title: Changes in prevalence of prescription opioid abuse after introduction of an abuse-deterrent opioid formulation.
abstract: OBJECTIVE
  The reformulation of oxycodone hydrochloride controlled-release (CR) tablets in August 2010 created a natural experiment at a national scale, providing an opportunity to evaluate patterns of abuse of prescription opioids and other drugs before and after introduction of this abuse-deterrent formulation (ADF).
  
  
  METHODS
  Observational, cross-sectional study
  
  
  METHODS
  Sentinel sample of adults assessed for substance abuse treatment within the NAVIPPRO® surveillance system
  
  
  METHODS
  Two hundred thirty-two thousand and eight hundred seventy-four adults at 437 facilities during January 1, 2008 through December 31, 2011.
  
  
  METHODS
  Time-series analysis using logistic regression to estimate quarterly prevalence of past 30-day abuse (adjusted for covariates and prescription volume) and changes in abuse pre-and post-ADF introduction.
  
  
  RESULTS
  Increases in abuse prevalence occurred for all prescription opioids as a class and for extended-release (ER) opioids. Significantly greater abuse of ER oxymorphone and buprenorphine occurred in the post-ADF period (relative risk [RR] = 2.91, 95% confidence interval [CI] = 2.59-3.27 and RR = 1.85, 95% CI = 1.74-1.96). Increases in abuse for these two compounds were significant among groups who reported abuse via preferential routes of administration (oral only, snorting only, injection only) post-ADF introduction.
  
  
  CONCLUSIONS
  Replacement of a widely prescribed opioid formulation known for its abuse potential alone may have had little impact on overall rates of prescription opioids as a class. However, changes in abuse levels of certain opioids coinciding with ADF introduction suggest possible switching of abuse among this study sample to specific long-acting opioid analgesics. Additional follow-up studies will be important to monitor changing abuse patterns and their public health impact as new opioid formulations are developed and introduced to market.
authors: Inflexxion, Inc., Newton, Massachusetts, USA.
authors: Theresa A
authors: TA
authors: Cassidy
authors: Pronabesh
authors: P
authors: DasMahapatra
authors: Ryan A
authors: RA
authors: Black
authors: Matthew S
authors: MS
authors: Wieman
authors: Stephen F
authors: SF
authors: Butler
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000453:epidemiology*; D010098:Oxycodone / Q000009:adverse effects* / Q000627:therapeutic use; D010111:Oxymorphone / Q000009:adverse effects* / Q000627:therapeutic use; D015995:Prevalence; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D010111:Oxymorphone; D010098:Oxycodone
keywords: Abuse Deterrent Formulation; NAVIPPRO; Oxycodone; Oxymorphone; Prescription Opioid Abuse; Tamper-Resistant Formulation