After 6 months on the market, Purdue Pharma's reformulation of this commonly abused drug deserves a second look.
In the spring of 2010, the FDA approved the reformulation of OxyContin, opening the doors for Purdue Pharma to begin distributing the new product with the hope that it would be more difficult for abusers to compromise and receive the “high” they crave. I discussed this issue several months ago and expressed hope that this reformulation would prove successful.
In mid-August 2010, the first of the reformulated OxyContin began to make its way into retail pharmacies across the United States. By the end of the year, most if not all pharmacies were no longer dispensing the old OxyContin. Very little cosmetic change can be noticed in the reformulated drug, except that the indicia “OC” is changed to “OP” and the 80-mg pill is slightly larger.
The big formulation change affects the ability of individuals to break the pill down for injection, snorting, chewing, and even smoking. The majority of people seeking to abuse this drug need to put the drug into their bodies as quickly as possible, thus the old term “rush” in the drug world. Purdue Pharma’s reformulation made the pills much more difficult to break down and abuse.
So, the question after 6 months is whether all the money spent on the reformulation was worth it. Although I must stress that it is early and making any definitive judgment on this reformulation is premature at best, there are some positive signs.
What makes me think I know the abuse level of the new OxyContin? I am the national president of the National Association of Drug Diversion Investigators (NADDI) and the commander of a large drug task force and High Intensity Drug Trafficking Area initiative in southwest Ohio. I talk to investigators across the country by e-mail and phone daily and participate in training conferences, during which I make it a point to ask about the changes, if any, with the new formulation. In addition, NADDI operates a list server with several hundred members online, and I recently asked the members the same question concerning changes in OxyContin street prices and demand, if any.
My own drug task force can provide 1 quick and easy measurement. Our undercover officers routinely bought the old version of OxyContin, as it remained steadily at about $1 per mg on the street. Since the reformulation, I am not sure if the street price has declined, because the offering of and demand for OxyContin has sharply decreased, if not gone away altogether.
My queries of law enforcement at our numerous state and regional conferences, including most recently in Savannah, Georgia, reveal the same result—the problem is oxycodone IR (30 mg). This is the same drug that has been flowing from Florida’s pill mills into our state and adjoining ones, and is one of the most in-demand pharmaceuticals of abuse currently on the illicit market. Street values are consistently $1 per mg.
Finally, I posed the OxyContin question to the several hundred members on our list server, who are representative of most of the country’s agencies. Once again, they made no mention of the abuse of the new OxyContin; instead, oxycodone IR seems to be the culprit. It may be too soon to say for sure, but the signs are positive.
It concerns me when politicians in particular continue to mention the OxyContin problem, with one Maryland official recently mentioning that the 30-mg tablets are fetching $1 per mg in his state. My guess is that he was referring to oxycodone IR, because he specifically mentioned the 30-mg dose, whereas most of the OxyContin abuse occurred with the 40- and 80-mg tablets. Regardless, if OxyContin is still being abused, so be it, but everyone should make sure they report this problem accurately, and that includes officials in law enforcement who distribute press releases.
In addition to the abuse of oxycodone IR 30 mg, I believe the reformulation has led to an even stronger increase in heroin abuse. Heroin is potent and relatively cheap in the United States, and it makes sense that some of the increase is the result of this change in formulation.
I will continue to monitor the reformulation of OxyContin, and be sure to report back the results, good or bad. In the meantime, if you have had some experience with the new formulation, please email me at email@example.com and tell me your story. PT
Cmdr Burke is commander of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad. Cmdr Burke is a 40-year veteran of law enforcement and the current president of the National Association of Drug Diversion Investigators. He can be reached by e-mail at firstname.lastname@example.org, via the Web site www. rxdiversion.com, or by phone at 513-336-0070.