Reduced Abuse, Therapeutic Errors, and Diversion Following Reformulation of Extended-Release Oxycodone in 2010
Reduced Abuse, Therapeutic Errors, and Diversion Following Reformulation of Extended-Release Oxycodone in 2010
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DOI：
10.1016/j.jpain.2013.04.011
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发表时间：
2013-10-01
期刊：
影响因子：
4
通讯作者：
Dart, Richard C.
中科院分区：
文献类型：
--
作者：
Severtson, Stevan Geoffrey;Bartelson, Becki Bucher;Dart, Richard C.
本研究评价了引入新配方羟考酮（ERO）后，与品牌缓释羟考酮（ERO）相关的滥用暴露、治疗错误暴露和转入非法市场的变化。原始ERO和重新制定的ERO街道价格也进行了比较。使用的数据来自研究性滥用、转移和成瘾相关监测系统（RADARS）的毒物中心和药物转移项目。采用负二项回归，将重新制定的ERO引入前2年（2008年10月至2010年9月）的季度利率与引入后（2010年10月至2012年3月）的季度利率进行比较。街头价格进行了比较，使用混合效应线性回归模型。在引入重新制定的ERO后，毒物中心ERO滥用暴露在每个人群中下降了38%（95%置信区间[CI]：31-45），在每个分发药物的独特接受者中下降了32%（95% CI：24-39）。每个人群的治疗错误暴露量下降24%（95% CI：15-31），每个分发药物的唯一接受者的治疗错误暴露量下降15%（95% CI：6-24）。每个人群的转移报告下降了53%（95% CI：41-63），每个分发药物的唯一接受者下降了50%（95% CI：39-59）。下降幅度超过了其他处方类阿片的总体下降幅度。在其推出后，重新制定ERO的街头价格显着低于原来的ERO.Perspective：本文表明，滥用，治疗错误，转移ERO下降后，推出了防篡改的产品重新制定。重新配制滥用的处方阿片类药物，使其具有防篡改特性，可能是减少这类产品滥用的有效方法。(C)2013年美国疼痛协会American Pain Society
This study evaluated changes in abuse exposures, therapeutic error exposures, and diversion into illegal markets associated with brand extended-release oxycodone (ERO) following introduction of reformulated ERO. Original ERO and reformulated ERO street prices also were compared. Data from the Poison Center and Drug Diversion programs of the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System were used. Quarterly rates 2 years prior to introduction of reformulated ERO (October 2008 through September 2010) were compared to quarterly rates after introduction (October 2010 through March 2012) using negative binomial regression. Street prices were compared using a mixed effects linear regression model. Following reformulated ERO introduction, poison center ERO abuse exposures declined 38% (95% confidence interval [CI]: 31-45) per population and 32% (95% CI: 24-39) per unique recipients of dispensed drug. Therapeutic error exposures declined 24% (95% CI: 15-31) per population and 15% (95% CI: 6-24) per unique recipients of dispensed drug. Diversion reports declined 53% (95% CI: 41-63) per population and 50% (95% CI: 39-59) per unique recipients of dispensed drug. Declines exceeded those observed for other prescription opioids in aggregate. After its introduction, the street price of reformulated ERO was significantly lower than original ERO.Perspective: This article indicates that the abuse, therapeutic errors, and diversion of ERO declined following the introduction of a tamper-resistant reformulation of the product. Reformulating abused prescription opioids to include tamper-resistant properties may be an effective approach to reduce abuse of such products. (C) 2013 by the American Pain Society