Drug Tampering and Abuse Deterrence

David J Mastropietro

doi:10.4172/2329-6631.1000119

Abstract

There has been a growing response from governments, industries, and academic institutions to address the worldwide incidence of prescription drug abuse. These organizations have addressed this prominent public health concern in different ways. One crucial step has been research and development into developing medications that are considerably more resistant to abuse. These novel medications prevent or discourage abuse and tampering, and consequently referred to most often as abuse-deterrent or tamper-resistant formulations. While prescription drugs used to treat insomnia, anxiety, and behavioral disorders are commonly abused, prescription opioids are most significant. Attempts to produce more rapid “high” or euphoria have resulted in various tampering techniques by abusers. Swallowing multiple dosage forms at once, either intact or crushed (chewed), is relatively considered the most common form of tampering, followed by nasal insufflation and injection. However, the prevalent route used can greatly depend on the drug or dosage form. The simultaneous use of prescription opioids with alcohol has also become a dangerous form of tampering that can lead to serious adverse effects and even death. The objective of this paper is therefore to provide a summary of the types of tampering commonly performed during abuse of prescription drugs that can be useful in developing dosage forms more resistant to multiple forms of abuse.

Highlights

There has been a growing response from governments, industries, and academic institutions to address the worldwide incidence of prescription drug abuse
Some have tried to better define tamper-resistant formulations as those having some type of physical resistance to tampering and abuse-deterrent formulations as those having added ingredients that reduce desirability in abusers [1]
No classification or naming system exists and other titles such as abuse-proof, tamper-proof, and abuse-resistant are used without distinction though recently, “Abuse-Deterrent Formulations” (ADFs) seem to be the preferred wording by regulatory agencies for all types

Summary

Introduction

Prescription medications are considered safe and effective therapies to treat a variety of medical conditions when used for legitimate purposes Their growing misuse was generally overlooked for a number of years as most early studies address their tendency for abuse were conducted over short periods of time [2]. Long-acting opioids are appropriate for chronic pain, a greater number of prescriptions are written for shortacting and immediate release products for management of acute and breakthrough pain This has provided greater access and availability of immediate release medications for abuse. Only a very small number of ADFs are formulated with immediate release properties and approved to treat acute pain This is even in light of the fact that immediate release opioid pain medications have been found to be more misused, abused, and diverted than extended release products [16]. The in-vitro evaluation of a products resistance to abuse is important for quantifying its resistance to tampering, and for product labeling and evaluating generic versions of a reference listed drug [18]

Methods of Tampering

Findings

Method Mechanical