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The epidemic of fatal overdoses linked to prescription opioid painkillers has healthcare officials and drug makers scrambling to find a solution. In 2014 alone, 47,055 people died from accidental overdoses. The Centers For Disease Control and Prevention (CDC) reports that in more than half of those fatalities, 60 percent in fact, opioid painkillers were involved. And the problem is not getting better.
The Food and Drug Administration (FDA), in 2010, began approving so called abuse deterrent opioids, such as Opana, with the goal of making it difficult for users to either snort or inject the powerful painkillers. The latest research, however, proves that individuals locked in a cycle of addiction are easily cracking the “abuse-deterrent” codes.
“Overall if a person is intent on using opioids intranasally or injecting, they will figure out a way to do it,” Dr. Ted Cicero, professor of psychiatry at Washington University in St. Louis, told Business Insider. “…the way that most people abuse these drugs is by swallowing them. We are not touching that part of the problem.”
Opana is a long-acting painkiller that contains oxymorphone, which was intended to replace oxycontin because it was more difficult to abuse by snorting or injecting. The original formula didn’t live up to the hype and has since been changed to actually work more as promised. Unfortunately, because it is much stronger than oxycontin, states like Indiana witnessed a rise in Opana overdose deaths.
The pharmaceutical company Endo Health Solutions, which makes the long-acting opioid painkiller Opana ER that sold as an abuse deterrent medication, just settled a lawsuit with the state of New York. The investigation by the N.Y. State Attorney’s office revealed the following facts about the company’s product:
- The Opana pill, which the company marketed as crush-resistant could easily be crushed and ground up by users that wanted to misuse the medication
- Instructed its sales representatives to downplay the dangers of Opana ER, such as the risk of becoming addicted to it
- Made unsubstantiated claims about their product in comparing it to other opioids on the market
- Failed to report relevant information regarding research into the effects of Opana ER
In a statement, the N.Y. State Attorney General, Eric T. Schneiderman, spoke to claims the company made about Opana being an abuse-deterrent product. “This may have bolstered Opana ER’s sales,” Schneiderman said, “but provided a false sense of security to healthcare providers and their patients.”
Under the settlement, Endo Pharmaceuticals agreed to stop marketing the painkiller as crush-resistant. It will also pay $200,000 in penalties, a total that some experts claim is barely a slap on the wrist for a pharmaceutical company worth $16 billion, according to Forbes.
Skeptics of pharmaceutical companies producing abuse deterrent medications argue these formulations are largely symbolic and a way to boost sales. They point to a 2012 National Survey on Drug Use and Health that found 40 to 70 percent of people that abuse prescription painkillers get the medication from friends or family, and when these sources dry up, abusers move to cheaper drugs like heroin.
“I’m not convinced we can engineer our way out of this epidemic,” said John Hopkins University doctor, Caleb Alexander, to the Associated Press,” and I would caution against over-relying on abuse-deterrent formulations to do so.”
Most proponents for abuse-deterrent meds acknowledge the limitations of the products, but seem to have a “some protection is better than nothing” attitude toward the issue. They also believe that these technologies will continue to improve.
Still, others believe it’s dangerous territory for a federal agency, like the FDA, to depend on pharmaceutical companies and their abuse-deterrent formulations, which are still clearly abusable, as a solution to the epidemic of opioid addiction and overdoses.