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Changing Opioid Rx Formulations May Help Curb Abuse

As opioid market changed, number of prescriptions, overdoses dropped, but heroin overdoses went up

TUESDAY, April 21, 2015 (HealthDay News) -- Opioids that have features that make them hard to abuse may be linked to a drop in both the number of prescriptions and overdoses of these drugs, according to a new study published online April 20 in JAMA Internal Medicine.

Marc Larochelle, M.D., M.P.H., an instructor at Boston University School of Medicine, and colleagues used data from a large health insurer with 31 million members. The authors looked at claims for opioids from 2003 through 2012, noting introduction of abuse-deterrent OxyContin on Aug. 9, 2010, and market withdrawal of propoxyphene on Nov. 19, 2010.

The researchers found that two years after the opioid market changes, total opioid dispensing dropped 19 percent and the rate of prescription opioid-linked overdoses dropped 20 percent across the United States. However, the rate of heroin overdoses increased by 23 percent during the same period, according to the researchers. "Reducing supply may have led some people who are abusing these drugs to substitute an illicit narcotic like heroin, and it may partially explain why we have seen an explosion in heroin use across the country," Larochelle told HealthDay.

Changing the formulation will not by itself solve the drug abuse problem, Larochelle said. "But it shows supply could be one part of the issue. Abuse-resistant formulations will not cure people who are addicted to narcotics. It could, however, prevent or slow down the number of new people who become addicted, because many people who use heroin may have started with pills," he said.

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