title: Comparison of opioid doctor shopping for tapentadol and oxycodone: a cohort study.
abstract: Obtaining opioids from multiple prescribers, known as doctor shopping, is 1 example of opioid abuse and diversion. The dual mechanism of action of tapentadol could make tapentadol less likely to be abused than other opioids. The aim of this retrospective cohort study was to compare the risk of shopping behavior between tapentadol immediate release (IR) and oxycodone IR. Subjects exposed to tapentadol or oxycodone with no recent opioid use were included and followed for 1 year. The primary outcome was the proportion of subjects who developed shopping behavior defined as subjects who had opioid prescriptions written by >1 prescriber with ≥1 day of overlap filled at ≥3 pharmacies. The opioids involved in the shopping episodes were assessed. A total of 112,821 subjects were exposed to oxycodone and 42,940 to tapentadol. Shopping behavior was seen in .8% of the subjects in the oxycodone group and in .2% of the subjects in the tapentadol group, for an adjusted odds ratio of 3.5 (95% confidence interval, 2.8 to 4.4). In the oxycodone group, 28.0% of the shopping events involved exclusively oxycodone, whereas in the tapentadol group, .6% of the shopping events involved exclusively tapentadol. Results suggest that the risk of shopping behavior is substantially lower with tapentadol than with oxycodone.
  
  
  CONCLUSIONS
  The risk of opioid doctor shopping, ie, obtaining opioid prescriptions from multiple prescribers, is lower with tapentadol than with oxycodone.
authors.affiliation: Janssen Pharmaceutical Research & Development, LLC, Titusville, New Jersey 08560, USA. scepeda@its.jnj.com
authors.forename: M Soledad
authors.initials: MS
authors.lastname: Cepeda
authors.forename: Daniel
authors.initials: D
authors.lastname: Fife
authors.forename: Lien
authors.initials: L
authors.lastname: Vo
authors.forename: Gregory
authors.initials: G
authors.lastname: Mastrogiovanni
authors.forename: Yingli
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000701:Analgesics, Opioid; D015331:Cohort Studies; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D010098:Oxycodone; D010636:Phenols; D010820:Physicians; D012189:Retrospective Studies; D018570:Risk Assessment; D000077432:Tapentadol; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D010636:Phenols; D010098:Oxycodone; D000077432:Tapentadol