Tamper-Resistant Oxycodone May Have Lead Users To Use Different Opioids

MedicalResearch.com Interview with:

Andrea Schaffer PhD Research Fellow Centre for Big Data Research in Health UNSW Sydney NSW Australia

Dr. Schaffer

Andrea Schaffer PhD
Research Fellow
Centre for Big Data Research in Health
UNSW Sydney NSW Australia 

MedicalResearch.com: What is the background for this study?

Response: Use and misuse of opioids has increased dramatically in Australia over the past 20 years. In 2014, Australia introduced tamper-resistant controlled-release (CR) oxycodone, which forms a viscous gel when crushed, and is designed to deter its injection or snorting. However, this formulation does not prevent dependence, and can still be misused orally. Tamper-resistant oxycodone CR was also introduced in the US (2010) and Canada (2012), resulting in reductions in oxycodone CR use. However, no large population-level studies have looked at switching behaviour in individuals using oxycodone CR, either in Australia or abroad.

MedicalResearch.com: What are the main findings? 

Response: Using nationally representative data on nearly 37,000 people dispensed oxycodone CR over 4.5 years, we found that introduction of tamper-resistant oxycodone CR led to a sustained decrease in use among people <65 years, with the greatest decrease observed for higher tablet strengths (40-80 mg). Despite this reduction, we did not observe any increase in discontinuation of opioid use, but rather an increase in switching from oxycodone CR to other opioids, particularly morphine in people aged <45 years using higher strengths of oxycodone CR.

MedicalResearch.com: What should readers take away from your report? 

Response: Our findings suggest that the introduction of tamper-resistant oxycodone may have led some people to seek out other, non-tamper-resistant opioids, such as morphine. While we could not determine whether people switching to other opioids were actually misusing opioids or not, younger people using high strength oxycodone CR have previously been identified in Australia as a group at greater risk of opioid misuse and harms, and may warrant closer monitoring in clinical practice 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: While we have shown that tamper-resistant oxycodone CR has led to changes in patterns of opioid use in Australia, further research is needed to determine whether the introduction of tamper-resistant oxycodone CR has also resulted in changes in health outcomes, such as opioid overdose and opioid-related mortality.

Disclosures: Three of the study’s co-authors have received untied, investigator-drive educational grants from pharmaceutical companies for post-market surveillance studies of opioids. The funders played no role in the design, conduct, or interpretation of the study’s findings, and there were no restrictions placed on publication.


Person-level changes in oxycodone use after the introduction of a tamper-resistant formulation in Australia

Andrea L. SchafferNicholas A. BuckleyLouisa DegenhardtBriony LaranceRose CairnsTimothy A. Dobbins and Sallie-Anne Pearson

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Last Updated on March 26, 2018 by Marie Benz MD FAAD