A new series of 13 buprenorphine-related deaths

Clin Biochem. 2002 Oct;35(7):513-6. doi: 10.1016/s0009-9120(02)00304-1.


Objectives: Buprenorphine at high dosage became available in France in 1996, as a substitution treatment for heroin addicts. Since this date, numerous deaths were attributed to this drug. This paper reports a new series of 13 fatalities involving buprenorphine observed at the Institute of Legal Medicine of Strasbourg, between August 2000 to October 2001.

Design and methods: During the mentioned period, about 800 forensic cases were screened at the laboratory. Buprenorphine and its primary metabolite norbuprenophine were assayed in postmortem specimens by HPLC/MS. From these 13 subjects, 11 were male. Blood levels ranged from 0.3 to 7.7 ng/mL (mean 3.5 ng/mL) and 0.3 to 16.2 ng/mL (mean 2.9 ng/mL) for buprenorphine and norbuprenorphine, respectively. The mean values appear to be within the therapeutic range.

Conclusions: IV injection of crushed tablets, a concomitant intake of psychotropics (especially benzodiazepines and neuroleptics) and the high dosage of the buprenorphine formulation available in France appear as the major risk factors for such fatalities.

MeSH terms

  • Analgesics, Opioid / blood
  • Analgesics, Opioid / poisoning*
  • Autopsy
  • Buprenorphine / analogs & derivatives*
  • Buprenorphine / blood
  • Buprenorphine / poisoning*
  • Death
  • Drug Interactions
  • Female
  • Forensic Medicine / methods
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Injections, Intravenous
  • Male
  • Poisoning / mortality
  • Psychotropic Drugs / adverse effects
  • Psychotropic Drugs / poisoning
  • Risk Factors


  • Analgesics, Opioid
  • Psychotropic Drugs
  • Buprenorphine
  • norbuprenorphine