Harder-to-Abuse OxyContin May Fuel Heroin Use

A new form of the prescription painkiller OxyContin that makes the tablets more difficult to crush into powder — and therefore harder to inhale or inject — may be responsible for a decline in its abuse, but may also be fueling an increase in heroin use, researchers say.

Among people who were seeking treatment for addiction to any opiate drug, the researchers found that the percentage who said they had taken OxyContin in the last 30 days fell from 47.4 percent before the harder-to-abuse version of the drug was introduced in 2010, to 30 percent in the two years after the introduction.

However, during that same period, the percentage of those who said they had used heroin in the past 30 days doubled, to about 20 percent.

Opiate abusers are replacing OxyContin with heroin, which is more dangerous because of higher likelihood of overdose, the researchers wrote in the July 12 issue of the New England Journal of Medicine.

The data were gathered from surveys done between 2009 and 2012 of more than 2,500 opiate drug abusers who sought treatment for their addictions. The researchers also conducted phone interviews with  participants.

"When we asked if they had stopped using OxyContin, the normal response was 'yes,'" said study researcher Theodore Cicero, a psychiatry professor at the University of Washington in Saint Louis.

In a phone interview, one addict said: “Most people that I know don’t use OxyContin to get high anymore. They have moved on to heroin [because] it is easier to use, much cheaper, and easily available," according to the paper.

People who abuse OxyContin typically crush the tablets; taking the pill whole means the drug is released slowly, which doesn’t produce the high that abusers seek. In fact, when OxyContin was originally introduced, this slow release led many to think it would be part of the solution to opiate drug addiction, according to the researchers.

The decrease in OxyContin’s abuse speaks to the success of the new formula, but "abuse-deterrent formulations may not be the 'magic bullets'that many hoped they would be in solving the growing problem of opioid abuse," the researchers concluded.

Because heroin sold on the street is often mixed with other chemicals, users are much more likely to overdose on it. Overdosing on heroin often results in death. Health-care providers should be aware of the uptick in heroin use, because that may be important in providing appropriate treatment, the researchers said.

Pass it on: Though a new formula of OxyContin has made the drug harder to abuse, this may be leading to an increase in heroin use.

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