Notes from the Field: Pediatric Emergency Department Visits for Buprenorphine/Naloxone Ingestion - United States, 2008-2015

MMWR Morb Mortal Wkly Rep. 2016 Oct 21;65(41):1148-1149. doi: 10.15585/mmwr.mm6541a5.

Abstract

Expanding access to office-based medication-assisted treatment with buprenorphine/naloxone for opioid dependence is a key part of the national strategy to address the opioid abuse epidemic (1). However, as buprenorphine/naloxone prescribing increased, emergency department (ED) visits and hospitalizations for unsupervised ingestions by young children began to increase, with buprenorphine/naloxone ingestions becoming the most common cause of hospitalization for medication ingestions by young children during 2010-2011 (2). Buprenorphine ingestions might be asymptomatic or can cause drowsiness, vomiting, or respiratory depression, which if untreated can result in death (3). Buprenorphine/naloxone was available only as tablets in multidose child-resistant bottles (Suboxone) until late 2010, when film strips packaged in unit-dose, child-resistant pouches were introduced. In 2013, tablets became available in unit-dose packaging (Zubsolv). Because unit-dose, child-resistant packaging encloses each dose until opened, it might limit unintended ingestions by young children compared with traditional child-resistant bottles that must be resecured after every use (4). This study compared ED visits for pediatric buprenorphine/naloxone ingestions before and after these product packaging/formulation changes.

MeSH terms

  • Buprenorphine / toxicity*
  • Buprenorphine, Naloxone Drug Combination
  • Child, Preschool
  • Drug Packaging
  • Eating
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Male
  • Naloxone / toxicity*
  • Pediatrics*
  • United States

Substances

  • Buprenorphine, Naloxone Drug Combination
  • Naloxone
  • Buprenorphine