A study conducted by scientists at Inflexxion and Collegium Pharmaceuticals was recently presented at the American Pain Society’s 35th Annual Scientific Meeting in Austin, Texas. The study completed by Drs. Butler, Black and Fleming is entitled Relative abuse of abuse deterrent formulations via alternative oral routes.

The study examined abuse of prescription opioid products that have been formulated to be crush-resistant.  Abuse of a combined group of three crush-resistant abuse deterrent formulation (ADF) products (reformulated OxyContin and Opana ER and Nucynta ER) was compared with non-ADF products that were self-reported via the ASI-MV®, Inflexxion’s computerized, clinical interview for adults in substance abuse treatment.  The ASI-MV captures self-report of past 30-day abuse of prescription medications and routes of administration.

Compared with non-ADFs, results showed that among those who abused products orally, the crush-resistant ADFs had a greater prevalence of abuse by routes other than swallowing the tablet or capsule whole (i.e., alternate oral routes that involve manipulation). Conversely, the ADF group was significantly less likely than comparators to be abused by swallowing whole.  Specifically, crush-resistant ADFs were significantly more likely to be chewed than all comparators and more likely to be dissolved in the mouth than the non-ADF versions of the products original or generic oxycodone ER, and morphine ER.

In conclusion, there is evidence that existing ADF crush-resistant tablets may reduce abuse by insufflation (snorting) and injection, but current crush-resistant ADFs appear to be more likely than non-ADF versions and non-ADF comparators to be abused by alternate oral routes associated with product manipulation.  These results have important implications in helping pharmaceutical companies and public health organizations better understand and deter abuse of opioid medications.

Inflexxion’s Health Research & Analytics group conducts epidemiological research using a combination of its unique proprietary data sources and its Web-Informed Services offerings. Interested in learning more?