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Abuse‐deterrent extended‐release oxycodone and risk of opioid‐related harm
Author(s) -
Paljarvi Tapio,
Strang John,
Quinn Patrick D.,
Luciano Sierra,
Fazel Seena
Publication year - 2021
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.15392
Subject(s) - oxycodone , medicine , opioid , cohort , odds ratio , propensity score matching , cohort study , hydrocodone , pediatrics , receptor
Aim To establish and quantify the association between abuse‐deterrent formulation (ADF) oxycodone and 1‐year risk of opioid‐related harm. Design Propensity score‐matched cohort study of electronic medical records for years 2014–18, with patients followed up for 1 year after their index health‐care visit. Setting More than 70 million patients from 56 US health‐care organizations. Participants Patients aged 18–64 years at index health‐care visit with any indication for an oral opioid analgesic, with no past 12‐month history of oral oxycodone use or substance use disorder, and who were alive at the end of the 1‐year follow‐up (new episode of prescription oral ADF oxycodone [OxyContin], n = 45 045; new episode of non‐ADF oxycodone opioid preparation, n = 1 377 359). Measurements International Classification of Diseases diagnoses of any opioid‐related disorder or non‐fatal opioid poisoning within 1 year of the index health‐care visit. Pooled odds ratios (OR) with 95% confidence intervals (95% CI). Findings After propensity score matching, 89 802 patients with a mean age of 44 [standard deviation (SD) = 11] years (62% women, 68% white) were included. During 1‐year follow‐up, 1445 diagnoses of opioid use disorder or opioid poisoning occurred in the ADF oxycodone cohort (34.8/1000 person‐years) and 765 occurred in the non‐ADF oxycodone cohort (18.2/1000 person‐years). The odds of opioid‐related adverse outcomes were increased in the ADF oxycodone cohort compared with the non‐ADF oxycodone opioid cohort, including for opioid use disorders (OR = 2.02; 95% CI = 1.83, 2.23) and opioid poisoning (OR = 1.64 95% CI = 1.35, 1.99). Conclusions Patients with a new prescription of abuse‐deterrent formulation oxycodone may be at increased risk of opioid‐related harm.