Abuse-Deterrent Opioids: What You Need to Know

Lauri R. Graham; Laurie Scudder, DNP, NP; Douglas Throckmorton, MD


August 25, 2016

Editorial Collaboration

Medscape &

Are Abuse-Deterrent Drugs Less Addictive?

Medscape: In a national survey[1] of internists, family physicians, and general practitioners, nearly one half stated that they believed abuse-deterrent formulations were less addictive than their counterparts. What are the FDA's efforts to provide correct information to clinicians?

Dr Throckmorton: We are working with health professional organizations and medical education providers to help educate prescribers about the value and limitations of current abuse-deterrent technologies. As I noted, abuse-deterrent properties do not signify that a product is abuse-proof; there is currently no technology that completely prevents abuse. Furthermore, addiction to opioid medications, with or without abuse-deterrent properties, can occur even when taken at recommended doses, so it's important that both prescribers and their patients understand these risks before taking any type of opioid medication, abuse-deterrent or not.

Abuse-deterrent properties do not signify that a product is abuse-proof; there is currently no technology that completely prevents abuse.

Medscape: Earlier this year, the FDA released draft recommendations for the evaluation of generic versions of abuse-deterrent opioid drug products. Generic versions should have the same abuse-deterrent properties as their brand-name counterparts. Why is this an important element in the overall strategy to combat the problem of opioid abuse?

Dr Throckmorton: Generic drugs play an important role in the United States, especially for patients in pain. Each year, 100 million Americans experience significant pain, and 9-12 million have significant chronic pain.[2] In general, generic drugs are important to help keep healthcare costs down. And for the millions of Americans with significant pain and the health systems that serve them, generics are crucial to delivering appropriate and affordable patient care. Many of these people have such serious and painful illnesses as cancer or sickle cell disease, and many have significant residual pain that is not effectively managed by other medications.

We hope that the availability of less costly generic products with abuse-deterrent properties has the potential to accelerate prescribers' shift away from the older products that do not have abuse-deterrent properties. The FDA looks forward to the day, hopefully soon, when most opioids in the United States are marketed in abuse-deterrent forms. To facilitate an open dialogue on this important issue, and to obtain clinical and scientific input from outside experts, the FDA plans to hold a public meeting in November to discuss issues related to the development and evaluation of abuse-deterrent technologies, particularly for generic drugs.