Wightman RS, Perrone J, Scagos R, et al. - A retrospective analysis was performed to evaluate opioid overdose deaths with buprenorphine detected in postmortem toxicology. Between 2016 and 2018, a retrospective review of opioid-involved drug overdose fatalities in Rhode Island (RI) applying the RI Department of Health State Unintentional Drug Overdose Reporting System database. They compared deaths with buprenorphine on toxicology testing vs opioid-involved overdose deaths without buprenorphine to evaluate the type and number of co-exposures. Twenty-nine (5.4%) out of 534 opioid-involved deaths, included buprenorphine and/or norbuprenorphine on toxicology. It was shown that decedents with buprenorphine detected on toxicology testing commonly had documented polysubstance use. It was considered that buprenorphine may provide some risk mitigation against full agonist opioid overdose including fentanyl, although data are limited. Future studies should evaluate the use of postmortem concentrations of buprenorphine, norbuprenorphine, and other opioid metabolites to ascertain the role of buprenorphine in fatal overdose pharmacology.