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A Shift To Abuse Deterrent Opioids May Fuel Greater Heroin Use In New Jersey

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Officials are advocating for greater use of abuse-deterrent painkillers in New Jersey to curb opioid misuse, but some fear the expensive pills will simply push addicts toward heroin.

The pills are reformulations of popular brand-name opioids, designed to be harder to abuse. The pills cannot be crushed to snort or inject like other medications, which lobbyists for the pharmaceutical companies say makes them key to combating rampant opioid abuse across the country. Advocates of abuse-deterrent medications are lobbying New Jersey lawmakers to pass legislation forcing insurance companies to cover the more expensive alternative medication, reports New Jersey 101.5.

Medical experts are wary about abuse-deterrent medications and caution they will do little to stop addiction in someone who is already craving opioids.

“The number one way that people abuse opioids is to take more than prescribed, so no different kind of formulation is going to stop you from taking more than is prescribed,” Dr. Deni Carise, chief clinical officer with the Recovery Centers of America, told New Jersey 101.5. “They’re still opioids, they still are an addictive medication.”

Some lawmakers are fearful addicts who can no longer get the same high off the abuse-deterrent medication will turn to heroin instead. They note prescription medication on the black market costs a substantial amount more than a baggie of heroin. (RELATED: How One Pain Pill Sparked A Three-Fold Increase In Heroin Deaths)

“A deck of heroin is $5, and that’s a hell of a lot cheaper than $20 a pop,” Democratic State Sen. Joseph Vitale told New Jersey 101.5. “They are a little expensive, certainly more expensive than the average painkiller that’s prescribed by a doctor.”

Studies show reformulation of opioids into abuse-deterrent pills may have played a big role in creating the current heroin crisis. After a number of lawsuits Purdue Pharma reformulated the drug OxyContin in 2010 to reduce the possibility for abuse.

In the absence of abusable Oxycontin, former users turned to heroin in large numbers to attain the same high. Researchers from RAND Corp. and the Wharton School concluded abuse-deterrent OxyContin is directly responsible for roughly “80% of the three-fold increase in heroin mortality since 2010.”

The reformulation succeeded in its intended purpose of reducing overall abuse of OxyContin, but it came with disastrous unintended consequences. There are 3.1 more heroin deaths per 100,000 people for every percentage decrease in OxyContin abuse. Heroin abuse exploded in states with the highest levels of OxyContin use prior to 2010.

Kentucky had an OxyContin misuse rate of 97 percent between 2004 and 2008. Heroin fatalities were on a steady decline in the state until 2010, when the pill was reformulated. Heroin deaths in Kentucky have more than tripled since 2010.

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