March 25, 2015
Reformulating OxyContin Reduces Abuse Somewhat,
But at a Cost

St. Louis—While the reformulation of OxyContin has reduced the drug’s illicit use, it has not curtailed it, according to a recent study finding that 25% of drug users entering rehabilitation said they had abused the opioid despite its drug-deterrent properties.

It also may have had the unintended consequence of steering more drug abusers to heroin, which is cheaper and easier to use to get a high, according to the report published online recently in JAMA Psychiatry.

Based on surveys of nearly 11,000 drug users at 150 drug-treatment facilities in 48 states, researchers from Washington University School of Medicine found that the abuse-deterrent formulation kept abusers and addicts from using the drug, but only to a point.

“We found that the abuse-deterrent formulation was useful as a first line of defense,” said senior investigator Theodore J. Cicero, PhD, a professor of neuropharmacology in psychiatry. “OxyContin abuse in people seeking treatment declined, but that decline slowed after a while. And during that same time period, heroin use increased dramatically.”

OxyContin originally was designed so that small amounts of oxycodone were released over an extended period of time. Abusers seeking an intense high simply crushed the pills and snorted the powder or dissolved the drug in a liquid and injected it.

The newer formulation of OxyContin makes the pills harder to crush or dissolve. At the time the abuse-deterrent product was introduced in 2010, 45% of study participants entering drug treatment reported they had used OxyContin to get high at least once in the previous 30 days, according to the report. Two years later, with only the abuse-deterrent form of the drug available, that percentage had dropped to 26%. Abusers told researchers they either took the drug orally or found new ways to snort or inject it.

Study authors said one surprising side effect was that almost half of the drug abusers surveyed in 2014 reported they had used heroin in the 30 days before they entered treatment.

Study authors raised the possibility that abuse of OxyContin declined “apparently owing to a migration to other opioids, particularly heroin.”

“Some people found ways to get around the abuse-deterrent formulation so that they could snort or inject it, and others simply swallowed the pills,” Cicero explained. “But many people switched to heroin, and that's a major concern.”
U.S. Pharmacist Social Connect