Abuse-Resistant Opioid Still Abused by Addicts

Although the popular opioid painkiller Oxycontin (oxycodone) was reformulated five years ago in an effort to deter its misuse, many drug abusers have still found a way to abuse the medication, according to a new study.

Theodore J. Cicero, PhD and Matthew S. Ellis, MPE, both of the Department of Psychiatry at Washington University in St Louis, Mo., examined the records of nearly 11,000 drug users at 150-drug treatment centers in 48 states. About 25% of the people entering rehab said they were still able to abuse Oxycontin, despite its abuse-resistant properties, they reported in JAMA Psychiatry.

The abuse-deterrent formulation hit the market in 2010 as a way to stem the high number of people abusing prescription opioids. At that time, 45% of those entering drug treatment said they used Oxycontin at least once in the past month to get high.

Although the original formulation was designed so that the drug was released into the blood stream slowly, abusers were able to crush the pills and then snort it, or dissolve it, giving them a quick high. The reformulated version was designed to make it more difficult to crush or dissolve the pills. But many users were able to still abuse Oxycontin.

“We found that the abuse-deterrent formulation was useful as a first line of defense,” Cicero said in a statement. “Oxycontin abuse in people seeking treatment declined, but that decline slowed after a while. And during that same time period, heroin use increased dramatically.”

Cicero and Ellis also found that of those who stopped using Oxycontin but switched to another drug, the drug of choice for 70% of them was heroin. Cicero explained the reason why is that while a prescription opioid might run as high as $30 per pill, getting a dose of heroin might cost as little as $10.

“The newer formulations are less attractive to abusers, but the reality is — and our data demonstrate this quite clearly — it’s naïve to think that by making an abuse-deterrent pill we can eliminate drug abuse,” Cicero said. “There are people who will continue to use, no matter what the drug makers do, and until we focus more on why people use these drugs, we won’t be able to solve this problem.”

Reference

Cicero TJ and Ellis MS. Abuse-Deterrent Formulations and the Prescription Opioid Abuse Epidemic in the United States. JAMA Psychiatry. 2015; doi:10.1001/jamapsychiatry.2014.3043.