The release of abuse-deterrent OxyContin and adolescent heroin use

Abstract

ObjectiveTo determine the association between the abuse-deterrent reformulation of OxyContin and adolescent lifetime heroin use in the United States. MethodsThe quasi-experimental study uses individual survey data from the 1999–2019 Youth Risk Behavior Surveillance System to examine whether the reformulation of OxyContin in August 2010 affected adolescent lifetime heroin use, exploiting heterogeneity in state-level rates of OxyContin misuse before the reformulation. Multiple regression analysis adjusted for state and year fixed effects, adolescent demographics, and time-varying state characteristics and policies. ResultsThe release of the abuse-deterrent reformulation of OxyContin was associated with a reduction in adolescents reporting ever using heroin. An adolescent in a state with a one percentage point higher state-level rate of pre-reformulation OxyContin misuse was 1.7% points less likely to report ever using heroin after the reformulation (95% confidence interval, [(CI) = −0.007, −0.027]). These effects are strongest for adolescent males (estimate: −0.028, [(CI) = −0.016, 0.040]) and non-whites (estimate: −0.021, [(CI) = −0.005, −0.037]). ConclusionsThese results suggest the release of abuse-deterrent OxyContin is associated with a decrease in the likelihood of adolescent lifetime heroin use in states with higher pre-reformulation rates of OxyContin misuse. Pharmaceutical innovations and policies that reduce the likelihood of prescription opioid misuse may be effective in reducing adolescent lifetime heroin use.