids

NATIONAL HARBOR, Md. — Compared with other opioids, the buprenorphine transdermal system had significantly fewer instances of intentional abuse, according to a study presented at the American Academy of Pain Medicine 31st Annual Meeting held here. 

Butrans is a once-weekly buprenorphine transdermal system. It is delivered via a patch and is the only buprenorphine-containing product approved to treat chronic pain in the United States. Few studies have looked at rates of abuse for the buprenorphine transdermal system compared with other opioids.

The researchers looked at patients who used at least one extended-release opioid product, including the buprenorphine transdermal system, fentanyl transdermal system, extended-release oxymorphone, extended-release oxycodone, or methadone. 

The number of prescriptions written for each drug was obtained from IMS Health. The primary outcome was intentional abuse exposures that had been reported to poison centers in the United States.

Out of 506,647 prescriptions for the buprenorphine transdermal system, there were only four reported overdoses (0.8 per 100,000). Out of 6,835,562 fentanyl transdermal system prescriptions, there were 361 reported overdoses (5.3 per 100,000; 6.69 times more than buprenorphine). Out of 6,058,158 extended-release oxycodone prescriptions, there were 230 reported overdoses (3.8 per 100,000; 4.81 times more than buprenorphine). Out of 959,557 extended-release oxymorphone prescriptions, there were 96 reported overdoses (10.0 per 100,000; 12.67 times more than buprenorphine). Out of 4,016,702 methadone prescriptions, there were 982 reported overdoses (24.4 per 100,000; 30.97 times more than buprenorphine).

The results show that the buprenorphine transdermal system had lower rates of overdoses in both the raw data and after adjusting for prescription rates compared with other opioids. While there were still incidences of abuse, the overall rates are significantly lower, suggesting that that the buprenorphine transdermal system could be a safer choice than comparable drugs.

The researchers note that this study only includes overdoses that resulted in a call to a poison center, which does not necessarily represent all overdoses.

All of the researchers in this study disclosed their status as employees of Purdue Pharma, L.P. in Stanford, Conn.