Abuse Deterrent Drugs May Curb Abuse in West Virginia
West Virginia is currently the drug overdose capital of the U.S. At 32.4 deaths per 100,000 persons, it is roughly 25% higher than it’s closest competitor, New Mexico. Most of those overdoses were related to opioid drugs, such as heron or prescription painkillers such as fentanyl. Between 2014-2015, deaths related to fentanyl increased from 55 to 154, nearly tripling.
This is a nationwide problem, however, and has begun to be taken seriously. According to the National Center for Health Statistics, in 2014 there were nearly 19,000 deaths related to prescription opioid painkillers in the U.S. – an increase of about 16%.
The FDA and Support for Abuse Deterrent Drugs
The U.S. Food and Drug Administration (FDA) released a 34-page document last week, entitled “General Principles for Evaluating the Abuse Deterrence of Generic Solid Oral Opioid Drug Products.” This document basically details the agency’s outlook on support for the development of generic opioids which include abuse deterrent formulations, with the goal of ensuring that the generic versions are equally abuse deterrent as the brand.
The FDA plan was developed to focus on policy which will curb the nation’s opioid epidemic, without neglecting pain treatment for patients who really need it.
FDA Commissioner Robert Califf:
“For the millions of Americans who suffer from significant pain, and the health systems that serve them, generic opioids can be an appropriate and affordable option for patient care. We recognize that abuse-deterrent technology is still evolving and is only one piece of a much broader strategy to combat the problem of opioid abuse.”
Abuse deterrent properties including preventing users from crushing or dissolving the drug. However, drug abuse is still entirely possible if the pill is swallowed whole. There is no opioid currently which has properties that are abuse-deterrent if the product is entirely ingested.
In the document, the FDA details abuse deterrence of generic solid opiod drugs, as well as general principals for evaluating those drugs, abuse routes, and additional consideration.
Results from a June, 2015 survey published in the Clinical Journal of Pain reveal that over 45% of physicians believe that abuse deterrent formulations do indeed make some medications less addictive.
However, that pretty much flies in the face of simple logic, does it not?
Ingesting an opioid pill is typically what gets patients addicted in the first place. Long before a user attempts to crush a pill for snorting or injection, they engage in use that is completely legal, but no less addictive in it’s own right. It may makes some types of abuse difficult or impossible, but does nothing to mitigate the addictive nature of the substance itself.
The truth of the matter is, no true opioid can completely deter abuse. All opioids are addictive, and all patients may succumb to a certain level of tolerance. Once the pill isn’t achieve desired benefits, the user may turn to heroin, which is available in any amount they choose to purchase.
I’m not advocating that abuse deterrent drugs are completely unworthy of pursuing. I just don’t believe that they are going to do much to curb prescription drug addiction.
~ G. Nathalee Serrels, M.A., Psychology
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