|Theresa A. Cassidy, MPH,
Simon H. Budman, PhD, Stephen F. Butler, PhD
Presented at CPDD 2014
Aims: Assessing the impact on abuse patterns of the introduction of abuse deterrent opioid formulations (ADFs) has focused, in part, on comparisons of the ADF’s route of administration (ROA) profile with its baseline profile prior to ADF introduction. However, the routes that abusers use may be influenced by several factors, including continued availability of the original formulation and availability of non-ADF products as alternatives for abuse, particularly generic versions of the parent drug.
Methods: ROA data from Q4 2012 through Q3 2013 were examined among adults assessed for substance abuse problems using the NAVIPPROⓇ Addiction Severity Index-Multimedia Version (ASI-MVⓇ). The ASI-MV is a computer-administered, clinical interview that collects self-report data from adults on past 30-day drug abuse, including prescription opioids. ASI-MV respondents differentiated abuse of prescription products using screen images.
Results: Among abusers of the product, the ROA profile for the original oxymorphone ER historically revealed high levels of snorting (76%) and low injection (19%). In the last year, the reformulated ER oxymorphone showed low levels of snorting (20%), but higher injection (62%). However, currently, abusers of original ER oxymorphone report continued snorting (60%) but greater injection (38%) than observed historically. The ROA profile for non-ADF generic versions are more often snorted (72%) and injected (32%).
Conclusions: ROA profiles for oxymorphone ER products change over time. Understanding the public health impact of ADFs must take into account this dynamic process as new products enter the market such as higher-dose, non-ADF generic versions. Data updated through Q1 2014 will be presented.