Less abuse with extended-release oxycodone, poison control center data suggest

FORT LAUDERDALE, Fla. — A deterrent formulation of oxycodone resulted in fewer serious medical outcomes and fewer intentional abuses compared to other opioid products, according to poison control center data.

Of 189 exposures to extended-release oxycodone (Xtampza ER) reported to poison control centers from 2016 to 2022, serious medical outcomes occurred in 12.7% of cases, which was lower than other opioid products ( 14-19 percent), according to Richard Dart, MD, PhD, of the Rocky Mountain Poison and Drug Center in Denver.

The percentage of exposures associated with death, however, was numerically highest with ER oxycodone, at 1.6% (three cases) versus 0.4-1.0% with the other opioid products, which included immediate-release oxycodone and other opioid deterrents.

Of ER oxycodone cases followed to a known outcome, 42% were intentional exposures or suspected suicidal exposures, which was lower than other drug groups (55-78%), according to a poster presentation at the American Academy of Pain Medicine (AAPM) annual meeting

“Compared to other opioid pain relievers, Xtampza ER produced less severe medical outcomes, highlighting the effects of its abuse-deterrent formulation,” Dart said.

AAPM session moderator Rosanne Sheinberg, MD, of the University of Washington in Seattle, said MedPage today that “there are probably two reasons for the low number of cases seen with Xtampza ER: it’s an expensive drug and insurance doesn’t cover it, so people don’t get it.” But she agreed the drug “has a low potential to be altered” or abused.

Researchers analyzed data from all poison control centers in the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADAR) system (51 of the 55 centers in the country).

During the study period, there were 3,907 exposures to other abuse-deterrent ER opioid formulations, 6,011 exposures to immediate-release oxycodone, 2,155 exposures to other ER opioids , 19,782 exposures to unspecified oxycodone (NOS) and 5,247 exposures to morphine NOS. .

Of these, the percentages of major medical effect or death were as follows:

• Other ED deterrent opioids: 16.5% and 0.7%, respectively
• Immediate-release oxycodone: 14.6% and 0.4%
• Other ER opioids: 14.2% and 0.6%
• Oxycodone NOS: 18.7% and 0.7%
• Morphine NOS: 16.9% and 1.0%

Rates of all intentional exposures, including suspected suicide, were 78% for oxycodone NOS, 72% for other abuse-deterrent ER opioids, 68% for morphine NOS, 61% for immediate-release oxycodone and 55% with other ER opioids.

“We believe that many of the pills associated with Oxycodone NOS are counterfeit pills,” Dart said, explaining that, based on the descriptions given to poison control, the pills were the wrong size or color to fit. be genuine oxycodone. He added that many of these counterfeit pills may also contain fentanyl.