New Oxycodone Formulation Decreased Overdose Rates

Oxycodone overdose rates fell significantly when the high-dose opioid painkiller’s manufacturer switched to an abuse-deterrent formulation in 2010, according to a new study.

Study authors also found a dip in the levels of dispensing connected to the formulation change in oxycodone—sold as OxyContin—as well as a link between lower opioid overdose and prescribing levels and the withdrawal of propoxyphene (Darvon) from the market in the same year, as a result of data emerging about its cardiac side effects.
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The team led by researchers from Harvard Medical School and the Boston University School of Medicine analyzed the prescribing of opioids to commercial health-plan members across the United States, to reach the estimated average level of morphine-equivalent dose (MED). They drew data from more than 31 million insured members, finding the dispensing rate for all opioids combined rose from 95 mg to 163 mg MED per plan beneficiary between 2003 and the third quarter of 2010.

Immediately following the interventions, however, the dispensing rate decreased by 14.8 mg MED per member, with the rate for the final quarter of 2012 estimated at 139 mg MED per member. In addition to this 19% drop, the estimated rate of overdose fell by 20% as well.

“We found the rate of prescription opioid overdose is directly related to supply,” says Marc Larochelle, MD, a fellow of general medicine and primary care in the department of population medicine at Harvard Medical School, and lead study author. Larochelle describes this correlation as “the main finding of importance for primary care practitioners when prescribing oxycodone or any opioid medication.”

“Each and every prescription we write increases that supply and potentially contributes to this critical public health issue,” says Larochelle. “When we do decide to prescribe opioids, we should prescribe only the minimum necessary, for the shortest amount of time needed, and re-evaluate the risk/benefit for each patient on a regular basis.”

—Mark McGraw

Reference

Larochelle M, Zang F, et al. Rates of opioid dispensing and overdose after introduction of abuse-deterrent extended-release oxycodone and withdrawal of propoxyphene. JAMA Intern Med. 2015.