In 2010 an abuse deterrent formulation of OxyContin was introduced. With this new formulation, “Oxy” would be harder to crush and put into solution for snorting or injection and it was believed that OxyContin abuse and addiction would decline. A study of people entering substance abuse treatment programs for primary prescription opioid addiction involved a survey of drug use selection. The study showed that indeed OxyContin use declined from 35.6% of the study’s participants to 12.8% with users substituting hydrocodone, other oxycodone agents, high potency fentanyl and hydromorphone. An aspect of the study addressed the drug of choice to “get high” in the past 30-days, OxyContin fell from 47.4% of the respondents to 30.0%. Heroin use was nearly double in the group.
Study participants who used OxyContin found that 66% switched to heroin and 24% learned to defeat the tamper-proof qualities built into the new OxyContin formulation. The unanticipated outcome of the reformulation of “Oxy” really did nothing to change the overall problem with opioid abuse; in fact it converted many users to a cheaper alternative with heroin. This opens the issues with unknown drug strengths of heroin purchased on the street and wildly increases the potential for drug overdoses as users make the switch.
We have an enormous problem in this country with prescription drug use, particularly of opioids. There is an easy link from prescription painkillers to heroin that somehow is not being considered in the response to our drug abuse problem. Substance abuse and addiction treatment programs can work but we need to stop increasing the problems through better controls with physicians who prescribe these drugs and active methods to restrict illegal access to drug inventories or importation from outside of the U.S. The issue with increased heroin use is going to bring a host of new problems for opioid abusers.