Methods and predictors of tampering with a tamper-resistant controlled-release oxycodone formulation

Area of Science:

• Pharmacology
• Addiction Medicine
• Public Health

Background:

• A tamper-resistant controlled-release oxycodone formulation was introduced in Australia in April 2014.
• Previous oxycodone formulations were subject to widespread tampering and misuse.

Purpose of the Study:

• To assess the effectiveness of a new tamper-resistant oxycodone formulation.
• To identify tampering methods and user characteristics associated with reformulated oxycodone.
• To evaluate the perceived attractiveness of original versus reformulated oxycodone for misuse.

Main Methods:

• A prospective cohort study of 522 individuals with a history of pharmaceutical opioid tampering.
• Two interviews were conducted before and after the reformulated oxycodone introduction.
• Data collected included tampering behaviors, methods, and participant demographics.

Main Results:

• Tampering and misuse attempts with reformulated oxycodone were significantly lower (29% use, 19% tampering) compared to the original formulation (81% tampering in the prior month).
• Reformulated oxycodone was mainly swallowed; injection, chewing, dissolving, and smoking methods were infrequent.
• Users tampering with the reformulated product were similar to those using the original, but more likely to report prescribed opioid use and stealing, and less likely to report anxiety.

Conclusions:

• The tamper-resistant formulation has successfully reduced, though not eliminated, tampering and misuse of controlled-release oxycodone.
• The reformulated oxycodone demonstrates lower attractiveness for misuse.
• Continued availability of effective treatment options is crucial for individuals with opioid dependence as abuse-deterrent products become more common.