Tamper resistant and abuse deterrent opioid formulations are designed to make drugs difficult or less desirable to use in any manner other than how they were prescribed. The formulations make them harder to crush, chew, cut, dissolve, inhale, inject, or less rewarding if done so, thus deterring use in many of the ways they are abused. With the goal of combatting the opioid epidemic, the “FDA is encouraging the development of opioid formulations with abuse-deterrent properties”.
It is important to note that while the development of tamper resistant and abuse deterrent drug formulations is being suggested as an approach to reducing the public health harms related to opioid prescribing and misuse, these formulations are still opioids and are not ‘abuse-proof’.
These formulations, while serving a specific purpose in battling the opioid epidemic, do not completely prevent all risks associated with opioids. While they were created to discourage individuals from abusing prescription medications, they do not prevent all diversion or abuse, nor do they eliminate overdose from taking more opioids or other opioids, such as heroin. There is also still a risk associated with combining high risk medications with opioids – whether abuse deterrent or not.
Regardless of its formulation, an opioid is still an opioid and should be taken only when the risks and benefits have been weighed out. There is still much work to be done beyond tamper resistance and abuse deterrent formulations when it comes to the opioid epidemic.
While these formulations are a step towards curbing abuse, there will not be one magic bullet to end the opioid epidemic problem. A multipronged, multidisciplinary, comprehensive solution including prevention or reducing exposures through evidence-based prescribing practices, utilization of prescription drug monitoring programs to help recognize aberrant drug-related behaviors, improving access to effective addiction treatment programs, and education to support informed decision making regarding benefits and risks of opioid therapy will be needed to curb opioid drug abuse and the toll of the epidemic.