Do Abuse-Deterrent Painkillers Really Stop Addicts?

By Paul Gaita 06/10/15

Support for abuse-deterrent features ignores the fact that oral consumption can also get you high.

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While a number of studies have shown that abuse-resistant elements have generated a decrease in the use of drugs like OxyContin, a growing number of experts believe that abuse-deterrent features are little more than an obstacle to be overcome by addicts in their pursuit of a high.

In response to the wave of addiction to and death from prescription painkillers that swept through the United States from 1999 to 2013, the manufacturers of opioids like OxyContin incorporated “abuse-deterrent” features that made it difficult for abusers to obtain more substantial highs by altering the pills through oral consumption or needle use.

Three such drugs, including Pfizer’s Embeda and Hysingla, were approved by the Food and Drug Administration (FDA) in 2014 to be sold as drugs with abuse-deterrent properties, and 30 more are currently in development.

Incidents such as the outbreak of HIV that affected more than 150 southern Indiana—all of whom had shared needles to inject Opana, a drug deemed resistant to liquefaction—add credence to statements like those made by Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, who said, “We can’t make an impregnable fortress out of [painkillers] ... or the patient isn’t going to get any pain relief.”

The widespread support for abuse-deterrent features also ignores the basic fact that oral consumption of a whole pill will provide the same high and addictive factor as one altered by crushing or liquefaction.

Despite this fact, a national survey of internists and general practitioners conducted in 2014 found that one-third of the participants believed that most prescription opioid abuse comes from injection or other non-oral means. More than half of those doctors also stated that they believed abuse-deterrent drugs were less addictive.

Issues such as these have prompted members of the medical community to push for a different term to describe these drugs, such as Bob Twillman, executive director of the American Academy of Pain Management. But his suggestion that “tamper-deterrent” is similar to the FDA-approved term “tamper-resistant,” which is used to describe outside packaging.

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.