“Tamper Proof”: The Hardest Opioids to Abuse

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Prescription drug abuse, as you know, is an epidemic in the United States. So, what are we doing about it? One of the new ways pharmaceutical companies are trying to help out is to make opioids with abuse “deterrent” properties. For folks who crush these opioids to snort or dissolve them to inject for quicker onset and a better high, it’s getting harder.

Here are the opioids that are hardest to abuse and why:

1.  Suboxone (buprenorphine + naloxone). This is a sublingual film that contains naloxone, a potent opioid antagonist. If injected into the veins, opioid tolerant patients will experience withdrawal signs and symptoms, thus deterring abuse.

2.  Exalgo. This is hydromorphone that is crush and extraction resistant. Exalgo has a tamper-resistant delivery system which releases hydromorphone at a controlled rate over an extended period of time.

3.  Oxecta is an immediate release oxycodone tab that uses a technology called AVERSION which is a combination of active and inactive ingredients that provide abuse deterrent features. If you try and dissolve this to inject intravenously, a viscous gelatinous mixture will form, trapping the oxycodone.

4.  Oxycontin controlled release tabs. This is a controlled release of oxycodone which uses a technology that makes it resistant to crushing. Oxycontin, if crushed to snort or dissolved to inject, will form a gel.

5.  Opana ER is an extended release form of oxymorphone which also uses a technology that allows it to form a gel if crushed or dissolved, making it harder to snort or inject.

Dr O.

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