Will Abuse-Deterrent Formulations of Opioid Analgesics Be Successful in Achieving Their Purpose?

@article{Bannwarth2012WillAF,
  title={Will Abuse-Deterrent Formulations of Opioid Analgesics Be Successful in Achieving Their Purpose?},
  author={Bernard Bannwarth},
  journal={Drugs},
  year={2012},
  volume={72},
  pages={1713-1723}
}
During the last 2 decades, there has been a dramatic increase in the use of strong opioids for chronic non-cancer pain. This increase has been accompanied by a steep increase in abuse, misuse, and both fatal and non-fatal overdoses involving prescription opioids. The situation is already alarming in the US. Prescription opioid-related harm is a complex, multifactorial issue that requires a multifaceted solution. In this respect, formulations of opioid analgesics designed to resist or deter… 
Abuse-Deterrent Opioid Formulations: A Key Ingredient in the Recipe to Prevent Opioid Disasters?
TLDR
The introduction of ADFs could provide a false sense of security among prescribers and dispensers, and it is feared that ADFs may have a minimal impact on non-medical use of prescription opioids.
The Clinical Applications of Extended-Release Abuse-Deterrent Opioids
TLDR
Different extended-release formulations of opioids available for clinical applications are presented with descriptions of the formulations, their physical properties, and the clinical studies performed to provide physicians with a better understanding of their uses.
A practical and ethical solution to the opioid scheduling conundrum
TLDR
The efficacy of ADFs in preventing abuse is not yet established, and therefore the authors could only comment on their “potential … to deter or resist some of the common forms of tampering associated with opioid misuse and abuse”.
Current Impact and Application of Abuse-Deterrent Opioid Formulations in Clinical Practice.
TLDR
Their relatively high costs, uncertain insurance policies, and limited data on pharmacoeconomics warrant collaborative monitoring and assessment by government agencies, pharmaceutical manufacturers, and data analysis services to define their therapeutic role in the future.
The Epidemic of Prescription Opioid Abuse, the Subsequent Rising Prevalence of Heroin Use, and the Federal Response
TLDR
The purpose of this article is to review and explore the combination of factors of events that led to the current “epidemic” of prescription opioid abuse and overdose deaths, as well as the subsequent resurgence of heroin use among opioid addicts.
Industry Testing of Opioids for Differential Schedule Control Purposes: Abuse-Deterrent Formulations
TLDR
Typical patterns of drug diversion and standardized methods used to administer the drug outside the scope of medical practice, or to divert for drug extraction are described.
Oxycodone extended release capsules for the treatment of chronic pain
TLDR
Preliminary data regarding oxycodone extended release capsules are encouraging, however, more data in different populations are necessary to confirm initial observations, and comparison should be performed with active substances.
Management of Patients on Abuse-Deterrent Opioids in the Ambulatory Surgery Setting
TLDR
The scope of the problem of prescription opiate abuse is reviewed, the currently available abuse-deterring opioids are summarized, and the anesthetic management of patients who are taking these new medications in the outpatient setting is discussed.
Drug Formulation Advances in Extended-Release Medications for Pain Control
TLDR
A comprehensive summary of the pharmacology, benefits, risks, and processes behind the development of currently available extended-release opioid drugs, as well as a glimpse into promising future formulations are provided.
Pharmacokinetic and pharmacodynamic evaluation of oxycodone and naltrexone for the treatment of chronic lower back pain
TLDR
This manuscript will review CLBP, the pivotal analgesic and clinical abuse potential studies of ALO-02, which is a tamper-resistant sustained release opioid consisting of extended release oxycodone and sequestered naltrexone and one of several opioids which can be considered in the management of CLBP.
...
...

References

SHOWING 1-10 OF 38 REFERENCES
Abuse-Deterrent and Tamper-Resistant Opioid Formulations What is their Role in Addressing Prescription Opioid Abuse?
About one in every three individuals will experience chronic pain in their lifetime, and opioids are known to be an effective means to treat this condition. Much attention, however, has been given to
Abuse-Deterrent and Tamper-Resistant Opioid Formulations
TLDR
It is believed that continued advances in opioid formulations can help mitigate risk for those with legitimate need for pain control, but only if used rationally in the context of good clinical practice.
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.
Opioid Formulations Designed to Resist/Deter Abuse
TLDR
Three new formulations of opioid analgesics designed to resist or deter abuse are examined, which hold individual promise, but it remains undetermined if they can truly prevent abuse.
Current status and evolving role of abuse-deterrent opioids in managing patients with chronic pain.
TLDR
A universal precautions and risk management package that includes risk assessment and patient monitoring is a recommended approach and can also include the use of abuse-deterrent and abuse-resistant formulations designed to reduce the nonmedical use of opioids.
Sustained-release morphine sulfate with sequestered naltrexone for moderate to severe pain: a new opioid analgesic formulation and beyond
  • X. Ruan
  • Medicine, Biology
    Expert opinion on pharmacotherapy
  • 2011
TLDR
Ebeda represents a new opioid formulation, adding to the arsenal to treat moderate to severe pain and playing its potential role in discouraging opioid abuse, misuse and diversion.
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.
Issues in long-term opioid therapy: unmet needs, risks, and solutions.
Community-based opioid overdose prevention programs providing naloxone - United States, 2010.
TLDR
Providing opioid overdose education and naloxone to persons who use drugs and to people who might be present at an opioid overdose can help reduce opioid overdose mortality, a rapidly growing public health concern.
...
...