Abuse-deterrent opioids: Worth the cost and effort?

Abstract

Drugmaker Purdue Pharma forever changed the landscape of pain treatment in 1996 with the release of a pinky-nail-sized pill etched with the letters “OC.” These small-but-mighty pills contained a larger dose of oxycodone, a semisynthetic opioid, than any that had come before. But they were also packed with ingredients that would prevent that whole dose from releasing immediately. Instead, the pills set the oxycodone free over approximately 12 hours in a person’s gut, extending pain relief. Patients taking these pills, dubbed OxyContin, had a less than 1% chance of becoming addicted, Purdue claimed. “What they didn’t count on was how quickly people learned to bypass the pills’ extended-release mechanism,” says Matthew Ellis, a psychiatric epidemiologist at Washington University in St. Louis. Chewing and then swallowing the pills gave users a high, and for an even bigger jolt, they crushed the pills into a powder and then snorted it or dissolved