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BACKGROUND: Opioid misuse and its associated health consequences, including unintentional drug poisoning (overdose) deaths have increased during the past decade both nationally and locally among New York City (NYC) residents. Medically assisted treatment with buprenorphine, approved for treatment of opioid dependence in 2002, is an important tool in reducing opioid morbidity and mortality. Recent studies suggest retention in buprenorphine treatment is associated improved health outcomes, but with dose over time. Little is known about the prevalence and patterns of buprenorphine use among New Yorkers. This study uses New York State Prescription Monitoring Program (PMP) data to examine these characteristics among NYC residents over a six-year period.
METHODS: We conducted a retrospective analysis of buprenorphine prescriptions filled by NYC residents over a six year period (2008–2013) using New York State’s PMP data. Prescription fill patterns were analyzed, including number of prescriptions filled, dose, and day supply. Day supply of each prescription filled was tallied to calculate total buprenorphine-months supplied. Patients filling buprenorphine prescriptions were described by gender, age, borough of residence. Age-adjusted rates per 1,000 residents were calculated.
RESULTS: Between 2008–2013, 470,239 buprenorphine prescriptions were filled by 40,879 NYC residents. The median daily dose was 16 milligrams and median day supply of each prescription was 30 days. The number of buprenorphine prescriptions per patient filled ranged from 1–902. The median duration of total buprenorphine-months supplied was 3 months; one-third (35%) of patients received only a one-month supply and an additional 12% of patients received a two-month supply of buprenorphine. Rates of patients filling buprenorphine prescriptions were highest among males (81 per 1,000 residents), those aged 45–54 (115 per 1,000 residents) and residents of Staten Island (194 per 1,000 residents).
CONCLUSIONS: PMP data is useful in understanding patterns of buprenorphine prescription filling among NYC residents. Prescriptions do not include diagnosis information therefore it cannot be discerned if buprenorphine was prescribed for pain or opioid dependence treatment. Although opioid dependence is a chronic illness, with studies indicating improved outcomes with longer length of treatment, the median duration buprenorphine prescriptions filled was three months. Future research is needed to elucidate why nearly half of patients filling a buprenorphine prescription filled only received less than three months of buprenorphine prescriptions. Extending length of time in treatment may help patients avoid adverse health consequences from opioid misuse, including overdose, and is a critical public health objective.