Effects of cold pressor pain on the abuse liability of intranasal oxycodone in male and female prescription opioid abusers.
BACKGROUND
Approximately 1.9 million persons in the U.S. have prescription opioid use disorders often with concomitant bodily pain, but systematic data on the impact of pain on abuse liability of opioids is lacking. The purpose of this study was to determine whether pain alters the intranasal abuse liability of oxycodone, a commonly prescribed and abused analgesic, in males and females.


METHODS
Sporadic prescription opioid abusers (10 females, 10 males) participated in this mixed (between and within-subject), randomized inpatient study. Experimental sessions (n=6) tested intranasal placebo, oxycodone 15 or 30 mg/70 kg during cold pressor testing (CPT) and a warm water control. Observer- and subject-rated drug effect measures, analgesia, physiologic and cognitive effects were assessed.


RESULTS
The CPT significantly increased blood pressure, heart rate, pain, stress, and "opiate desire" compared to the no-pain control but did not alter opioid liking, high or street value. Intranasal oxycodone produced effects within 10 min, significantly decreasing pain and significantly increasing subjective measures of abuse liability (e.g., high). Females had higher ratings of street value, high, and liking for one or both active doses.


CONCLUSIONS
The CPT was a reliably painful and stressful stimulus that did not diminish the abuse liability of intranasal oxycodone. Females were more sensitive to oxycodone on several abuse liability measures that warrant further follow-up. Snorting oxycodone rapidly produced psychoactive effects indicative of substantial abuse liability.
University of Kentucky, Department of Psychiatry, Lexington, KY 40509, USA. michelle.lofwall@uky.edu
Michelle R
MR
Lofwall
Paul A
PA
Nuzzo
Sharon L
SL
Walsh
D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D003080:Cold Temperature; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006791:Hostility; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage; D009483:Neuropsychological Tests; D009293:Opioid-Related Disorders / Q000523:psychology*; D010098:Oxycodone / Q000008:administration & dosage; D010146:Pain / Q000523:psychology*; D010147:Pain Measurement / Q000523:psychology*; D011312:Pressure; D011680:Pupil / Q000187:drug effects; D012727:Sex Characteristics; D014839:Vomiting / Q000139:chemically induced; D055815:Young Adult
D009294:Narcotics; D010098:Oxycodone; D006854:Hydrocortisone