(5/7/2015) Abuse of Pain Pills Fuels Virus’s Spread


The abuse of a pain pill from Endo International Plc and its generic copies is being blamed for an increase of hepatitis C among drug addicts — an unintended consequence of a regulatory decision meant to cut down on misuse.

In 2010, U.S. regulators approved a hard-to-abuse version of Purdue Pharma LP’s OxyContin, which for a long time had been a drug of choice for opioid addicts. They didn’t just quit using, though, flocking instead to Endo’s extended-release Opana and its generics. The wide needle they use is also perfect for spreading blood-borne viruses.

In a report published Thursday, the Centers for Disease Control and Prevention found a sharp rise in new hepatitis C cases in Kentucky, Tennessee, Virginia and West Virginia. Many of the infected were white, young and used injectable drugs. Co-author Jon Zibbell, a CDC scientist, has blamed the abuse of Opana for the surge of cases in some of the poorest areas of the U.S., though the drug wasn’t specifically mentioned in Thursday’s report…

Endo created an abuse-resistant form of Opana, its top-selling brand-name drug with sales of almost $200 million last year, and sells only that version now. But the FDA said in 2013 that the abuse-deterrent features weren’t good enough to justify blocking cheaper generic versions that aren’t made with the same kind of barriers to misuse…

Painkillers were implicated in a recent outbreak of HIV in Indiana’s Scott County, just north of the Kentucky border. Public officials found that of the sudden burst of HIV cases, more than 80 percent also had hepatitis C. Almost all were pain-medicine addicts.

Does the CDC or the media believe there is a difference between “pain-medicine addicts” and chronic pain patients?

Since hepatitis C can live for two to three weeks on surfaces, people can pass the virus through other drug paraphernalia, not just needles, Zibbell said. The abuse-deterrent features of Opana may even help pass the virus. When they prepare the drug, addicts may use more cotton balls as filters, water to cook or injections to get high — all adding up to more opportunities for exposure…

Abuse-deterrent technologies add to the cost of drugs, and some work better than others. For now, the pills remain on the market, and infections caused by their abuse continue. “We need more research into abuse-deterrent forms of drugs,” Jerome Adams, Indiana’s state health commissioner, said on a call with reporters. “Just because a drug comes in an abuse-deterrent form, it doesn’t automatically make it safe.”

Sure, that’s the answer — more abuse-deterrent forms of drugs.  That will cure addiction.

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