Changes in Rx Market, Changes in Health

Prescription opioid abuse decreased after market adjustments

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Recent changes in the prescription opioid market might have led to a big step forward in the fight against opioid dependency.

A new study found that fewer opioid prescriptions had been filled in recent years. The number of overdoses from prescription opioids also decreased. The authors of this study said they believe this was likely due to two market changes in 2010.

Opioid drugs (such as heroin) and medications are produced from compounds found in poppy plants. Opioids can be highly addictive. Prescription opioid painkillers are often the initial source of drug dependency.

In 2010, an extended-release oxycodone hydrochloride (OxyContin) entered the market. It was unable to be crushed or dissolved. This made it harder to abuse for a stronger high. Later that year, the opioid painkiller propoxyphene was pulled from the market. Propoxyphene had long been a commonly abused opioid. These two changes shifted the overall availability of prescription opioid medications, according to the authors of this study.

"Following these market changes, the rate of nonfatal emergency department visits and inpatient visits for opioid analgesic overdoses decreased," wrote Hillary V. Kunins, MD, of the New York City Department of Health and Mental Hygiene in New York City, in an editorial about this study.

In other words, these two small changes in the market appeared to reduce negative outcomes.

In this recent study, Marc R. Larochelle, MD, of Harvard Medical School and Boston University School of Medicine, and colleagues looked at the effect of these market changes. They found that fewer prescriptions had been filled since 2010. Also, overdoses due to prescription opioids were down 20 percent. The difficulty in abusing the new form of OxyContin caused less dependency to be created, Dr. Larochelle and team wrote. Fewer opioids available might also have reduced false prescription seeking, they said.

However, deaths due to heroin overdose increased by 23 percent during the study period. Dr. Larochelle and team wrote that "This increase may be linked to the previously unrelenting increase in prescription opioid abuse because most heroin users misuse prescription opioids prior to initiating heroin use."

The study and editorial were published online April 20 in JAMA Internal Medicine.

The Health Resources and Services Administration, Harvard Pilgrim Health Care Institute and Ryoichi Sasakawa Fellowship funded this research. Dr. Larochelle and team disclosed no conflicts of interest.

Review Date: 
April 20, 2015
Last Updated:
April 21, 2015