Misuse and Diversion of Methadone and Buprenorphine Are Increasing, but Buprenorphine Appears to Have a Better Safety Profile
Buprenorphine is increasingly used for opioid agonist treatment and methadone for pain, raising concerns about diversion, misuse, and overdose. To assess the relative safety of both medica-tions investigators analyzed data from the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS) system from 2003 to 2007. This system collects data from prescription-medication investigators and regulators, poison-control centers, and opioid-agonist treatment programs. Estimated rates of abuse, misuse, and diversion were calculated based on census data and pharmacy records.
- Rates of misuse and diversion of both medications increased from 2003 to 2007 but were consistently higher for methadone.
- Seventy-three percent of methadone-diversion cases were of the tablet form used for pain treatment as opposed to the liquid form used for opioid agonist treatment.
- Poison-control centers received many more calls for methadone (7746) than for buprenorphine (1117). Almost half of the methadone calls were for major life-threatening events (3500 calls versus 288 for buprenorphine). They also received reports of 140 deaths associated with methadone versus 5 associated with buprenorphine.