(450) Abuse rates of oxycodone in the US: data from the RADARS System

Abstract

Extended release formulations of oxycodone (ER-O) have historically produced some of the highest rates of misuse, abuse, and diversion in the United States. Introduction of an abuse-deterrent formulation (ADF) resulted in a 60% reduction in ER-O diversion rates; however, preliminary data has suggested that abusers migrated from ER-O to non–ADFs of immediate release oxycodone (IR-O). To better understand current abuse trends and characteristics of individuals who abuse IR-O, data from 5 RADARS® (Researched Abuse, Diversion, and Addiction Related Surveillance) Systems were evaluated between 1st quarter 2010 through 2nd quarter 2013: College Survey (CS), Drug Diversion (DD), Poison Center (PC), Street Prescription Program (SPP), and Treatment Programs (TP). Comparisons of intentional-abuse exposure, diversion, past 3-month non-medical use, past 30-day abuse, and street-price between IR-O and other prescriptions were made using the total US population and unique recipients of dispended drug (URDD). Routes of abuse reported included oral (83%[PC] and 81%[CS]) and IV (21%, TP). Based on population estimates, IR-O intentional-abuse exposure, diversion rates, and past 3 month nonmedical use were significantly (p < 0.001) higher than all other opioids, except hydrocodone, throughout 2012 and the first half of 2013; however, was generally lower or similar to most other opioids in the TC Program. Adjusting for URDD, the intentional-abuse rates, diversion rates, and past 3 month nonmedical use of IR-O were similar or lower than other prescription opioids. Average street price for IR-O was $1.48 in 1st quarter 2013; an increase from $0.91 in 1st quarter 2011. As additional abuse-deterrent products become available, the nonmedical use, abuse, and diversion rates of non-ADFs should be monitored closely to help understand the changes in their use among the overall population and those who are prescribed non-ADFs. Extended release formulations of oxycodone (ER-O) have historically produced some of the highest rates of misuse, abuse, and diversion in the United States. Introduction of an abuse-deterrent formulation (ADF) resulted in a 60% reduction in ER-O diversion rates; however, preliminary data has suggested that abusers migrated from ER-O to non–ADFs of immediate release oxycodone (IR-O). To better understand current abuse trends and characteristics of individuals who abuse IR-O, data from 5 RADARS® (Researched Abuse, Diversion, and Addiction Related Surveillance) Systems were evaluated between 1st quarter 2010 through 2nd quarter 2013: College Survey (CS), Drug Diversion (DD), Poison Center (PC), Street Prescription Program (SPP), and Treatment Programs (TP). Comparisons of intentional-abuse exposure, diversion, past 3-month non-medical use, past 30-day abuse, and street-price between IR-O and other prescriptions were made using the total US population and unique recipients of dispended drug (URDD). Routes of abuse reported included oral (83%[PC] and 81%[CS]) and IV (21%, TP). Based on population estimates, IR-O intentional-abuse exposure, diversion rates, and past 3 month nonmedical use were significantly (p < 0.001) higher than all other opioids, except hydrocodone, throughout 2012 and the first half of 2013; however, was generally lower or similar to most other opioids in the TC Program. Adjusting for URDD, the intentional-abuse rates, diversion rates, and past 3 month nonmedical use of IR-O were similar or lower than other prescription opioids. Average street price for IR-O was $1.48 in 1st quarter 2013; an increase from $0.91 in 1st quarter 2011. As additional abuse-deterrent products become available, the nonmedical use, abuse, and diversion rates of non-ADFs should be monitored closely to help understand the changes in their use among the overall population and those who are prescribed non-ADFs.