Format
Scientific article
Published by / Citation
Ronald S. Litman, Olivia H. Pagán, Theodore J. Cicero; Abuse-deterrent Opioid Formulations. Anesthesiology 2018;128(5):1015-1026. doi: 10.1097/ALN.0000000000002031.
Original Language

English

Country
United States
Keywords
Opioid
opioids
abuse-deterrent opioid formulation
legislation
Opioid Use Disorder
overdose

Abuse-Deterrent Opioid Formulations

Abstract

Abuse-deterrent opioid formulations have been suggested as one way to decrease the abuse, addiction, and overdose of orally prescribed opioids. Ten oral opioid formulations have received abuse-deterrent labeling by the U.S. Food and Drug Administration (FDA). Their properties consist of physical and/or chemical means by which the pills resist manipulation and create a barrier to unintended administration, such as chewing, nasal snorting, smoking, and intravenous injection. In this review, we describe the mechanisms of abuse-deterrent technology, the types of premarketing studies required for FDA approval, the pharmacology of the currently approved abuse-deterrent opioid formulations, and the evidence for and against their influence on opioid abuse. We conclude that there is currently insufficient evidence to indicate that the availability of abuse-deterrent opioid formulations has altered the trajectory of opioid overdose and addiction; however, postmarketing studies are in their infancy, and novel deterrent formulations are continually being developed and submitted for marketing approval.