Chronic Pain Health — 11 July 2012

OxyContin tablets crushed into powder for snorting.

A change in the formula for the powerful painkiller OxyContin – designed to make the drug less likely to be abused — may be encouraging the use of more dangerous drugs. Many abusers are switching from OxyContin to heroin to get high, according to researchers at Washington University School of Medicine in St. Louis, who reported their findings in the New England Journal of Medicine.

The widely prescribed and abused painkiller was designed to be released into the system slowly, so it wouldn’t produce an immediate high. But drug abusers found they could crush OxyContin pills and inhale the powder or dissolve the pills in water and inject the solution to get an immediate rush.

To discourage that practice, Purdue Pharma, the maker of OxyContin, changed the formula for the drug in 2010 to make the pills harder to crush and dissolve.

“Our data show that OxyContin use by inhalation or intravenous administration has dropped significantly since that abuse-deterrent formulation came onto the market,” said principal investigator Theodore J. Cicero, PhD, a professor of neuropharmacology in psychiatry. “In that sense, the new formulation was very successful.”

Over the course of three years, Cicero and his colleagues surveyed 2,500 patients at 150 drug treatment centers in 39 states, asking them about their use of OxyContin. They found that while many abusers stopped using OxyContin, they switched to heroin and other opioids to get high. The researchers are still analyzing the data, but wanted to make their findings known as quickly as possible. Their report appears as a letter to the editor in the journal.

“The most unexpected, and probably detrimental, effect of the abuse-deterrent formulation was that it contributed to a huge surge in the use of heroin,” Cicero said. “We’re now seeing reports from across the country of large quantities of heroin appearing in suburbs and rural areas. Unable to use OxyContin easily, which was a very popular drug in suburban and rural areas, drug abusers who prefer snorting or IV drug administration now have shifted either to more potent opioids, if they can find them, or to heroin.”

Since the researchers started gathering data from patients in the study, the number of users who selected OxyContin as their drug of choice decreased from about 35 percent under the old formula to less than 13 percent now.

When asked which opioid they used to get high in the past 30 days, OxyContin fell from about 47% of respondents to 30 percent. During the same time period, reported use of heroin nearly doubled.

“When we asked if they had stopped using OxyContin, the normal response was ‘yes,'” Cicero said. “And then when we asked about what drug they were using now, most said something like: ‘Because of the decreased availability of OxyContin, I switched to heroin.'”

“This trend toward increases in heroin use is important enough that we want to get the word out to physicians, regulatory officials and the public, so they can be aware of what’s happening,” said Cicero. “Heroin is a very dangerous drug, and dealers always cut the drug with something, with the result that some users will overdose. As users switch to heroin, overdoses may become more common.”

A new formulation of OxyContin called OxyNeo was introduced in Canada in March to combat widespread abuse. Like the 2010 formulation, it is also designed to be harder to crush and turns into a gel when dissolved in water. But that didn’t stop efforts addicts and drug dealers from finding new ways to process the medication. On internet forums, addicts are sharing recipes for turning OxyNeo tablets into powder, a complicated process that includes microwaving and freezing the tablets.

A surge in heroin use is also being reported in London, Ontario and other Canadian cities.


About Author

Pat Anson, Editor

Pat is Editor in Chief of American News Report. He is a veteran journalist and a former correspondent and producer for HealthWeek (PBS), Nightly Business Report (PBS) and other nationally syndicated shows. Pat has won numerous journalism awards, including a Golden Mike award for investigative reporting.

(2) Readers Comments


    How did they get that the sales were down because abusers were now using heroin? Did they count the multitude of pain patients that switched to another medication because the new formula wasn’t controlling pain as well as it was before they switched it? I wish the media and the individuals that write this so-called news would stop and think how they are being used by the government to appease families of druggies. It works because most of you swallow everything they say without stopping to think about the people the medication was intended to help. All people seem to care about. Is saving another junkie. I wish the government and general public cared as much for suffering people as they did for junkies.

  2. I think this was pretty predictable. If you’re addicted & willing to inject or snort oxycontin, why wouldn’t you be willing to do that with another drug? A cheaper one? Another “unintended consequence” of the failed War on Drugs. I had to stop taking Oxycontin when the new formula came out (first, I suffered for almost three months, not knowing the formula was different….as the pills were the same color & shape, and my pharmacy never told me they were different). My pain was poorly controlled, I had terrible stomach pains, headaches, anxiety, poor sleep, etc… Whatever the “gel” is made of inside, ripped my insides apart. I was doubled over in pain with stomach cramps….it was awful. My doctor finally figured it out, when he called the pharmacy. The pharmacist said that other pain patients had said the same thing…..poor pain control & it was making them SICK. Of course, I called the pharm co., and the FDA, but what was done was done. They changed the pills for the abusers, and now legit patients were suffering because of it. I have not had my pain as well controlled since the original formula of Oxycontin was taken off the market. I also think the longterm effects of the “new” formula will be found detrimental to people’s health. Whatever they used for material in it, probably shouldn’t be used for human consumption. maybe someday, the government will start treating addiction as the disease that it is, and stop thinking that people will stop using because of a formula change. There will always be drugs to abuse, until people get the help they need to get into recovery, they will use anything! In the meantime, more legit pain patients have to suffer the typical “unintended consequences”, pay for the actions of others, and deal with less effective medications for pain. All these “unintended” consequences are really adding up. People in severe pain don’t need anymore consequences, whether they are intended or not. They just become consequences, and intentions DON’T count when the end result sucks.