Sometimes, things don’t go according to plan. According to a study it is among the main lessons learned from this crisis.
In the present, Buy Oxycontin online the tale of the opioid crisis is well-known. During the 1990s, pharmaceutical companies promoted opioids with a lot of force — and specifically Purdue Pharma with the newly launched OxyContin that purported to be safer and less susceptible to abuse as other opioids.
This led to an increase in prescriptions for opioids, which caused more use of the drug and also, as people became hooked on opioids this led to a rise in the consumption of other opioids, such as heroin and fentanyl, which is a narcotic. The country is battling the deadliest drug overdose ever with thousands of people suffering from addiction and drug abuse each year.
One of the main reasons Purdue could market its product as safe was a possible wrong assumption about how people would utilize the drug. OxyContin was described in the market as an “extended-release” product — the opioids were intended to enter the system within 12 hours after the drug was taken. This, theoretically, was intended to reduce the risk of OxyContin to abuse, as the dose of opioids of the drug will take effect gradually.
But some have discovered ways around this. In crushing the tablet in order to take it in or using a liquefying process in order to inject it they can consume the entire amount of opioid in the form of an OxyContin pill almost instantly. The drug has become a lucrative option for those who are addicted to opioids, providing an legal way to get high.
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In 2010 Purdue attempted to end this by replacing OxyContin by the “abuse-deterrent” formula. When the drug is broken it becomes a gummy like substance, making it difficult to take or snort. It is not completely eliminated the possibility of misuseit can be used to induce a high by inhaling it orally and there are methods to circumvent the change to continue ingesting the drug through other methods. However, it made the process of misuse somewhat more difficult.
A new work paper by scientists William Evans, Ethan Lieber along with Patrick Power, suggests that this could have resulted in OxyContin less likely to be misused however, it also had the risk of causing death: When people decided that OxyContin was a bit of a hassle for them, some previously OxyContin users switched to heroin. The subsequent increase in the number of deaths due to heroin overdose could be enough for the researchers to claim to equal or surpass any benefit that this reformulation OxyContin was able to do in terms of preventing overdoses with painkillers deaths — at the very least in the short-term.
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A specialist in drug policy who was not associated with this study said that the results do not necessarily mean that reformulation of OxyContin (or other opioids with extended release) was not a good ideaand it did, in fact seem to make the drug less susceptible to abuse. However, the research indicates that when it comes to dealing with the opioid crisis, just reducing the use of painkillers that are opioids isn’t enough.
What did the study reveal
This study, that hasn’t been peer-reviewed yet, employed economic models to assess the trends in deaths from opioids and break them down into specific areas, such as heroin to examine what changed after the OxyContin reformulation was implemented in the year 2010.
The report found that there had been a change in the trend that began August 2010, the month when the reformulation was implemented. In particular, the number of deaths from heroin overdoses began to increase more rapidly after that month.
“The hope was reformulation would make it harder to abuse, so at the very least we would stop the growth of deaths from opioids,” Lieber One of the study’s authors, said to me. “But instead of witnessing that happening there is evidence that lots of users have switched to heroin or other substances. Since heroin is especially risky, the actual opioid mortality rate — even if you take in heroin isn’t actually affected due to this reformulation.”
There were other indicators that the reformulations had made an impact, as per the report: “A number of national time series including shipments of oxycodone (a proxy for consumption), prescriptions for oxycodone, the fraction of people that use pain medicine recreationally, and health care encounters for heroin poisonings all show a trend break in August, 2010 or immediately thereafter.”
The study also examined the impact of these effects in various states, and analyzed this on the basis of the size of the state’s OxyContin as well as heroin market. The results showed that states with the largest market for heroin and OxyContin saw the most significant increase in the number of deaths from heroin. However, states that had smaller OxyContin or heroin marketplaces had the least growth. When heroin was readily accessible, people were typically more inclined to change between OxyContin to the illegal opioid.
Researchers looked into possible reasons for these changes in the previous trends: for instance, In the event of an abrupt drop in heroin price that could have caused a rise in heroin use or whether the new databases for monitoring prescription drugs could have blocked accessibility to OxyContin and forced users to take heroin more than the reformulation. Also, if the crackdowns against Florida pills mills who shadily gave out prescriptions for opioids — drove people to take heroin more strongly than the reformulation.
However, the researchers concluded that none of them could be the sole explanation for the study’s findings. They calculated, for instance that Florida Pill mill crackdown was responsible for approximately 25% of the rise in deaths from heroin in states that were the most affected by the supply of Florida’s pill mills.
“We can’t completely reject that Florida was playing a role,” Lieber declared. “But we can reject that it was playing the major role.”
What’s the deal with the fentanyl?
This kind of drug is recently appearing on the underground market where fentanyl as well as its derivatives are frequently infused with other substances or being sold as heroin. Since fentanyl’s potency is higher than heroin, it creates the risk of an overdoses, which could be the reason for the rise in deaths. Fentanyl is believed to have risen on the black market in 2013, which is three years following it was reformulated as OxyContin reformulation, and so much from the time frame the study examined.
A caveat is that a lot of those who have made the switch towards heroin instead of OxyContin probably did so without thinking. Keith Humphreys, a drug policy expert at Stanford I spoke to, said it’s one of the “natural evolution” of addiction is that addicts will eventually become tolerant of the opioids they’re using and then seek a stronger high. It could have led them to switch from OxyContin in favor of heroin irrespective of the change in. “A lot of them would have ended up as heroin users,”
Humphreys said.
This is only one study. Future research may result in different conclusions. However, Buy Oxycontin for the moment the study suggests that the change in OxyContin might have increased the number of deaths from heroin overdoses — maybe enough to over time exceed the lives saved by stopping further OxyContin overdoses.
