OxyContin users are switching to heroin

A new formulation of the widely prescribed painkiller OxyContin has led drug abusers to shift to heroin, according to research results reported as a letter to the editor in the July 12 issue of the New England Journal of Medicine.

The letter details the preliminary findings of a study led by Theodore J. Cicero, PhD, a professor of neuropharmacology in psychiatry at Washington University in St. Louis. Dr. Cicero and his research team collected data quarterly over a period of 3 years-from before to after a new formulation of OxyContin was introduced to the market, which made it more difficult for drug users to evade the slow-release mechanism of the drug and abuse the painkiller.

From July 1, 2009, through March 31, 2012, Dr. Cicero and his team collected quarterly data using anonymous self-administered surveys from patients with opioid dependence who were entering treatment programs around the United States and for whom a prescription opioid was the primary drug of abuse. Of these patients, 103 agreed to online or telephone interviews for more information.

Their findings show that while OxyContin decreased as the primary drug of abuse from 35.6% before the release of the abuse-deterrent formula to 12.8% after the release, other opioids increased in favor. In addition, OxyContin fell from 47.4% to 30% as the primary opioid used “in the last 30 days,” while heroin use nearly doubled. And, they noted that although 24% found a way to defeat the tamper-resistant properties of the abuse-deterrent formulation, 66% indicated a switch to another opioid, with “heroin” being the most common response.

“Our data show that an abuse-deterrent formulation successfully reduced abuse of a specific drug but also generated an unanticipated outcome: replacement of the abuse-deterrent formulation with alternative opioid medications and heroin, a drug that may pose a much greater overall risk to public health than OxyContin,” Dr. Cicero and his colleagues wrote. They believed it was important to alert physicians, regulatory officials, and the public to what is happening.