In Australia, after the introduction of tamper-resistant oxycodone, dispensing rates for higher-strength formulations decreased for people younger than 65 years, revealed study published in CMAJ. The effect had no change in older adults, added scientists.
Canada, the United States and Australia are the highest per capita consumers of opioids worldwide. Opioid use has increased 15-fold in Australia over 20 years (1992 to 2012), making it the country with the second highest per capita consumption of oxycodone. In 2014, the country introduced tamper-resistant controlled-release oxycodone.
The study looked at whether reformulation changed use of controlled-release oxycodone and opioid-related harms in a sample cohort of 36 528 adults who had at least one filled prescription for oxycodone during the study period (July 2012 to November 2016). After reformulation, dispensing of oxycodone in both 10-30 mg and 40-80 mg strengths gradually decreased for people under age 65 years, for total decreases of 11% and 31.5%, respectively. People younger than 65 years, especially those younger than 45 years, were more likely to switch to morphine after reformulation, and there was an increase in participants of all ages switching to oxycodone/naloxone.
Despite reductions in dispensing of stronger oxycodone, poisonings from injected oxycodone did not decrease, as measured by calls to the New South Wales Poison Information Centre, which receives about 50% of all poisoning calls yearly in Australia. "We did not find an increase in ending use of strong opioids in parallel with an increase in switching to other non-tamper-resistant strong opioids," write the authors.