Tamper-resistant formulations of drugs will not solve the problems of opioid addiction and overdose, argues a commentary in CMAJ (Canadian Medical Association Journal).
Governments in Canada and the United States are promoting tamper-resistant drugs, which are more difficult to crush, snort or inject, to prevent addiction and other harms. Opioid users may tamper with prescribed tablets, capsules or patches for a faster "high."
"Misuse and diversion of opioids is a complex problem that requires a comprehensive solution; simply substituting one formulation for another will not work," writes Dr. Pamela Leece, Dalla Lana School of Public Health, University of Toronto, with coauthors.
Canada and the US are the highest per-capita users of narcotics in the world. Oxycodone prescriptions in Ontario rose 850% from 1991 to 2007, and deaths from opioids doubled between 1991 and 2004.
Although some studies indicate that tamper-resistant formulations of oxycodone may have reduced use of the drug,, there is increasing evidence that the overall number of deaths has not decreased. People who are addicted to opioids will use other types of opioids as well as heroin, which can cause lethal overdoses.
"Regulations requiring tamper resistance represent an expensive, technical approach that is influenced by pharmaceutical interests and cannot solve the opioid crisis. An evidence-based, multifaceted strategy is needed -- one that has real potential to curb opioid-related harms at a population level," the authors conclude.