A new study blames OxyContin for the rise in heroin use and hepatitis C infections.
Heroin use has been soaring across the US for decades, but particularly in states where OxyContin misuse was highest.
In fact, the new report says, the situation escalated when OxyContin was reformulated in 2010 to make it harder to abuse – driving scores of addicts to heroin.
After 2010, heroin and hepatitis C rates rocketed in OxyContin’s top prescribing states, the RAND Corporation report says.
‘These results show that efforts to deter misuse of opioids can have unintended, long-term public health consequences,’ said David Powell, the study’s lead author and a senior economist at RAND, a nonprofit research organization.
Drug injection has long been one of the most common causes of hepatitis C, but experts were intrigued by the sudden spike after 2010. After investigation, the authors of the RAND report say over-prescription of pain medicine, particularly OxyContin, was a driver of opioid abuse
‘As we continue to develop policies to combat the opioid epidemic, we need to be careful that new approaches do not make another public health problem worse.’
The findings, published today in the journal Health Affairs, come amid two lawsuits against Purdue Pharma, the maker of OxyContin – blaming the firm for fueling the opioid addiction epidemic which claimed hundreds of thousands of lives.
Overdoses have killed more than 200,000 since 2010.
Hepatitis C, a virus which causes liver disease, is responsible for more deaths in the United States than any other infectious disease.
In 2015, 20,000 deaths were attributed to hepatitis C in the US.
In the last few years, the rate of new diagnoses has plateaued. But that’s only after a huge surge through the most devastating years of the opioid addiction epidemic.
Drug injection has long been one of the most common causes of hepatitis C, but experts were intrigued by the sudden spike after 2010.
After investigation, the authors of the RAND report say over-prescription of pain medicine was a clear driver of opioid abuse.
OxyContin was one of the most prescribed drugs, and became one of the most notoriously abused, typically by people crushing it up and either inhaling it or boiling it down to inject – delivering a powerful, dangerous and often lethal dose in one hit.
In 2010, Purdue took action amid calls to pull it off the market.
The drug was not pulled completely; the firm manufactured a new version of the pill which was difficult to crush or dissolve.
RAND had already shown in a previous study that the reformulation of OxyContin drove scores of users to heroin in 2010.
But this new article shows a broader implication to that switch: it also increased rates of hepatitis C, curtailing global health missions to bring an end to the deadly virus.
Researchers from RAND and the Wharton School at the University of Pennsylvania examined rates of hepatitis C infections in each state from 2004 to 2015, examining differences between states based on the level of misuse of the drug before the reformulation occurred.
The analysis found that states with above-median OxyContin misuse prior to the reformulation experienced a 222 percent increase in hepatitis C infections after reformulation, while states with below-median misuse of OxyContin experienced a 75 percent increase in hepatitis C infections over the same period.
Before the reformulation, there was almost no difference in hepatitis C infections rates across the two groups of states.
‘Even with recent advancements in the treatment for hepatitis C, the dramatic increase in infections represents a substantial public health concern that can have tremendous long-term costs if infected people are not identified and treated,’ said Rosalie Liccardo Pacula, a study co-author, and co-director of the RAND Opioid Policy Tools and Information Center and the RAND Drug Policy Research Center.
As drug abuse policy continues to reduce access to abusable prescription opioids, researchers say the study suggests that there could be further unintended public health consequences if drug abusers switch to injected drugs.
‘It is important that strategies that limit the supply of abusable prescription opioids are paired with polices to ease the harms associated with switching to illicit drugs, such as improved access to drug treatment and increased efforts to identify and treat diseases associated with injection drug use,’ Pacula said.