by Amanda Conschafter, Blog Editor
Legislators in the New York State Senate have made a bold move. Amid mounting concern about pain pill abuse, state senators passed Bill 7125, requiring New York pharmacists to dispense abuse-deterrent formulas for opioid analgesic prescriptions. New York now joins Pennsylvania and Massachusetts, states that have also signaled a growing interest in using abuse-deterrent technology to crack down on prescription drug abuse.
Abuse-deterrent technology hinders the ability to crush, cut, snort, inject or otherwise ingest pain medications in a manner inconsistent with recommended use. Some technologies do this by incorporating a physical barrier or by using aversion technology, whereby pills that individuals attempt to crush or dissolve into liquid (typically alcohol) instead turn into a gel substance.
The Food and Drug Administration (FDA) has also endorsed abuse-deterrent technology as a means to fight pain pill abuse. FDA Commissioner Margaret A. Hamburg, M.D. called pain pill abuse a “major public health challenge for our nation,” while the FDA Center for Drug Evaluation and Research Deputy Director Douglas Throckmorton, M.D. described abuse-deterrent technology as “a high public health priority.”
But others worry that, as the shift toward abuse-deterrent formulas inevitably trickles down to generic pharmaceutical manufacturers, the costs of such technology will increase expenses for all patients – many of whom cannot afford it. The technology may target abusers, but it could simultaneously punish legitimate pain patients in the form of higher prices at the pharmacy counter.
And nearly all factions acknowledge that abuse-deterrent formulas offer only a partial solution; the technology cannot address all facets of the drug abuse epidemic. Patient and prescriber education and improved treatment for abuse and overdose also play a role. So do effective prescription drug monitoring programs, as discussed in a recent Alliance for Patient Access white paper.
These tactics may help to address diversion – accessing the medication without a prescription – as well as misuse – using the prescribed drug in a manner inconsistent with the physician’s instructions, sometimes resulting in accidental overdose. Combined with prescription drug abuse, these phenomena present a formidable challenge for the policy community; the Centers for Disease Control reports that deaths involving overdose or misuse of opioid analgesics have more than tripled since 1990.