Unexpected Consequences of Oxycodone Abuse Deterrent Formulation

Unexpected Consequences of Oxycodone Abuse Deterrent Formulation

More than 115 people in the US die every day from opioid overdoses, and the  Centers for Disease Control and Prevention estimates the cost of prescription opioid misuse at $78.5 billion a year.  The beginning of the current opioid epidemic is commonly attributed to  the launch of OxyContin in 1996 with a marketing campaign designed to reassure health care professionals about the addiction potential of opioids and promoting the drug for treating chronic long term pain.  Since that time, deaths due to opioid addiction have steadily increased and the FDA enacted the first REMS (Risk Evaluation and Mitigation Strategy) program for long acting opioids in 2012.   Part of the REMs is a requirement of abuse deterrent formulations in long acting opioid formulations, which the manufacturers of OxyContin introduced in 2010.

Abuse deterrents, which generally convert the drug to a thick gummy substance if the drug is crushed, are designed to prevent individuals from crushing and rapidly ingesting long acting formulations, preventing both the extreme high and reducing the risk of overdose.  Unfortunately, despite FDA interventions, death rates due to drug overdose continue to rise.  While the continued rate of drug overdose deaths is likely multifactorial, one issue is some individuals addicted to prescription opioids convert to heroin when prescription opioids become inconvenient to abuse.   A study recently reported by the National Bureau of Economic Research demonstrated that after the introduction of oxycodone with an abuse deterrent formulation there was a reduction in the number of oxycodone prescriptions written in the US, suggesting the new formulation did reduce the misuse of oxycodone, however there was a corresponding increase in heroin deaths over the same time period.  

Its important to note that while individuals addicted to prescription opioids often substitute heroin for prescription opioids,  the formulation likely prevents non-addicted individuals from abusing prescription opioids in the the first place. 

Additional information about Oxycodone can be found in the Top 300 Pharmacy Drug Cards.  If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to the Top 300 Pharmacy Drug Cards.  If your institution does not provide access, ask your medical librarian about subscribing.

Read more at: 

Opioid Overdose CrisisThe Family that Built an Empire of Pain,  FDA Rems, Drug Overdose Death RatesOxycodone Abuse Deterrents