Pharmageddon Deferred: New Measures to Stop Opioid Abuse

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There’s a party going on and the entire country is invited. The problem is, it’s an opioid party—and too many Americans have been accepting the invitation. As I reported a few weeks ago, the development of new forms of highly addictive painkillers like Oxycodone, Oxycontin and hydrocodone has led to a 10-fold increase in prescriptions since 1990, an explosion of illegal sales and a quadrupling of accidental overdose deaths. Just this week, however, there was promising news on a couple of fronts that could help reverse—or at least—slow the trend.

The first good—and very straightforward—idea comes from the U.S. Drug Enforcement Administration (DEA), which is scheduling a nationwide prescription drug take-back day on Saturday, Sept. 25. Part of the reason so many people get addicted to meds is that they are routinely given 30-day prescriptions for opioids after procedures like tooth extractions, which often require only a day or two of drugs before the pain subsides. The couple dozen remaining pills then get stored in medicine chests, where teens  can grab them and the person to whom they were prescribed can be tempted to take the recreationally. (More on Who’s High? A School Suspends a Student for Bloodshot Eyes)

Flushing the pills down the toilet or tossing them in the trash can lead to other kinds of problems since, as I also reported back in April, this contributes to the growing problem of pharmaceutical toxins in waterways and reservoirs. This causes developmental changes in aquatic animals and may be doing the same to us.

The government has instead set up 3,400 take-back sites around the country where people can safely dump unwanted drugs, which can then be disposed of in environmentally safe ways. The DEA website offers a complete list of all the collection locations, which is easily searchable by zip code. (More on Evidence Review: Anti-Drinking Drug Shows Modest Success)

A different approach is being taken by New Jersey-based King Pharmaceuticals. The journal Drugs recently published a review article about three experimental abuse deterrents the company is trying to build directly into pills. One of the things that makes opioids especially dangerous is that addicts have found they can crush or chew the tablets to produce a faster, more powerful kick. Chemists are thus developing opioid pills that are also spiked with niacin, which can produce side effects such as flushing, rapid heart rate and nausea if taken in too potent a dose. Another approach involves including coated pellets of a chemical called naltrexone—which neutralizes the effects of opioids—in the pill. The pellets remain intact and pass through the body if the drug is taken as intended; if it’s crushed, however, the naltrexone is released—killing the high. A third technique involves manufacturing the pills as a slow release gel cap, which is metabolized only deep in the gut and must arrive there intact or it will not be effective.

Painkillers can be very, very good things; abusing them can be very, very dangerous. A little creative chemistry and a lot of vigilant pill collection can move us closer to balancing the two.

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