New data presented at the American Academy of Pain Medicine’s 31st Annual Meeting shows a reduction in abuse, addiction, and opioid poisoning diagnoses following the introduction of reformulated Oxycontin (oxycodone HCl extended-release tablets; Purdue Pharma).  The researchers found there was a 29% reduction in these diagnoses among commercially-insured individuals for whom OxyContin was the only opioid prescribed. Specifically the research showed the following:

  • Aggregate diagnosis rates for the cluster of opioid abuse, addiction, and poisoning decreased 12% (95% CI: -17%, -7%) among all individuals prescribed OxyContin, 29% (95% CI: -38%, -18%) among individuals prescribed OxyContin as their only opioid analgesic, and 10% (95% CI:-16%, -5%) among individuals prescribed OxyContin along with other opioids.
  • Changes for OxyContin alone (29% decrease in the three diagnoses of interest) were significantly different from those for comparator opioids—diagnosis rates increased 29% for ER oxymorphone, 8% for ER morphine, 15% for IR single-entity oxycodone (ie, no acetaminophen), and 10% for IR hydromorphone. 
  • Among patients dispensed multiple opioids in addition to OxyContin, the reduction in rate of the three diagnoses for OxyContin was not significantly different from other opioids.

The results presented are consistent with findings from other surveillance programs, including reports from poison control centers and surveys of individuals in substance abuse treatment programs.

The reformulated Oxycontin tablet has physical and chemical properties that make abuse via injection difficult and reduces abuse via the intranasal route (snorting). It is also more difficult to crush, break, or dissolve the tablets which may reduce therapeutic misuse, such as crushing the drug to sprinkle it onto food or to administer via gastric tube. The reformulated product reduces the likelihood that this drug will be misused and abused, although it cannot completely eliminate this possibility as OxyContin can still be abused or misused by simply ingesting larger doses than are recommended.

The original formulation of OxyContin was approved in 1995. The product was abused, often following manipulation intended to defeat its extended-release properties. Such manipulation causes the drug to be released more rapidly, which increases the risk of serious adverse events, including overdose and death. By August 2010, Purdue Pharma stopped shipping the original OxyContin to pharmacies. The reformulated Oxycontin provides the same therapeutic benefits as the original.

Purdue is conducting a range of epidemiological studies required by the U.S. Food & Drug Administration (FDA). The data from these studies are being shared with the FDA on an ongoing basis and with the scientific community through scientific meetings and publications.

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