Analysis of the Abuse and Diversion of the Buprenorphine Transdermal Delivery System

J Pain. 2016 Jun;17(6):745-52. doi: 10.1016/j.jpain.2016.02.015. Epub 2016 Mar 18.


Prescription opioid abuse and diversion are major causes of morbidity and mortality in the United States. The buprenorphine transdermal delivery system (BTDS) is indicated for the treatment of moderate to severe chronic pain and provides a continuous dose of 5, 7.5, 10, 15, or 20 μg/h buprenorphine for 7 days. Quarterly rates of abuse and diversion of BTDS were compared with 4 comparator groups: 1) other buprenorphine products, 2) fentanyl patches, 3) extended-release (ER) opioid tablets/capsules, and 4) ER tramadol. Data were obtained from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System Poison Center, Drug Diversion, Treatment Programs Combined (Opioid Treatment and Survey of Key Informants' Patients Programs), and College Survey Programs. Rates were calculated using case counts per population and mentions per prescriptions filled. Poisson regression analysis was used to compare mean rates over time across drug groups after allowing for drug group-specific dispersion parameters. Population adjusted abuse rates were low for BTDS in all of the RADARS System programs compared with the other comparator groups. Findings were similar for the prescription adjusted rates, with BTDS reported at the lowest rates in all programs. Route of abuse differed slightly for BTDS and the comparator groups depending on the program. BTDS was abused and diverted at low rates compared with the other opioid groups in 5 programs of the RADARS System using either population-based rates or prescription dispensed rates.

Perspective: Data from the RADARS System show the BTDS is abused and diverted at low rates compared with other opioid groups including other forms of buprenorphine, fentanyl patches, ER opioid formulations, and ER tramadol.

Keywords: Buprenorphine; Butrans; RADARS; opioid abuse; opioid diversion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Adolescent
  • Adult
  • Buprenorphine / administration & dosage*
  • Chronic Pain / drug therapy*
  • Dose-Response Relationship, Drug
  • Female
  • Fentanyl / administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Narcotics / administration & dosage*
  • Opiate Substitution Treatment / methods*
  • Opiate Substitution Treatment / statistics & numerical data
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / epidemiology
  • Prescription Drug Diversion*
  • Surveys and Questionnaires
  • United States / epidemiology
  • Young Adult


  • Narcotics
  • Buprenorphine
  • Fentanyl