The evolving consequences of Oxycontin reformulation on drug overdoses

Original research
by
Powell, David, & Rosalie Liccardo Pacula

Release Date

2021

Geography

USA

Language of Resource

English

Full Text Available

Yes

Open Access / OK to Reproduce

No

Peer Reviewed

Yes

Objective

Recent evidence suggests that the short-term transition of the opioid crisis from prescription opioids to heroin can be attributed to the reformulation of OxyContin, which substantially reduced access to abusable prescription opioids.

Findings/Key points

In this paper, we find that over a longer time horizon, reformulation stimulated illicit drug markets to grow and evolve. More exposed areas experienced disproportionate increases in fatal overdoses involving synthetic opioids (fentanyl) and nonopioid substances like cocaine, suggesting that these new epidemics are related to the same factors driving the rise in heroin deaths. Instead of just short-term substitution from prescription opioid to heroin overdoses, the transition to illicit markets spurred by reformulation led to growth in the overall overdose rate to unprecedented levels.

Design/methods

We compare overdose trajectories in areas more exposed to reformulation, defined as states with higher rates of nonmedical OxyContin use before reformulation, to less exposed areas.

Keywords

Overdose
Illegal drugs
Outcomes