Prescription opioid dispensing and overdoses decreased after abuse-deterrent oxycodone hit the market and propoxyphene left it.
Prescription opioid dispensing and overdoses decreased after abuse-deterrent oxycodone (OxyContin) hit the market and propoxyphene (Darvon) left it.
The pain medication market changes took effect close together, as the tamper-resistant OxyContin formulation became available in August 2010, while propoxyphene was taken off the market in November 2010.
Propoxyphene almost immediately spurred an opioid abuse problem when it received the FDA’s nod in 1957, and it became the second-leading agent in deaths from prescription drugs in 1977, according to a study published JAMA Internal Medicine. The painkiller was voluntarily withdrawn after new data showed it could cause “serious toxicity to the heart, even when used at therapeutic doses,” according to the FDA.
Abuse-deterrent OxyContin is resistant to crushing and dissolving methods used to bypass extended-release mechanisms for a quicker and more intense high, the study authors noted.
The researchers examined claims from a national health insurer, which had data on 31.3 million insured individuals aged 18 to 64 years between 2003 and 2012. The average follow-up was 20 months.
The results showed opioid dispensing decreased 19% from the anticipated rate 2 years after the market interventions were implemented. In addition, overdoses related to prescription opioids dropped 20% between 2010 and 2012.
“Our results have significant implications for policymakers and health care professions grappling with the epidemic of opioid abuse and overdose,” the researchers wrote. “Changes imposed through regulatory mandates or voluntary company actions may be a viable approach to stemming prescription abuse.”
While overdoses from prescription opioids have decreased, some drug abusers may have turned to heroin instead. In fact, the researchers found heroin overdoses increased by 23% during the post-intervention period.
“Pharmaceutical market interventions may have value in combatting the prescription opioid overdose epidemic, but heroin overdose rates continue to increase,” the authors concluded.