Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations

Figures & data

Table 1. Key US data on routes of abuse of prescription opioid analgesics.

			Route of abuse (%)
Population	Year	No. of subjects	Oral	Inhalation*	Injection	Reference
Individuals categorized as “users” of OxyContin presenting at substance-abuse treatment programs	2001–2004	981	72	11	17	[24]
Drug users in New York City	2004–2006	586	68	15	4	[26]
Undergraduate university students	2005	4580	97	18	0.5	[11]
Prescription opioid abusers	Not specified	791	91	68	24	[30]
Substance abuse admissions/Treatment Episode Data Set (TEDS)	2012	169,868	59	24	17	[6]

*Including snorting, smoking and inhaling.

Figure 1. Proportions of respondents reporting different manipulation methods and routes of abuse for prescription opioid analgesics in the USA (unweighted findings, across all drugs). Data from [31]. i.v.: intravenous.

Figure 2. Route of administration for different prescription opioid analgesic formulations reported by individuals entering substance-abuse treatment facilities. Data from [29]. Individuals may have reported multiple routes of abuse.

IR: immediate-release; ER: extended-release; fentanyl IR: sublingual formulation; fentanyl ER: patch formulation.

Figure 3. Route of abuse of prescription opioid analgesics according to age. Data from a custom analysis of the 2006 Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality Treatment Episode Data Set (TEDS) database. From Katz N, et al. [15] (Taylor & Francis Ltd, www.tandfonline.com reprinted with permission from the publisher).

Figure 4. Gender differences in routes of abuse of prescription opioid analgesics. Data from [70].

Figure 5. Percentages of individuals abusing extended-release oxycodone, oxymorphone and morphine via specific routes of administration* before and after introduction of the abuse-deterrent reformulation of oxycodone.

*Percentages do not add up to 100% because respondents can report multiple routes of administration. For oxycodone, pre-period includes only the previous extended-release formulation, while post-period includes only the abuse-deterrent reformulation. Because analysis is limited to those reporting abuse of oxycodone, a reduction in the percentage of patients reporting abuse through non-oral routes was accompanied by a corresponding increased percentage reporting abuse through oral routes. Reprinted from Butler et al. [111], Copyright (2015), with permission from Elsevier.

ER: extended-release.

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