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Tuesday, June 30, 2015

Reformulating Opioid Medications May Not Solve The Problem

In recent months there has been much debate regarding the efficacy of tamper-resistant opioid medications. Prescription drugs with abuse-deterrent properties are designed to make it more difficult for addicts to crush medications to be snorted or injected. While there is some evidence that reformulated OxyContin ® (oxycodone) has reduced overall use of the drug, there is data which suggests that the overall number of opioid overdose number has not decreased, ScienceDaily reports.

Many addicts that are presented with tamper resistant medications will often turn to other opioid drugs that do not host such properties. Sadly, a number of addicts have turned to heroin as a stronger and less expensive alternative. Reformulating existing opioid medications to make them harder to abuse may not do the trick, especially if addicts will just pivot to other narcotics, according to a new commentary in the Canadian Medical Association Journal (CMAJ).

"Misuse and diversion of opioids is a complex problem that requires a comprehensive solution; simply substituting one formulation for another will not work," writes Dr. Pamela Leece, Dalla Lana School of Public Health, University of Toronto, with coauthors. 

While the United States uses the vast majority of prescription opioid narcotics, Canada has seen a dramatic rise of opioid use in recent years. From 1991 to 2007, oxycodone prescriptions in Ontario rose 850%, according to the report. The number of opioid overdose deaths doubled between 1991 and 2004.

The authors conclude:

"Regulations requiring tamper resistance represent an expensive, technical approach that is influenced by pharmaceutical interests and cannot solve the opioid crisis. An evidence-based, multifaceted strategy is needed -- one that has real potential to curb opioid-related harms at a population level." 

The commentary can be read in the Canadian Medical Association Journal.

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