Sustained Reduction of Diversion and Abuse after Introduction of an Abuse Deterrent Formulation of Extended Release Oxycodone

Author(s)

Stevan G. Severtson, Rocky Mountain Poison and Drug Center, Denver Health and Hospital AuthorityFollow
Matthew Ellis, Washington University School of Medicine in St. LouisFollow
Steven P. Kurtz, Nova Southeastern UniversityFollow
Andrew Rosenblum, Institute for Treatment and Services Research, National Development and Research InstitutesFollow
Theodore J. Cicero, Washington University in St. LouisFollow
Mark W. Parrino, American Association for the Treatment of Opioid Dependence
Michael K. Gilbert, Epidemico, Inc.
Mance E. Buttram, Nova Southeastern UniversityFollow
Nabarun Dasgupta, Epidemico, Inc.
Becki Bucher-Bartelson, Rocky Mountain Poison and Drug Center, Denver Health and Hospital AuthorityFollow
Jody L. Green, Rocky Mountain Poison and Drug CenterFollow
Richard C. Dart, Rocky Mountain Poison and Drug Center, Denver Health and Hospital AuthorityFollow

ORCID ID

0000-0002-7372-9447, 0000-0002-4716-3398, 0000-0002-7458-7815, 0000-0002-5001-7391, 0000-0002-4098-605X, 0000-0003-1776-6400, 0000-0001-5989-9354

ResearcherID

H-3010-2014

Publication Title

Drug and Alcohol Dependence

ISSN

0376-8716

Publication Date

2016

Abstract

Background: The development of abuse deterrent formulations is one strategy for reducing prescription opioid misuse and abuse. A putative abuse deterrent formulation of oxycodone extended release (OxyContin®) was introduced in 2010. Early reports demonstrated reduced abuse and diversion, however, an analysis of social media found 32 feasible methods to circumventthe abuse deterrent mechanism. We measured trends of diversion, abuse and street price of OxyContin to assess the durability ofthe initial reduction in abuse. Methods: Data from the Poison Center Program, Drug Diversion Program, Opioid Treatment Program, Survey of Key Informant Patients Program and StreetRx program of the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS®) System were used. The average quarterly rates of abuse and diversion for OxyContin were compared from before reformulation to the rate in second quarter 2015. Rates were adjusted for population using US Census data and drug availability. Results: OxyContin abuse and diversion declined significantly each quarter after reformulation and persisted for 5 years. The rate of abuse of other opioid analgesics increased initially and then decreased, but to lesser extent than OxyContin. Abuse through both oral and non-oral routes of self-administration declined following the reformulation. The geometric mean difference in the street price of reformulated OxyContin was 36% lower than the reformulated product in the year after reformulation. Discussion: Despite methods to circumvent the abuse deterrent mechanism, abuse and diversion of OxyContin decreased promptly following the introduction of a crush- and solubility- resistant formulation and continued to decrease over the subsequent 5 years.

DOI

10.1016/j.drugalcdep.2016.09.018

Volume

168

First Page

219

Last Page

229

NSUWorks Citation

Severtson, S. G., Ellis, M., Kurtz, S. P., Rosenblum, A., Cicero, T. J., Parrino, M. W., Gilbert, M. K., Buttram, M. E., Dasgupta, N., Bucher-Bartelson, B., Green, J. L., & Dart, R. C. (2016). Sustained Reduction of Diversion and Abuse after Introduction of an Abuse Deterrent Formulation of Extended Release Oxycodone. Drug and Alcohol Dependence, 168, 219-229. https://doi.org/10.1016/j.drugalcdep.2016.09.018