Tablets incorporating this technology have been marketed for reformulated oxycodone CR, tapentadol ER, and reformulated oxymorphone ER. One specific strategy for abuse deterrence, as stated above, involves incorporating a physical barrier into tablets that is designed to render them crush resistant and therefore difficult to prepare for insufflation or injection ( Coleman et al., 2010 Cone, 2006 Hamed and Moe, 2010 Webster and Fine, 2010 Wright et al., 2006). It has been hypothesized that these formulations may be most likely to reduce the attractiveness of prescription opioids to abusers who snort, smoke, or inject them ( Budman et al., 2009). Examples of such opioid formulations are Suboxone ®, which is buprenorphine combined with naloxone (Reckitt Benckiser Johnson et al., 2003 Mendelson and Jones, 2003), and now produced in a film ( Strain et al, 2011) Embeda ®, an extended-release formulation of morphine containing sequestered naltrexone, that will only be released when the granules are crushed (King Pharmaceuticals/Pfizer Johnson and Setnik, 2011 Smith, 2011) Remoxy ™, a water-insoluble oxycodone extended-release formulation in a gelatin-capsule (Pain Therapeutics and King Pharmaceuticals/Pfizer Friedmann et al., 2011a, b Setnik et al., 2011) reformulated Ox圜ontin ®, an oxycodone extended-release formulation with a polymer coating that is difficult to crush and turns into a gel when mixed with water ( Mannion, 2008) Nucynta ® ER (Ortho-McNeil-Janssen Pharmaceuticals, Titusville, NJ Tzschentke et al., 2007 2009), which is tapentadol with a polyethylene oxide matrix that has been designed to be crush-resistant (INTAC ™, Grünenthal GmbH, Aachen, Germany) and reformulated Opana ®, which is oxymorphone HCl (Endo Pharmaceuticals Inc., Chadds Ford, PA) containing the same INTAC ™ matrix as Nucynta ® ER. To counter medication-tampering techniques that may lead to behaviors that are accompanied by such health risks, a great deal of attention is being paid to drug formulation technologies that may deter abuse ( Coleman et al., 2005, 2010 Cone, 2006 Hamed and Moe, 2010 Katz et al., 2011). Administration of drugs in either manner is accompanied by increased health risks, such as overdose, or the transfer of communicable disease ( Green et al., 2011 Scheinmann et al., 2007 Surratt et al., 2011 Martinez and Talal, 2008 Marcias et al., 2008). With regard to prescription opioids, users may crush the pills into particles small enough for insufflation (“snorting”), or crush and dissolve the pills for injection (“shooting”) ( Raffa and Pergolizzi, 2010). The relationship between rate of drug delivery and drug preference has been demonstrated, although not extensively modeled, across multiple drug classes ( Abreu et al., 2001 Comer et al., 2009 de Wit et al., 1992, 1993 Marsch et al., 2001 Mumford et al., 1995 Nelson et al., 2006 Roset et al., 2001 Volkow et al., 1995). And yet, prescription opioid abusers also tamper with these medications in order to achieve a more rapid and robust drug effect ( Budman et al., 2009 Cone, 2006 Farré and Camí, 1991 Hays, 2004 Katz et al., 2011 Oldendorf, 1992 Webster, 2009). Most nonmedical use of prescription opioids consists of ingesting the medication orally ( Katz et al., 2008, 2011 TEDS, 2007 Webster, 2009). Cost estimates of prescription opioid abuse to the United States society have risen from $8.6 billion in 2001 to $55.7 billion in 2007 ( Birnbaum et al., 2006, 2011 Hansen et al., 2011 Strassels, 2009). Estimates of prescription opioid related mortality have increased correspondingly ( Maxwell, 2011). An estimated 5.3 million people aged 12 years or older (approximately 1.7% of the entire US population) are current, non-medical users of pain relievers, while 1.9 million individuals were classified with pain reliever abuse or dependence (SAMHSA, 2010). Estimates from the National Survey on Drug Use and Health reveal that non-medical use of narcotic pain relievers among persons aged 12 years or older was second only to that of marijuana in 2009 (SAMHSA, 2010). The abuse of opioid analgesics is a public health problem in the United States.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |