The risk for abuse was significantly lower among patients using Nucynta extended release than abuse-deterrent formulation opioids and non-abuse deterrent formulation extended-release opioids, according to data presented at PainWeek 2018.
“Safety measures intended to reduce risk of abuse/misuse include development of prescription opioids with abuse-deterrent properties as well as the use of atypical opioids that have different mechanisms of action such as tapentadol,” Jared Beaumont, MPH, from Inflexxion Inc, and colleagues wrote in the abstract.
Beaumont and colleagues analyzed data from the National Addictions Vigilance Intervention and Prevention Program Addiction Severity Index–Multimedia Version to compare the abuse profile of tapentadol (Nucynta ER, Collegium Pharmaceutical) with extended-release opioids with FDA abuse-deterrent labeling and non-abuse-deterrent extended-release opioids among 205,189 adults.
Participants self-reported past 30-day abuse of product-specific prescription medications, alcohol and illicit substances. The researchers calculated scores correlating to severity of addiction based on participants’ responses. Those with higher scores had more severe addiction.
Results indicated that participants who abused tapentadol were mainly aged between 18 and 34 years (58.7%), male (65.2%) and white (67.4%), while those who abused abuse deterrent formulation opioids and non-abuse deterrent formulation extended-release opioids were mainly aged between 18 and 34 years (68% and 67.4%, respectively) and white (80.1% and 86.2%, respectively), but both genders were equally as likely (51.6% and 47.5%, male respectively).
Drug severity ratings were lower among abusers of tapentadol (67.4%), compared with abusers of abuse-deterrent formulation extended-release opioids (83.8%) and non-abuse deterrent formulation extended-release opioids (85.1%).
The risk for abuse was statistically significantly lower among tapentadol users (0.009 cases/100 assessments/1,000,000 tablets; 95% CI, 0.006-0.011) than abuse-deterrent formulation extended-release opioids (0.064; CI 0.062-0.066) and non-abuse deterrent formulation extended-release opioids (0.045; CI 0.044-0.046) after adjusting for drug utilization.
The most commonly used route for abusing tapentadol was swallowing the product whole (58.7%), followed by oral routes, such as chewing, dissolving in mouth or drinking after dissolved in liquid (17.4%), injecting (10.9%) and snorting (2.2%).
Abusers of abuse-deterrent formulation extended-release opioids also reported swallowing the product whole as the most common route of abuse (53.8%), followed by snorting (29.3%), injecting (26.1%) and other oral routes (23.5%). Abusers of non-abuse deterrent formulation extended-release opioids most commonly reported injecting (42.9%), then snorting (39%), swallowing whole (35%) and other oral routes (11.3%).
“The abuse profile of Nucynta ER indicates less risk of abuse and less use via alternate routes than other schedule II opioid analgesics,” Beaumont and colleagues concluded. – by Alaina Tedesco
Beaumont J, et al. Nucynta ER abuse profile: An evaluation of abuse and route of administration among individuals receiving substance abuse treatment. Presented at: PAINWeek 2018; Sept. 4-9; Las Vegas.
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