Diversion and Abuse of Buprenorphine

TECHNICAL REPORT:
ANALYSIS OF AVAILABLE DATA ON BUPRENORPHINE AS OF APRIL 9, 2006
BY
JANE C. MAXWELL, PH.D.
Data Sources. The data analysis conducted for this report employed data from the Automation
of Reports and Consolidated Orders System (ARCOS), Vermont Medicaid records, DAWNLive!
Emergency Department reports, DAWN medical examiner reports, National Forensic Laboratory
Information System (NFLIS) reports, treatment data from the Vermont Office of Drug and
Alcohol Programs and SAMHSA’s Treatment Episode Data Set (TEDS), the Northern New
England Poison Control Center, and the Vermont corrections system.
Data from DEA’s Automation of Reports and Consolidated Orders System (ARCOS). In
the national ARCOS data, Vermont leads in the consumption of Subutex and Suboxone tablets
per 100,000 population, followed by Maine, Massachusetts, Rhode Island, and Maryland.
(Exhibit 1).
Exhibit 1. ARCOS Data: States With the Highest Consumption
of Buprenorphine (in grams and dosage units per 100,000
population), January – December 2005
Vermont
Maine
Massachusetts
Rhode Island
Maryland
U.S. Average
Buprenorphine Assessment: Final Report
Dosage Units
Per 100,000 Pop.
82,948
53,573
37,642
31,783
20,588
9,090
Vermont
Maine
Massachusetts
Rhode Island
Maryland
U.S. Average
Grams Per
100,000 Pop.
583.56
324.02
253.17
204.27
127.56
56.73
Source: U.S. Drug Enforcement Administration: Automation of Reports and Consolidated
Orders System, ARCOS 2, Report 4, 01/01/2005 to 12/31/2005.
Exhibits 45 and 46 at the end of this chapter provide ARCOS data for all States.
Of the various formulations of Suboxone, the largest amount shipped to Vermont is the 8 mg.
formulation (Exhibit 2). A comparison of Medicaid and ARCOS data shows that the number of
dosage units per patient and the number of dosage units prescribed per physician vary greatly
from one Vermont county to another. This may be partially attributable to concentrations of
dispensing pharmacies in certain counties. Even given this factor, however, the ability to
compare the number of patients, the number of prescribing physicians, and the number of dosage
units shipped into a given county provides a useful method for tracking patterns of use and
monitoring for possible diversion.
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