Potency of immediate release painkillers versus extended-release opioids to treat opioid addiction

Potency of immediate release painkillers versus extended-release opioids to treat opioid addiction

The growing epidemic of opioid addiction is gripping the United States, with a large majority of Americans succumbing to overdoses of prescription painkillers in recent times. Lack of access to care for people battling substance abuse is one of the biggest problems ailing the country today, which calls for additional resources and funding to combat the existing opioid addiction.

Tackling the ongoing crisis of opioid addiction is a complicated task, requiring a consistent effort focusing on education of patients and clinicians, development of alternative therapies to treat pain, guidance on pain management strategies for both patients and doctors, among others. And now, researchers are focusing on developing painkillers with “abuse-deterrent” properties. RoxyBond, an immediate-release oxycodone, if approved, could become the first immediate-release opioid carrying the label of “abuse-deterrent.”

RoxyBond: Abuse deterrent for both intranasal and intravenous routes of abuse

The significance of abuse-deterrent opioids can be understood from the directive rolled out by the Food and Drug Administration (FDA), under which extended-release opioids are to be prescribed for chronic pain due to considerably lower risk of dependency. Although currently, there are nine opioids that are marked as abuse-deterrent, all of them are extended-release.

In a recent conference between the Anesthetic and Analgesic Drug Products Advisory Committee (AADPAC) and the Drug Safety and Risk Management Committee (DSaRM) in April 2017, the FDA advisors voted in favor of RoxyBond, stating that the drug carried enough evidence to carry abuse-deterrence labeling for both intravenous and intranasal methods of abuse. However, according to Ronald Litman, of the University of Pennsylvania and the only panelist to have abstained from voting, “Abuse-deterrent formulations are a red herring, a distraction from the real problems underlying the opioid crisis.”

Identifying differences between immediate release and extended-release opioids

Opioid analgesics are extremely potent painkillers that are primarily prescribed for chronic pain, but have been on the hit list of abusive drugs in America in recent times. Prescription oxycodone, hydrocodone and morphine are some of the most frequently abused prescription opioids. When looking at opioids as a treatment option for chronic pain, doctors can opt either for short-acting (immediate release) or for long-acting (extended-release) opioids.

Immediate release opioids are meant for use every four to six hours, whereas extended-release opioids are can be taken twice a day, depending on the extent of the pain. Another category of opioid medications, methadone and buprenorphine, enable medication-assisted treatment. These, coupled with behavioral therapy and counseling, are used for the treatment of opioid addiction.

Last year, considering the huge risk of immediate-release opioid medications, and in an effort to educate people using these medications and those dispensing them, the FDA declared that the immediate release opioids required class-wide safety labeling. It also mandated that medications belonging to this category should carry a “boxed warning” about their possible risks of misuse, addiction and overdose.

Significance of abuse-deterrent drugs in curbing opioid addiction

According to Douglas Throckmorton, deputy director for regulatory programs, Center for Drug Evaluation and Research, “A drug marked abuse-deterrent only makes certain experiences less rewarding to the pathways involved in the dopamine effect, and thereby diminishes the dependency or addiction.”

Opioids that are labeled as abuse-deterrent have properties that make them less liable for abuse either through snorting or through intramuscular route. “Abuse-deterrent properties make certain types of abuse, such as crushing in order to snort or dissolving in order to inject, more difficult or less rewarding,” as per the FDA. However, irrespective whether a drug is abuse-deterrent or not, pharmaceutical companies are obliged to market them with warning regarding the risks of addiction.

Road to recovery

Opioid addiction problems stemming from pain treatment are responsible for most overdose-related deaths in America. If you or your loved one is hooked on opioids and is looking for help, get in touch with the Prescription Drug Abuse Helpline of California for information on various prescription drug rehabs in California. Call our 24/7 helpline number 855-738-2770 or chat online for expert advice on available prescription drug addiction treatment in California.