Reformulated OxyContin Leads to Increased Opana Abuse

A new formulation of OxyContin that makes abuse more difficult has caused increased abuse of Opana, which brings added risk of addiction and overdose.

Reformulated OxyContin (oxycodone) pills make getting high harder, so opioid abusers are turning to Opana (oxymorphone) instead, according to a July 12, 2012, report in USA Today. As a result, the report added, Opana-related crime, including pharmacy robberies and overdose deaths, as well as treatment for oxymorphone addiction have been rising in several states.

Prior to August 2010, when Purdue Pharma reformulated OxyContin, opioid abusers could crush, break, or dissolve the pills in order to snort or inject the drug, which produces a more rapid high. The new formulation cannot be broken, crushed, or dissolved, so addicts must either take larger quantities of the drug or find another option.

In Kentucky, according to USA Today, oxymorphone appeared as a factor in 23% of overdoses in 2011, up from just 2% in 2010. In nearby Ohio, the Ohio Substance Abuse Monitoring Network reported in January 2012 that many opioid abusers said they were using oxymorphone as a replacement for oxycodone.

This is not the first time oxymorphone abuse has been in the spotlight. According to a May 2011 intelligence brief from the Drug Enforcement Administration, oxymorphone abuse was popular during the early 1970s, when many who injected it considered it superior to heroin or morphine. The brief singled out New Castle, Delaware, and Philadelphia, Pennsylvania, as present-day hot spots of oxymorphone abuse.

Meanwhile, Nassau County in New York State issued a public health alert regarding increased oxymorphone abuse in the first half of 2011. Officials noted the trend after tracking Medicaid prescriptions filled through local pharmacies, observing a 43% drop in oxycodone prescriptions and a 45% increase in oxymorphone prescriptions.

Oxymorphone abuse can be particularly dangerous. Its high fades rapidly, requiring additional doses to maintain euphoria and increasing the risk of developing a serious narcotic habit. The drug is also more potent than oxycodone, yielding a risk of unintentional overdose.

On June 14, 2012, Endo Health Solutions, the manufacturer of Opana, reported that it had completed its transition to a crush-resistant Opana Extended-Release formula that is meant to curb abuse of the drug. Older formulations are now listed as discontinued, the company stated.

“While the original formulation of Opana ER was deemed by FDA to be safe and effective when taken according to the prescribing information, the original formulation was subject to both intentional and inadvertent abuse and misuse,” Ivan Gergel, MD, chief scientific officer at Endo, said in a press release. “Patient safety is our top concern and addressing appropriate use of opioids is a responsibility we take very seriously.”

Despite the reformulations, abusers will likely look to other drugs—legal or not—for the next fix, according to experts quoted by USA Today.

“It’s almost like a game of Whac-a-Mole,” Jeffrey Reynolds, executive director of the Long Island Council on Alcoholism and Drug Dependence, told USA Today. “You get a handle on OxyContin; they switch to Opana. My guess is it will be something new tomorrow.”

Previous Pharmacy Times coverage of prescription painkiller abuse:

• Chronic Painkiller Abuse, Methadone-Related Deaths Both Increasingly Common
• New York State Set to Crack Down on Painkiller Abuse
• Adolescent Painkiller Abuse Likely to Begin During High School
• Friends and Family Frequently Provide Pills to Prescription Drug Abusers
• Prescription Drug Overdoses Reach Epidemic Levels