Earlier this year, Inflexxion and KemPharm Pharmaceuticals presented a poster at the International Conference on Opioids based on a recent study of non-medical use of prescription opioids.  According to SAMSHA, Non-medical use of prescription opioids continues to increase.  However, little is known about the potential impact commonly prescribed opioids, such as hydrocodone combination products (HCPs), have on abuse progression and their influence on the overall problem of prescription opioid abuse.  HCPs are the most commonly prescribed opioid product and initial opioid exposure may serve as a sentinel event for individuals who use prescription opioids non-medically.

The purpose of the study was to understand the progression of non-medical use of HCPs and how it relates to abuse of other prescription opioids and illicit drugs, routes of administration, and associated life problems.  Methods used included Internet-based surveys (N=472) were administered to individuals aged ≥18 who visited drug-related discussion forums, recruited from September-December 2015.

As a result, we found that approximately 63% of respondents reported first non-medical use of HCPs in their lifetime between the ages of 10 and 18, and approximately 74% reported the same age at first non-medical opioid use and first non-medical HCP use. The majority (54%) of respondents who continued to abuse HCPs did so at least a few times per week, while 55% of those who stopped using HCPs progressed to other prescription opioids. Among respondents (49.8%) that believed initial use of HCPs led them to abuse other prescription opioids, those who began using HCPs at age ≤18, versus age >18, were more likely to report subsequent snorting (75.2% vs. 47.4%), injecting (30.6% vs. 19.2%), and smoking (30.6% vs. 23.1%) other prescription opioids.

In conclusion, these findings suggest that, among recreational drug abusers, HCPs are commonly the first prescription opioid used, and that initial abuse during adolescence can lead to abuse of more potent opioids and more dangerous routes of administration.

Supported by: Inflexxion, Inc. and KemPharm Pharmaceuticals Inc.

Authors: Theresa A. Cassidy1, Natasha K. Oyedele1, Jared Beaumont1, Sven Guenther2, Travis C. Mickle2

1Inflexxion, Inc., Newton, MA 02464

2KemPharm, Inc., Coralville, IA 52241