Do Abuse-Deterrent Painkillers Actually Work?

Abuse-deterrent properties of specific opioid painkillers are intended to significantly deter their abuse, though they may not fully prevent it. When a alters an abuse-deterrent’s intended intake method to increase the drug’s effect, the process will backfire and often decrease, rather than increase, the user’s intended outcome of his or her experience.

People are split when it comes to the question of whether or not abuse-deterrent drugs actually help addicts in their recovery. They believe that abuse-deterrent versions of popular painkillers like OxyContin and Vicodin are a step in the right direction, but questionthe limit to just how well these alternatives work. Many abuse-deterrent drugs are designed to make crushing, sniffing, and injecting painkillers difficult. They’re not aimed at reducing the rate of oral abuse.

Several studies have shown that abuse-deterrent drugs have resulted in a decrease in the use of drugs like OxyContin, but a growing number of experts believe that abuse-deterrent options are just a hurdle for addicts to clear in their pursuit of getting back to their old lives and the high they crave.

There are studies that confirm that abuse-deterrent drugs have in fact decreased abuse. However, these same studies point out that many addicts simply just move on to other, easier to abuse drugs, such as heroin.

Names of some opioid painkillers that people often get addicted to include OxyContin, Vicodin, Percocet, hydrocodone, oxycodone and Demerol.

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Why it Can Be So Easy to Get Addicted

These prescription painkillers are often quite strong and give the user a euphoric, or “high,” feeling to alleviate the pain caused by a severe injury or intensive surgery, for example. Many users get used to that euphoric feeling and seek to prolong or intensify the effect. Users looking for that extra high employ alternatives to ingest painkillers prescribed to be taken orally. They may crush and snort or smoke them, or dissolve them into a liquid so that they can be injected into the body. These methods increase the potency of the drugs and decrease the time it takes for the drugs to take effect.

The FDA has approved three formulations that it claims to be abuse-deterrent, including OxyContin, Embeda and Targiniq. Naloxone and naltrexone are called opioid antagonists; they block receptors in the brain that create a ceiling for how high a person can get while taking an opioid, which can help prevent overdose.

How Abuse-deterrent Painkillers Work

Abuse-Deterrent Painkillers

Abuse-deterrant painkillers are more difficult to cut, crush, or dissolve.

The regular versions of opioid painkillers have the same effect as their abuse-deterrent alternatives. The difference is that the abuse-deterrent versions are designed to be harder to crush, cut, or dissolve. Those looking to inject a painkiller will be foiled by some abuse-deterrent drugs that transform into a gel when mixed with water. This makes it much harder to inject than the original versions that readily dissolve. Abuse-deterrent drugs are prescribed especially to addicts, or those in addiction recovery, to prevent them from abusing painkillers that they need, but are at risk of abusing once in their possession.

Physical barriers have been designed to prevent the abuse of painkillers by preventing them from being chewed, crushed or ground, instead of being taken orally in pill form. Chemical barriers, such as gelling agents, can prevent users from extracting opioids who are using water, alcohol or other solvents to prepare a liquid to inject into a vein. These barriers also can change the effect the drug has on the user when its intentional use is altered, so that it is less effective, or even, when a drug contains an agonist, causes an unpleasant experience. Such effects dramatically decrease the chance of abuse.


Opioid drug users also have a tendency, over time, to build up a tolerance to their drug of choice. Tolerance occurs when the person no longer responds to the drug as strongly as he or she did initially, thus requiring that he or she take a higher dose to achieve the same effect. The results of tolerance stem from an opioid’s ability to desensitize the brain’s natural opioid system, making it less responsive over time.

Tolerance is what contributes to a high risk of overdose during an addict’s relapse after an absence of exposure to the drug. The user’s tolerance drops if he or she does not use the drug for a period of time, and if he or she goes back to using, usually goes back to his or her most recent dose. This dose usually produces a much stronger effect on a person than he or she is used to because the tolerance that had built up in his or her system has depleted or completely worn off. This can easily lead to overdose, hospitalization and even death.

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Are Abuse-deterrent Painkillers Just a Band-Aid?

Many health officials worry that these abuse-deterrent drugs are simply lulling the public into a false sense of security. They worry that pharmaceutical companies have only placed a bandage over the wound and that that bandage is not going to be effective because while they certainly present less risk of addiction, the pills themselves aren’t any less addictive.

Holding doctors and pharmacies accountable for prescribing and dispensing dangerous medication is important, but much more needs to be done to gain control of the problem of opioid addiction. There are prescription drug monitoring programs in place in many states. There are abuse-deterrent meds on the market, yet record numbers of people are still becoming addicted and dying as a result of painkiller abuse.

Increasing access to treatment is a crucial step in the process. There always will be people who will get addicted to opioids, whether they are prescribed by a doctor, such as OxyContin, Percocet or Vicodin, or bought off the street, like heroin. Once addicted, treatment is often a matter of conflict, as some health insurance plans don’t cover treatment for substance abuse. What happens to unfortunate individual who cannot afford the treatment he or she needs?

The real solution to helping keep opioid addicts on the road to recovery depends on a combination of regulation, education, and increased access to treatment. The general consensus on abuse-deterrent drugs is that they work as a short-term fix, but they do not address the overall situation.

the Take-Away

Learn about a new form of painkillers that are more difficult to abuse.