title: The relative abuse liability of oral oxycodone, hydrocodone and hydromorphone assessed in prescription opioid abusers.
abstract: Abuse of prescription opioids has risen precipitously in the United States. Few controlled comparisons of the abuse liability of the most commonly abused opioids have been conducted. This outpatient study employed a double-blind, randomized, within-subject, placebo-controlled design to examine the relative abuse potential and potency of oral oxycodone (10, 20 and 40 mg), hydrocodone (15, 30 and 45 mg), hydromorphone (10, 17.5 and 25mg) and placebo. Healthy adult volunteers (n=9) with sporadic prescription opioid abuse participated in 11 experimental sessions (6.5h in duration) conducted in a hospital setting. All three opioids produced a typical mu opioid agonist profile of subjective (increased ratings of liking, good effects, high and opiate symptoms), observer-rated, and physiological effects (miosis, modest respiratory depression, exophoria and decrements in visual threshold discrimination) that were generally dose-related. Valid relative potency assays revealed that oxycodone was roughly equipotent to or slightly more potent than hydrocodone. Hydromorphone was only modestly more potent (less than two-fold) than either hydrocodone or oxycodone, which is inconsistent with prior estimates arising from analgesic studies. These data suggest that the abuse liability profile and relative potency of these three commonly used opioids do not differ substantially from one another and suggest that analgesic potencies may not accurately reflect relative differences in abuse liability of prescription opioids.
authors.affiliation: Department of Behavioral Sciences, Center on Drug and Alcohol Research, University of Kentucky, 515 Oldham Court, Lexington, KY 40502, USA. sharon.walsh@uky.edu
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Walsh
authors.forename: Paul A
authors.initials: PA
authors.lastname: Nuzzo
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Lofwall
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Holtman
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005059:Euphoria / Q000187:drug effects; D006801:Humans; D006853:Hydrocodone; D004091:Hydromorphone; D015877:Miosis / Q000139:chemically induced; D009801:Oculomotor Muscles / Q000187:drug effects; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D010098:Oxycodone; D055553:Prescription Drugs; D011597:Psychomotor Performance / Q000187:drug effects; D011680:Pupil / Q000187:drug effects
chemical_list: D000701:Analgesics, Opioid; D055553:Prescription Drugs; D006853:Hydrocodone; D010098:Oxycodone; D004091:Hydromorphone