Does the Deterrent Formula for Oxycontin Actually Help?

As published in the New England Journal of Medicine, a new deterrent formula for the much abused and addictive prescription opioid Oxycontin was released in August 2010.  The intent was to discourage insufflation as well as injection use of the drug.  The actual effects, if any, were examined and supported by the Denver Health and Hospital Authority, predominately by Ph.Ds Theodore Cicero and Matthew Ellis of Washington University in St. Louis, and Ph.D Hillary Surratt of Nova Southeastern University.

To collect the data for the study they sent out anonymous, self administered surveys to 2566 opioid dependent patients, as described by the DSM-IV, from July 1, 2009, through March 31, 2012.  These patients had to all be entering treatment programs for which prescription opioids were the primary drug of choice.  They did allow for the use of heroin, but it could not be the primary drug of abuse.  Of the 2566 surveyed, 103 allowed for follow up interviews to gain more information to aide in interpreting the findings.

According to the information gathered from the patients, after the release of the deterrent formula, Oxycontin as the primary drug of choice dropped from 35.6% before the release, to 12.8% 21 months after the release.  Also, in this time period, the use of hydrocodone and other oxycodone as the primary choice increased, as did other opioids such as fantanyl and hydromorphone.  The other opioids increased from a rate of 20.%1 to 32.3%.  Oxycontin as the primary drug of abuse fell from 47.4% to 30%, while heroin use doubled.

After interviews with the patients, most admitted that they preferred the older formula, however 24% found a way to defeat the new deterrent formula.  66% indicated that they chose to switch entirely to another drug of choice, with heroin being the favorite as it was "easier to use, much cheaper, and easily available."  From the study there was no evidence that Oxycontin abusers stopped altogether their drug use, but it rather they simply shifted their abuse to a new drug.

The researchers were able to formulate a conclusion that abuse deterrent formulas work to reduce the abuse of one specific drug, but actually lead to replacements of the drugs with other opioids as well as much more dangerous heroin.  Thus, these formulas don't seem to be amazingly helpful for overall drug use.