Tamper-Proof Pills No Panacea for Opiate Abuse
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Tamper-Proof Pills No Panacea for Opiate Abuse


A new study suggests the tamper-resistant form of OxyContin has been effective in reducing painkiller overdoses. But that may not be much cause for celebration.

The good news is that according to the study published last month in the journal JAMA Internal Medicine, there was a 19 percent drop in overdoses in the two years after “abuse-deterrent” Oxy was introduced in 2010. The bad news? Heroin overdoses increased by 23 percent during the same period.

In other words, a tamper-resistant pill may help curb supply and slow down addiction, but it won’t help the estimated 26.4 million to 36 million people worldwide who are already abusing opioids. Instead, it sounds like addicts are shifting their business from prescription-happy doctors to street-corner heroin dealers. That’s a real problem.

One Simple Step to Addiction

First off, a little chemistry. Although they are chemically different, both heroin and prescription painkillers target the same brain receptors. OxyContin slowly releases its active ingredient, oxycodone, over 12 hours. But before the tamper-resistant version was developed, it was easy to break the pill open, pour out the fine powder and snort it or inject it, just like dope. One simple step, and the high was the same you get from heroin. And they’re both highly addictive.

Even when taken correctly, prescription pain medication is highly addictive and subject to abuse. The 2009 National Survey on Drug Use and Health found that nearly two million Americans were dependent on or abusing prescription pain relievers—that’s nearly twice the number of people addicted to cocaine. These alarming figures are what fueled public pressure on drug manufacturers to make their pills tamper-proof in the first place.

Now opiate addicts can avoid having to deal with the rigmarole of tamper resistance by switching to heroin (although ingenious addicts have figured out ways to outsmart the tamper-proof pill). After all, once they’re addicted to something, that’s it, an addict will find a way to get high. There’s nothing that anyone can say or do to stop them. My favorite example of this? I once had a friend who would get so desperate he’d go to the flower market for the dried poppies he needed to make opium tea.

The Black Market Beckons

Heroin versus OxyContin? The way I see it, the only real difference is that an Oxy addict ingests an FDA-approved substance while who knows what a heroin junkie is shooting or snorting. Those who switch from Oxy to smack go from picking up a prescription from a doctor’s office to involving themselves in a dirty, dangerous black market. And then there’s the issue of safety. Without needle exchanges or safe injection sites, heroin taken intravenously is particularly dangerous because people may share needles, exposing themselves to blood-borne diseases such as HIV and hepatitis.

Dr. Marc Larochelle of the Boston University School of Medicine, the lead researcher on the JAMA study, concedes that “Abuse-resistant formulations will not cure people who are addicted to narcotics.” But reducing the supply of prescription painkillers, he says, could “prevent or slow down the number of new people who become addicted, because many people who use heroin may have started with pills.”

Well, Marc, I suppose that’s better than nothing. But what of the mess that we’ve already made?

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About Author

Melissa Petro is a freelance writer and writing instructor living in New York City. She has written for NY Magazine, The Guardian, Salon, The Daily Beast, The Huffington Post, Jezebel, xoJane, The Fix and elsewhere. She is the founder of Becoming Writers, a community organization that provides free and low cost memoir-writing workshops to new writers of all backgrounds and experiences.