Brief report Use of prescription opioids with abuse-deterrent technology to address opioid abuse

Abstract Objective:The development of new formulations of extended-release (ER) opioids with abuse-deterrent technologyattempts to deter prescription opioid abuse while maintaining appropriate access to care for pain patients.This study examined the degree to which some patients may avoid switching to reformulated ER opioids withabuse-deterrent technology and the extent to which those patients are more likely to be abusers.Research design and methods:We analyzed Truven MarketScan pharmacy and medical claims data following the introduction of tworeformulated ER opioids with abuse-deterrent technology. Adults aged 18–64 who were continuoususers of extended-release oxycodone HCl (ER oxycodone) or extended-release oxymorphone HCl (ERoxymorphone) in a 6 month period prior to the introduction of the respective reformulations of thoseproducts were identified and categorized based on whether they switched to the reformulation, switchedto other ER/long-acting (LA) opioids (without abuse-deterrent technology), or discontinued ER/LA opioidtreatment in a 6 month post-reformulation period. Abusers were identified using ICD-9-CM diagnosis codesfor opioid abuse/dependence. Pearson’s chi-squared tests and Fisher’s exact tests were then used tocompare rates of abuse between patients who avoided switching to a reformulated ER opioid. Sensitivityanalyses examined several definitions used in this analysis.Main outcome measures:ER/LA opioid utilization; rates of diagnosed opioid abuse.Results:A total of 31%–50% of patients avoided switching to reformulated ER opioids. Rates of diagnosed opioidabuse were higher among these patients compared to patients who transitioned to the reformulatedER opioids.Limitations:Due to the observational research design, caution is warranted in causal interpretation of the findings. Thestudy was conducted among commercially insured continuous ER oxycodone or ER oxymorphone users;future research should consider additional patient populations, such as non-continuous users and thosewithout commercial insurance (i.e., Medicare, Medicaid, uninsured).Conclusions:Some patients switched to other ER/LA opioids without abuse-deterrent technology or discontinued ER/LAopioid treatment when their existing ER treatment was reformulated. Rates of opioid abuse were higheramong patients who switched to other ER/LA opioids or discontinued ER/LA opioid treatment, suggestingthat abusers may seek more easily abuseable alternatives such as prescription opioids without abuse-deterrent technology.