title: Tampering with prescription opioids: nature and extent of the problem, health consequences, and solutions.
abstract: BACKGROUND
  Transdermal and solid oral prescription opioid (PO) formulations can be abused by ingesting (with or without tampering), snorting, or injection (both requiring tampering).
  
  
  OBJECTIVE
  To determine the patterns of tampering with POs for abuse.
  
  
  METHODS
  Information was collected from published studies and databases.
  
  
  RESULTS
  Tampering with POs for abuse is common practice. Ingestion is the most prevalent method of abuse, followed by snorting and injection. From 1992 to 2002, injecting POs has decreased in favor of ingesting and snorting. Methods of abuse vary widely by product. Abuse methods with the highest morbidity are injection and inhalation.
  
  
  CONCLUSIONS
  The seriousness of health outcomes associated with tampering with POs warrants the development of PO formulations that prevent or deter tampering.
authors.affiliation: Analgesic Solutions, Natick, MA, USA. nkatz@analgesicsolutions.com
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Katz
authors.forename: Richard C
authors.initials: RC
authors.lastname: Dart
authors.forename: Elise
authors.initials: E
authors.lastname: Bailey
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Trudeau
authors.forename: Eric
authors.initials: E
authors.lastname: Osgood
authors.forename: Florence
authors.initials: F
authors.lastname: Paillard
mesh_terms: D000281:Administration, Intranasal; D000284:Administration, Oral; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects*; D016739:Behavior, Addictive / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D002626:Chemistry, Pharmaceutical / Q000379:methods / Q000706:statistics & numerical data*; D016208:Databases, Factual; D006306:Health Surveys; D006801:Humans; D007275:Injections, Intravenous / Q000706:statistics & numerical data; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control / Q000523:psychology*; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid