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Invited Commentary
June 2015

Abuse-Deterrent Opioid FormulationsPart of a Public Health Strategy to Reverse the Opioid Epidemic

Author Affiliations
  • 1New York City Department of Health and Mental Hygiene, Queens, New York
JAMA Intern Med. 2015;175(6):987-988. doi:10.1001/jamainternmed.2015.0939

Rapid increases in the supply of opioid analgesics have largely driven the nearly unremitting increase in overdose deaths in the United States, which have grown by more than 150% over the past decade, from 16 849 in 1999 to 41 502 in 2012.1,2 Since the 1990s, opioid analgesic sales have increased more than 4-fold, with rising and widely variable regional prescribing patterns. Increased market supply makes opioids more available for misuse and diversion to people engaging in recreational use and to people with addiction. In both cases, misuse and diversion increase, elevating population overdose risk. In fact, geographic areas with higher opioid prescribing rates experience higher overdose rates.2 In addition, patient-level data demonstrate that the intensity of opioid exposure, including higher prescribed doses and longer duration of therapy, elevates overdose risk.3,4 Given this opioid-overdose epidemic, the clinical literature is understandably replete with efforts that target individuals most at risk, including strategies such as routine screening for risk of addiction, patient agreements, and urine toxicology monitoring. Unfortunately, these approaches have not yet demonstrated widespread effectiveness in reversing the epidemic.5

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