Six deaths linked to concomitant use of buprenorphine and benzodiazepines

Aims. Buprenorphine at high dosage became available in 1996 for substitution treatment in France. This drug is considered particulary safe and has become widely available in general medical practice. We investigated the possible implication of a buprenorphine‐benzodiazepine association in six deaths...

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Bibliographic Details
Published in:Addiction (Abingdon, England) England), 1998-09, Vol.93 (9), p.1385-1392
Main Authors: Reynaud, Michel, Petit, Georges, Potard, Denis, Courty, Pascal
Format: Article
Language:English
Subjects:
Addiction
Adolescent
Adult
Benzodiazepines
Biological and medical sciences
Buprenorphine
Cause of Death
Death
Dependency rehabilitation
Drug abuse
Drug abusers
Drug addiction
Drug addictions
Drug Interactions
Drug therapy
Factors
Fatalities
France
France - epidemiology
Health care
Humans
Male
Medical sciences
Mortality
Narcotics
Opiates
Opioid-Related Disorders - mortality
Substance abuse
Substance-Related Disorders - mortality
Toxicology
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Summary:Aims. Buprenorphine at high dosage became available in 1996 for substitution treatment in France. This drug is considered particulary safe and has become widely available in general medical practice. We investigated the possible implication of a buprenorphine‐benzodiazepine association in six deaths of known abusers. Design. Full investigation of cause of death was conducted for six drug abusers. Setting. The deaths occurred in two regions of France (Auvergne and Lorraine). Assays were carried out by the Institut de Medecine Legale at Strasbourg, France, one of the few French laboratories equipped to assay buprenorphine. Measurement. First, the blood and urine underwent triple exhaustive screening. Secondly, buprenorphine and norbuprenorphine were analysed in all the autopsy samples by HPLC/MS. Findings. Benzodiazepine‐buprenorphine associations were found in every case; no other substances that could account for the death were found. The tissue concentrations were markedly higher than the blood levels. Conclusion. If the number of deaths linked to such drug misuse proves high, it may be necessary to review how buprenorphine is dispensed.
ISSN:0965-2140
1360-0443
DOI:10.1046/j.1360-0443.1998.93913859.x