Abuse-deterrent opioid primary cause of heroin overdose boom, researchers find

The release of abuse-deterrent OxyContin directly coincides with the surging rates of heroin overdose deaths, according to a new working paper from researchers at the RAND Corp. and the Wharton School.

In 1996, Purdue Pharma released its blockbuster painkiller OxyContin. The opioid was designed to provide extended pain relief over the course of 12 hours, but drug users found they could bypass the time release mechanism by crushing up the pill before snorting or injecting it. From 1999 to 2010, overdose deaths attributable to opioid painkillers nearly quadrupled, making this the worst drug overdose epidemic documented in the history of the United States, according to The Washington Post.

In 2007, Purdue paid $600 million in fines after pleading guilty to misleading consumers about the potential addictive qualities of the drug. Then, in 2010, the drugmaker released a version of the pill, which was harder to crush. It became the first drug to receive "abuse-deterrent" designation from the Food and Drug Administration, according to the Post. Rates of heroin overdose deaths have been climbing ever since. In 2015, heroin overdoses killed more people than gun homicides.

The launch of "abuse-deterrent" OxyContin represents the most significant driver of the rising rates of heroin abuse, according to the paper, Researchers examined the differences in heroin deaths after 2010 in states with differing rates of OxyContin abuse prior to the 2010 drug release. They found states that experienced the highest increase in heroin overdose death rates also had the highest rates of OxyContin abuse prior to the release of the abuse-deterrent formulation.

"Between 2010 and 2013, the actual heroin death rate increased by 101 percent [nationally]. We predict that in the absence of reformulation, we would have observed only a 21 percent increase. Thus, our estimates imply that OxyContin reformulation is responsible for as much as 80 percent of the recent growth in heroin deaths," wrote the paper's authors. "Treating underlying demand may prove to be the more effective strategy for dealing with the current opioid epidemic, particularly because substitutes are readily available."

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