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Reformulation of oxycodone 80 mg to prevent misuse: A cohort study assessing the impact of a supply-side intervention.
Int J Drug Policy. 2020 Jul 06; 83:102848.IJ

Abstract

BACKGROUND

In August 2010, extended-release OxyContin® products, including oxycodone 80 mg, were reformulated and released as abuse-deterrent medications. This paper describes changes in individual prescription filling patterns that followed the reformulation of oxycodone 80 mg.

METHODS

Using New York State prescription monitoring program data, we conducted a retrospective analysis of a cohort of New York City residents who had filled at least three consecutive prescriptions for oxycodone 80 mg immediately prior to the reformulation. We classified cohort members into one of three groups (continuers, switchers, and discontinuers) based on prescription filling patterns post-reformulation. Descriptive analyses were conducted to identify prevalence of filling patterns. Differences in median morphine milligram equivalents (MME) pre- and post-reformulation were compared using the Wilcoxon signed-rank sum test. Analyses were completed in 2018.

RESULTS

A cohort of 4,098 New York City residents filled continuous prescriptions for oxycodone 80 mg immediately prior to reformulation. Post-reformulation, 14% of the cohort discontinued filling opioid analgesic prescriptions; 46% continued to fill prescriptions for oxycodone 80 mg; and 40% switched to a different opioid analgesic, most commonly oxycodone 30 mg. Post-reformulation, the median MME dose decreased significantly among all three groups: 45 mg among continuers, 150 mg among switchers, and 360 mg among discontinuers.

CONCLUSION

Post-reformulation, more than half the cohort changed their filling patterns. Following reformulation, median MME dose decreased significantly among the cohort. We hypothesize that the dramatic decrease in MME dose prompted many to transition to heroin in order to avoid severe withdrawal.

Authors+Show Affiliations

Bureau of Alcohol and Drug Use Prevention Care and Treatment, New York City Department of Health and Mental Hygiene, Long Island City, New York, United States; Department of Population Health, New York University Grossman School of Medicine, New York, United States. Electronic address: mnolan2@health.nyc.gov.Bureau of Alcohol and Drug Use Prevention Care and Treatment, New York City Department of Health and Mental Hygiene, Long Island City, New York, United States; Department of Population Health, New York University Grossman School of Medicine, New York, United States.Bureau of Alcohol and Drug Use Prevention Care and Treatment, New York City Department of Health and Mental Hygiene, Long Island City, New York, United States; Department of Population Health, New York University Grossman School of Medicine, New York, United States.Bureau of Alcohol and Drug Use Prevention Care and Treatment, New York City Department of Health and Mental Hygiene, Long Island City, New York, United States; Department of Population Health, New York University Grossman School of Medicine, New York, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32645583

Citation

Nolan, Michelle L., et al. "Reformulation of Oxycodone 80 Mg to Prevent Misuse: a Cohort Study Assessing the Impact of a Supply-side Intervention." The International Journal On Drug Policy, vol. 83, 2020, p. 102848.
Nolan ML, Harocopos A, Allen B, et al. Reformulation of oxycodone 80 mg to prevent misuse: A cohort study assessing the impact of a supply-side intervention. Int J Drug Policy. 2020;83:102848.
Nolan, M. L., Harocopos, A., Allen, B., & Paone, D. (2020). Reformulation of oxycodone 80 mg to prevent misuse: A cohort study assessing the impact of a supply-side intervention. The International Journal On Drug Policy, 83, 102848. https://doi.org/10.1016/j.drugpo.2020.102848
Nolan ML, et al. Reformulation of Oxycodone 80 Mg to Prevent Misuse: a Cohort Study Assessing the Impact of a Supply-side Intervention. Int J Drug Policy. 2020 Jul 6;83:102848. PubMed PMID: 32645583.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reformulation of oxycodone 80 mg to prevent misuse: A cohort study assessing the impact of a supply-side intervention. AU - Nolan,Michelle L, AU - Harocopos,Alex, AU - Allen,Bennett, AU - Paone,Denise, Y1 - 2020/07/06/ PY - 2019/09/16/received PY - 2020/06/11/revised PY - 2020/06/29/accepted PY - 2020/7/10/pubmed PY - 2020/7/10/medline PY - 2020/7/10/entrez KW - Heroin KW - Opioid analgesics KW - OxyContin KW - Oxycodone KW - Prescription drug monitoring program KW - Prescription drugs KW - Reformulation SP - 102848 EP - 102848 JF - The International journal on drug policy JO - Int. J. Drug Policy VL - 83 N2 - BACKGROUND: In August 2010, extended-release OxyContin® products, including oxycodone 80 mg, were reformulated and released as abuse-deterrent medications. This paper describes changes in individual prescription filling patterns that followed the reformulation of oxycodone 80 mg. METHODS: Using New York State prescription monitoring program data, we conducted a retrospective analysis of a cohort of New York City residents who had filled at least three consecutive prescriptions for oxycodone 80 mg immediately prior to the reformulation. We classified cohort members into one of three groups (continuers, switchers, and discontinuers) based on prescription filling patterns post-reformulation. Descriptive analyses were conducted to identify prevalence of filling patterns. Differences in median morphine milligram equivalents (MME) pre- and post-reformulation were compared using the Wilcoxon signed-rank sum test. Analyses were completed in 2018. RESULTS: A cohort of 4,098 New York City residents filled continuous prescriptions for oxycodone 80 mg immediately prior to reformulation. Post-reformulation, 14% of the cohort discontinued filling opioid analgesic prescriptions; 46% continued to fill prescriptions for oxycodone 80 mg; and 40% switched to a different opioid analgesic, most commonly oxycodone 30 mg. Post-reformulation, the median MME dose decreased significantly among all three groups: 45 mg among continuers, 150 mg among switchers, and 360 mg among discontinuers. CONCLUSION: Post-reformulation, more than half the cohort changed their filling patterns. Following reformulation, median MME dose decreased significantly among the cohort. We hypothesize that the dramatic decrease in MME dose prompted many to transition to heroin in order to avoid severe withdrawal. SN - 1873-4758 UR - https://www.unboundmedicine.com/medline/citation/32645583/Reformulation_of_oxycodone_80 mg_to_prevent_misuse:_A_cohort_study_assessing_the_impact_of_a_supply-side_intervention L2 - https://linkinghub.elsevier.com/retrieve/pii/S0955-3959(20)30189-4 DB - PRIME DP - Unbound Medicine ER -
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