Q: 48 year male with history of chronic back pain is admitted to ICU with opioid and other substance overdose/abuse. Patient is now recovering. Pain team recommend only Abuse deterrent formulations (ADFs) of opioids for patient. What is Abuse deterrent formulations (ADFs) of opioids?
Answer: Patients on chronic opioid prescription drugs sometimes chew the tablets or crush them to facilitate smoking, inhalation, or intravenous (IV) injection. Deterrent formulations, popularly known as ADFs, are designed to prevent these altered routes of administration, while retaining efficacy with oral administration. Although theoretically it makes a lot of sense but evidence seems lacking in its effect from prevention of abuse, or decreasing adverse effects. Also, they are not very cost-effective.
#toxicology
References:
1. Maincent J, Zhang F. Recent advances in abuse-deterrent technologies for the delivery of opioids. Int J Pharm 2016; 510:57.US Food and Drug Administration.
2. Abuse-deterrent opioids—evaluation and labeling. Guidance for industry. 2015. https://www.fda.gov/downloads/Drugs/Guidances/UCM334743.pdf (Accessed on March 11, 2020).
Answer: Patients on chronic opioid prescription drugs sometimes chew the tablets or crush them to facilitate smoking, inhalation, or intravenous (IV) injection. Deterrent formulations, popularly known as ADFs, are designed to prevent these altered routes of administration, while retaining efficacy with oral administration. Although theoretically it makes a lot of sense but evidence seems lacking in its effect from prevention of abuse, or decreasing adverse effects. Also, they are not very cost-effective.
#toxicology
References:
1. Maincent J, Zhang F. Recent advances in abuse-deterrent technologies for the delivery of opioids. Int J Pharm 2016; 510:57.US Food and Drug Administration.
2. Abuse-deterrent opioids—evaluation and labeling. Guidance for industry. 2015. https://www.fda.gov/downloads/Drugs/Guidances/UCM334743.pdf (Accessed on March 11, 2020).
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