Abuse and Diversion of Immediate Release Opioid Analgesics as Compared to Extended Release Formulations in the United States

Author(s)

Janetta Iwanicki, Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority
S. G. Severtson, Rocky Mountain Poison and Drug Center, Denver Health and Hospital AuthorityFollow
Heather McDaniel, Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority
Andrew Rosenblum, Institute for Treatment and Services Research, National Development and Research InstitutesFollow
Chunki Fong, National Development and Research Institutes, Incorporated
Theodore J. Cicero, Washington University in St. LouisFollow
Matthew Ellis, Washington University School of Medicine in St. LouisFollow
Steven P. Kurtz, Nova Southeastern UniversityFollow
Mance E. Buttram, Nova Southeastern UniversityFollow
Richard C. Dart, Rocky Mountain Poison and Drug Center, Denver Health and Hospital AuthorityFollow

ORCID ID

0000-0001-9608-391X, 0000-0002-7372-9447, 0000-0001-7026-5117, 0000-0002-4716-3398, 0000-0002-5001-7391, 0000-0001-5989-9354

ResearcherID

H-3010-2014

Publication Title

PLoS One

ISSN

1932-6203

Publication Date

12-9-2016

Abstract

Background

Therapeutic use and abuse of prescription opioids in the United States increased substantially between 1990 and 2010. The Centers for Disease Control estimated deaths related to pharmaceutical opioids reached nearly 19,000 in 2014. Of prescription opioids sold, 10% are extended release (ER) and 90% immediate release (IR). However, most regulations and interventions have focused on decreasing ER abuse. Our objective was to compare rates of abuse and diversion of ER and IR opioid analgesics over time using multiple surveillance programs.

Methods

Rates of abuse and diversion of ER and IR opioid formulations were compared using data from four surveillance programs in the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS®) System. Data were evaluated from 2009 through 2015, and Poisson regression used to compare IR and ER opioid cases over time.

Results

From 2009 to 2015, IR opioids were prescribed at a rate 12 to 16 times higher than ER. In the Poison Center Program, population-adjusted rates of Intentional Abuse for IR were 4.6 fold higher than ER opioids (p

Conclusions

Between 2009 and 2015, IR opioids were prescribed at a much higher rate than ER opioids. Results from four surveillance programs show population-adjusted rates of prescription opioid abuse were markedly higher for IR than ER medications. For the greatest public health benefit, future interventions to decrease prescription opioid abuse should focus on both IR and ER formulations.

DOI

10.1371/journal.pone.0167499

Volume

11

Issue

12

First Page

1

Last Page

12

NSUWorks Citation

Iwanicki, J., Severtson, S. G., McDaniel, H., Rosenblum, A., Fong, C., Cicero, T. J., Ellis, M., Kurtz, S. P., Buttram, M. E., & Dart, R. C. (2016). Abuse and Diversion of Immediate Release Opioid Analgesics as Compared to Extended Release Formulations in the United States. PLoS One, 11 (12), 1-12. https://doi.org/10.1371/journal.pone.0167499