Abuse-deterrent opioid formulations: Are they a pipe dream?

@article{Katz2008AbusedeterrentOF,
  title={Abuse-deterrent opioid formulations: Are they a pipe dream?},
  author={Nathaniel Katz},
  journal={Current Rheumatology Reports},
  year={2008},
  volume={10},
  pages={11-18}
}
The continued need for opioids to treat pain and their unavoidable link to abuse and addiction create a need for risk mitigation approaches that optimize their risk-benefit ratio. Abuse-deterrent formulations (ADFs) have emerged as a means for supporting opioid access while limiting abuse and its consequences. Several different types of ADFs have emerged including physical barriers to tampering, agonist-antagonist formulations, aversion, prodrugs, and alternative methods of administration. Each… 
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References

SHOWING 1-10 OF 164 REFERENCES
Challenges in the Development of Prescription Opioid Abuse-deterrent Formulations
TLDR
This manuscript captures the main consensus opinions of experts on opioid abuse and diversion, and information gleaned from a review of the relevant published literature, to identify major impediments to the development of opioid abuse-deterrent formulations and offer strategies that may accelerate their commercialization.
Use and abuse of opioid analgesics: potential methods to prevent and deter non-medical consumption of prescription opioids.
TLDR
The extent of the illicit use of prescribed opiate analgesics and some of the steps that can be taken to potentially reduce the risk of their misuse or diversion for abuse are highlighted.
Foundations of Opioid Risk Management
TLDR
The principles of opioid risk management are reviewed by examining the epidemiology of prescription opioid abuse in the United States, identifying key stakeholders involved in opioids risk management and their responsibilities for managing or monitoring opioid abuse and diversion, and summarizing the mechanisms currently used to monitor and address prescription opioids abuse.
Therapeutic use, abuse, and nonmedical use of opioids: a ten-year perspective.
TLDR
An updated 10-year perspective on therapeutic use, abuse, and non-medical use of opioids and their consequences is provided.
Opioid analgesia: perspectives on right use and utility.
The ability of opioids to effectively and safely control acute and cancer pain has been one of several arguments used to support extending opioid treatment to patients with chronic pain, against a
Abuse of prescription drugs and the risk of addiction.
Opioids in pain management
Definitions related to the use of opioids for the treatment of pain.
  • Medicine, Psychology
    WMJ : official publication of the State Medical Society of Wisconsin
  • 2001
TLDR
Confusion regarding the treatment of pain results in unnecessary suffering, economic burdens to society, and inappropriate adverse actions against patients and professionals.
A Profile of OxyContin Addiction
  • L. Hays
  • Medicine, Psychology
    Journal of addictive diseases
  • 2004
TLDR
It is concluded that a socio-cultural understanding is needed to better treat these addicts as is improved communication between the pain treatment community and the addiction treatment community.
...
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