(465) Trends and characteristics of individuals who abuse ER morphine: data from the RADARS System

Abstract

The goal of abuse-deterrent formulations (ADFs) of opioids is reduction of misuse and abuse that can lead to hospitalization or death. As novel ADFs become available, epidemiologic studies must be carefully designed and conducted to help assess if their introduction effectively reduces misuse and abuse. ADFs of extended release morphine (ER-M) are in late stages of development, thus we sought to understand ‘baseline’ trends and characteristics of ER-M abusers. Data from 5 programs from RADARS® (Researched Abuse, Diversion, and Addiction-Related Surveillance) System were evaluated between 1st-quarter of 2010 through 2nd-quarter of 2013: College Survey (CS), Drug Diversion (DD), Poison Center (PC), Street Prescription Program (SPP), and Treatment Programs (TP). Comparison of intentional-abuse exposure, diversion, past 3-month nonmedical use, past 30-day abuse, and street-price of ER-M compared to other prescription opioids were calculated using the total US population (TUP) and unique recipients of dispensed drug (URDD). ER-M was abused mainly through oral administration (∼80%[PC] and ∼76%[CS]) and IV (∼33%[TP]). Rates and trends of abuse varied by database; indicating that opioid preferences may be based on type of abuser and experience level. ER-M URDD-adjusted abuse rates were higher than IR-oxycodone and hydrocodone but similar or significantly lower than other opioids when compared using TUP rates (PC, TP). Diversion rates were 92% higher than hydrocodone but similar or lower compared to other opioids when adjusted for URDD. In 2012, 3 month nonmedical use (CS) for ER-M was significantly higher than hydrocodone (69% [PC], and 33%[CS]) and IR-oxycodone (30% [PC] and CS[33%]) but significantly lower than other opioids when adjusted for URDD. Although ER-M is prescribed less than other opioids, the high rates of nonmedical use and diversion among those filling a prescription suggests that ER-M has a particularly high abuse potential. The goal of abuse-deterrent formulations (ADFs) of opioids is reduction of misuse and abuse that can lead to hospitalization or death. As novel ADFs become available, epidemiologic studies must be carefully designed and conducted to help assess if their introduction effectively reduces misuse and abuse. ADFs of extended release morphine (ER-M) are in late stages of development, thus we sought to understand ‘baseline’ trends and characteristics of ER-M abusers. Data from 5 programs from RADARS® (Researched Abuse, Diversion, and Addiction-Related Surveillance) System were evaluated between 1st-quarter of 2010 through 2nd-quarter of 2013: College Survey (CS), Drug Diversion (DD), Poison Center (PC), Street Prescription Program (SPP), and Treatment Programs (TP). Comparison of intentional-abuse exposure, diversion, past 3-month nonmedical use, past 30-day abuse, and street-price of ER-M compared to other prescription opioids were calculated using the total US population (TUP) and unique recipients of dispensed drug (URDD). ER-M was abused mainly through oral administration (∼80%[PC] and ∼76%[CS]) and IV (∼33%[TP]). Rates and trends of abuse varied by database; indicating that opioid preferences may be based on type of abuser and experience level. ER-M URDD-adjusted abuse rates were higher than IR-oxycodone and hydrocodone but similar or significantly lower than other opioids when compared using TUP rates (PC, TP). Diversion rates were 92% higher than hydrocodone but similar or lower compared to other opioids when adjusted for URDD. In 2012, 3 month nonmedical use (CS) for ER-M was significantly higher than hydrocodone (69% [PC], and 33%[CS]) and IR-oxycodone (30% [PC] and CS[33%]) but significantly lower than other opioids when adjusted for URDD. Although ER-M is prescribed less than other opioids, the high rates of nonmedical use and diversion among those filling a prescription suggests that ER-M has a particularly high abuse potential.