A researcher says a change in the formula of OxyContin to fight its abuse has had some success, but might have only driven many of its abusers to a worse drug.
Theodore J. Cicero, PhD (photos courtesy, Washington University School of Medicine and U.S. Drug Enforcement Administration)
In 2010, OxyContin was reformulated to make it harder to abuse. Professor Theodore Cicero at Washington University in St. Louis headed up a study that asked people entering drug rehab if they had been abusing OxyContin, and what they did after that reformulation.
“What our data suggests is they did not quit taking drugs. They still remained drug users, but they switched to an alternative medication such as oxymorphone, hydromorphone, fentanyl and in some cases they switched to heroin.”
See the report in the New England Journal of Medicine.
Cicero says this and other studies show that drug abuse doesn’t just stop, it shifts from one substance to another. He says the way to fight it is to address demand.
“Interdiction efforts to stop the flow of drugs into the drug abuse culture in this country have largely failed to decrease the supply. As long as there’s this demand out there, there’s going to be some way to supply addicts with the drugs they’re looking for. Our study really begs for more research and more study of intervention and prevention techniques.”
He says the answer is to keep attacking supply, but focus more on attacking demand. “What we do as we develop policies nationwide is to recognize that yes, limiting the supply is not a bad thing, it’s a good thing, but we need to in some way or other decrease the demand side. That is a very difficult task and that’s why there’s been so little progress made in that area.”
Cicero says heroin is a far more dangerous, affordable and unpredictable drug than OxyContin. “Once you start to buy heroin, you’re buying a powder form … it’s always cut by the dealers down to as little as five percent pure. What this makes for is a great deal of difficulty in estimating what dose you’re taking. So in contrast to the legal drugs where you’re certain of dose, you are very uncertain with heroin about what dose is acceptable and what you’re going to inevitably lead to is overdose.”
The data is still being evaluated but Cicero felt it was important to get the early results out. “This trend toward increases in heroin use is important enough that we want to get the word out to physicians, regulatory officials and the public, so they can be aware of what’s happening.”Â
The report appears as a letter to the editor in the New England Journal of Medicine.
AUDIO:Â Mike Lear interviews Professor Theodore Cicero, PhD