title: The introduction of a potentially abuse deterrent oxycodone formulation: Early findings from the Australian National Opioid Medications Abuse Deterrence (NOMAD) study.
abstract: BACKGROUND
  There is increasing concern about tampering of pharmaceutical opioids. We describe early findings from an Australian study examining the potential impact of the April 2014 introduction of an abuse-deterrent sustained-release oxycodone formulation (Reformulated OxyContin(®)).
  
  
  METHODS
  Data on pharmaceutical opioid sales; drug use by people who inject drugs regularly (PWID); client visits to the Sydney Medically Supervised Injecting Centre (MSIC); and last drug injected by clients of inner-Sydney needle-syringe programmes (NSPs) were obtained, 2009-2014. A cohort of n=606 people tampering with pharmaceutical opioids was formed pre-April 2014, and followed up May-August 2014.
  
  
  RESULTS
  There were declines in pharmacy sales of 80mg OxyContin(®) post-introduction of the reformulated product, the dose most commonly diverted and injected by PWID. Reformulated OxyContin(®) was among the least commonly used and injected drugs among PWID. This was supported by Sydney NSP data. There was a dramatic reduction in MSIC visits for injection of OxyContin(®) post-introduction of the new formulation (from 62% of monthly visits pre-introduction to 5% of visits, August 2014). The NOMAD cohort confirmed a reduction in OxyContin(®) use/injection post-introduction. Reformulated OxyContin(®) was cheaper and less attractive for tampering than Original OxyContin(®).
  
  
  CONCLUSIONS
  These data suggest that, in the short term, introduction of an abuse-deterrent formulation of OxyContin(®) in Australia was associated with a reduction in injection of OxyContin(®), with no clear switch to other drugs. Reformulated OxyContin(®), in this short follow-up, does not appear to be considered as attractive for tampering.
authors.affiliation: National Drug and Alcohol Research Centre, UNSW, Australia. Electronic address: l.degenhardt@unsw.edu.au.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
authors.affiliation: School of Medicine, University of Tasmania, Australia.
authors.forename: Raimondo
authors.initials: R
authors.lastname: Bruno
authors.affiliation: University of Adelaide, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Ali
authors.affiliation: The Langton Centre, South East Sydney Local Health District (SESLHD) Drug and Alcohol Services, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lintzeris
authors.affiliation: National Drug and Alcohol Research Centre, UNSW, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Farrell
authors.affiliation: National Drug and Alcohol Research Centre, UNSW, Australia.
authors.forename: Briony
authors.initials: B
authors.lastname: Larance
mesh_terms: D001315:Australia; D002626:Chemistry, Pharmaceutical; D015331:Cohort Studies; D003132:Commerce / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D009294:Narcotics / Q000008:administration & dosage / Q000737:chemistry*; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000517:prevention & control*; D010098:Oxycodone / Q000008:administration & dosage / Q000737:chemistry*; D010594:Pharmacies / Q000706:statistics & numerical data
chemical_list: D009294:Narcotics; D010098:Oxycodone
keywords: Abuse deterrence; Injecting drug use; Opioid dependence; Pharmaceutical opioids; Post-marketing surveillance; Tamper resistance