Effect of Abuse-Deterrent Formulation of OxyContin

Cicero, Theodore J.; Ellis, Matthew S.; Surratt, Hilary L.

doi:10.1056/nejmc1204141

Cited by 290 publications

(233 citation statements)

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“…Given that 79.5% of new heroin initiates in the National Survey on Drug Use and Health reported that their initial drug was a prescription opioid and that reported heroin use by patients in a substance-abuse program nearly doubled after the introduction of abuse-deterrent OxyContin, it seems likely that the reformulation of extended-release oxycodone in 2010 has contributed to the increase in reported heroin use. 26,27 Whatever the precise cause, changes in rates of opioid analgesic abuse are associated with increasing heroin-related mortality. The similarities between data from the National Survey on Drug Use and Health and data from the National Poison Data System with respect to heroin use and adverse consequences are striking ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Trends in Opioid Analgesic Abuse and Mortality in the United States

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Trends in Opioid Analgesic Abuse and Mortality in the United States

et al. 2015

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“…[94][95][96][97][98][99] A growing body of evidence suggests that introduction of the abuse-deterrent formulation of oxycodone has been associated with decreased rates of abuse and diversion of this opioid analgesic in the USA. [101,[110][111][112][113][114][115][116][117][118][119]. Cost savings have also been reported to be associated with reductions in abuse following the introduction of the abuse-deterrent reformulation of oxycodone in the USA.…”

Section: Differences In Routes Of Abuse Between Populationsmentioning

confidence: 99%

Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations

Gąsior

Bond

Malamut

2015

Postgraduate Medicine

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Prescription opioid analgesics are an important treatment option for patients with chronic pain; however, misuse, abuse and diversion of these medications are a major global public health concern. Prescription opioid analgesics can be abused via intended and non-intended routes of administration, both intact or after manipulation of the original formulation to alter the drug-delivery characteristics. Available data indicate that ingestion (with or without manipulation of the prescribed formulation) is the most prevalent route of abuse, followed by inhalation (snorting, smoking and vaping) and injection. However, reported routes of abuse vary considerably between different formulations. A number of factors have been identified that appear to be associated with non-oral routes of abuse, including a longer duration of abuse, younger age, male sex and a rural or socially deprived location. The development of abuse-deterrent formulations of prescription opioid analgesics is an important step toward reducing abuse of these medications. Available abuse-deterrent formulations aim to hinder extraction of the active ingredient, prevent administration through alternative routes and/or make abuse of the manipulated product less attractive, less rewarding or even aversive. There are currently five opioid analgesics with a Food and Drug Administration abuse-deterrent label, and a number of other products are under review. A growing body of evidence suggests that introduction of abuse-deterrent opioid analgesics in the USA has been associated with decreased rates of abuse of these formulations. The availability of abuse-deterrent formulations therefore appears to represent an important step toward curbing the epidemic of abuse of prescription opioid analgesics, while ensuring the availability of effective pain medications for patients with legitimate medical need.

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“…The use of tamper-resistant formulations, which are designed to impede modification, should reduce use by this means [18]. A recent analysis of self-reported substance use by patients admitted to treatment facilities since the switch to tamperresistant oxycodone ER (Oxycontin and generic) has demonstrated a change back to short-acting oxycodone and possibly heroin [19]. Interestingly, the FDA allows label claims for abuse deterrence based on several criteria, one of which is the relative likeability of one product compared to older formulations of the drug.…”

Section: Limitationsmentioning

confidence: 99%

Likeability and Abuse Liability of Commonly Prescribed Opioids

et al. 2012

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Introduction Nonmedical use of prescription opioid analgesics is associated with epidemic levels of morbidity and mortality. There are several factors that affect the abuse liability of the various opioids, including likability or the pleasurable subjective effects. Due to rising public health concerns over escalating prescription opioid abuse, we sought to examine the literature about abuse liability with a specific focus on likability studies. Methods A search of EMBASE and MEDLINE databases identified articles that described the comparative likeability and/or abuse potential of hydrocodone and oxycodone relative to each other and/or of either one to morphine. After an assessment of study quality using the Oxford/Jadad scale, relevant details such as demographics, study design, and outcome measures were compiled into an evidence table.Results We identified nine studies that met inclusion criteria. All were double-blinded, randomized, placebocontrolled crossover studies and scored 5 out of 5 Jadad scale. There was no consistent clinically significant difference between abuse liability of morphine and hydrocodone. Oxycodone demonstrated high abuse liability on the basis of its high likability scores and a relative lack of negative subjective effects. Conclusion Oral oxycodone has an elevated abuse liability profile compared to oral morphine and hydrocodone.

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Effect of Abuse-Deterrent Formulation of OxyContin

Cited by 290 publications

References 0 publications

Trends in Opioid Analgesic Abuse and Mortality in the United States

Trends in Opioid Analgesic Abuse and Mortality in the United States

Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations

Likeability and Abuse Liability of Commonly Prescribed Opioids

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