Newly Published
Review Article  |   December 2017
Abuse-deterrent Opioid Formulations
Author Notes
  • From the Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, Institute for Safe Medication Practices, Horsham, Pennsylvania, and the Food and Drug Administration’s Anesthetic and Analgesic Drug Products Advisory Committee, Silver Spring, Massachusetts (R.S.L.); Drexel University, Philadelphia, Pennsylvania (O.H.P.); and the Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri (T.J.C.).
  • Submitted for publication August 3, 2017. Accepted for publication November 13, 2017.
    Submitted for publication August 3, 2017. Accepted for publication November 13, 2017.×
  • Evan D. Kharasch, M.D., Ph.D., served as Handling Editor for this article. Ronald S. Litman, D.O., is the medical director for the Institute for Safe Medication Practice.
    Evan D. Kharasch, M.D., Ph.D., served as Handling Editor for this article. Ronald S. Litman, D.O., is the medical director for the Institute for Safe Medication Practice.×
  • Research Support: Support was provided solely from institutional and/or departmental sources.
    Research Support: Support was provided solely from institutional and/or departmental sources.×
  • Competing Interests: Dr. Cicero receives grant and consultation compensation to participate in the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) program.
    Competing Interests: Dr. Cicero receives grant and consultation compensation to participate in the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) program.×
  • Correspondence: Address correspondence to Dr. Litman: 3401 Civic Center Blvd, Department of Anesthesiology and Critical Care, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania 19104. Litmanr@email.chop.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Review Article / Pain Medicine / Pharmacology
Review Article   |   December 2017
Abuse-deterrent Opioid Formulations
Anesthesiology Newly Published on December 21, 2017. doi:10.1097/ALN.0000000000002031
Anesthesiology Newly Published on December 21, 2017. doi:10.1097/ALN.0000000000002031
Abstract

Abuse-deterrent opioid formulations have been suggested as one way to decrease the abuse, addiction, and overdose of orally prescribed opioids. Ten oral opioid formulations have received abuse-deterrent labeling by the U.S. Food and Drug Administration (FDA). Their properties consist of physical and/or chemical means by which the pills resist manipulation and create a barrier to unintended administration, such as chewing, nasal snorting, smoking, and intravenous injection. In this review, we describe the mechanisms of abuse-deterrent technology, the types of premarketing studies required for FDA approval, the pharmacology of the currently approved abuse-deterrent opioid formulations, and the evidence for and against their influence on opioid abuse. We conclude that there is currently insufficient evidence to indicate that the availability of abuse-deterrent opioid formulations has altered the trajectory of opioid overdose and addiction; however, postmarketing studies are in their infancy, and novel deterrent formulations are continually being developed and submitted for marketing approval.