Poster Number-7 - Non-Medical Use of XTAMPZA ER: Motivation, Methods, and Perceptions of Tampering

Opioid abuse-deterrent formulations (ADF) were developed to impede manipulation with the intention of reducing the improper use of opioids. XTAMPZA ER^® is an extended-release (ER), abuse-deterrent formulation oxycodone product that uses DETERx^® technology designed to reduce manipulation. The effectiveness of XTAMPZA ER at reducing improper use has been studied in preclinical and clinical settings, and results from real world contexts are growing. Among poison center calls, XTAMPZA ER intentional drug exposures rates were shown to be lower than other ADF products and immediate release (IR) oxycodone (1). In addition, the odds of past-month abuse of XTAMPZA ER among entrants to opioid treatment facilities were lower than for other ADF products (1). Relatively little is known about why drug users choose to non-medically use ADF products, how effective ADF products are in preventing tampering in the real world, and perceived risks of using ADF products. The goal of this study was to assess the motivations, methods, and perceptions of tampering with XTAMPZA ER with the intention of non-medically using the tampered product.

Methods:

The Survey of Non-Medical Use of Prescription Drugs (NMURx) Program is an online general population survey from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS^®) System. A repeated cross-sectional survey about drug use was administered in two survey waves in 3^rd quarter 2021 and 1^st quarter 2022 to a commercial online panel, which is a convenience sample of the national adult population. Participants who reported non-medical use (NMU) of XTAMPZA ER, other extended-release abuse-deterrent opioids (other ER-ADF opioids); and immediate release, single entity oxycodone (IR-SE oxycodone) were included in the analysis. The ER-ADF opioids included were OxyContin^®, Hysingla^®, and generic forms of ER oxycodone or hydrocodone. NMU of a drug was defined as “used < drug > in a way not directed by your healthcare provider” in the last 12 months.

Participants who met these criteria were given a follow-up survey with detailed questions about whether they tampered with the pills. Participants were asked if they tampered in the following ways: break apart, chew, crush, heat or melt, dissolve in mouth, dissolve in liquid, or combine with another drug. For each, they were asked why they tampered in that manner and how difficult it was. Finally, the participant was asked about their perceived risk of tampering with each drug.
Data from this study is still being collected, but results will be completed at the time of the conference. Descriptive percentages of types of tampering and motivations for each type will be reported. Differences in difficulty of tampering and perceived risk of tampering between drugs will be compared. Race and ethnicity were asked where Hispanic ethnicity was a separate question, and participants could select any of the following races: White, Black, Asian, American Indian or Alaskan Native, Native Hawaiian or Pacific Islander, or something else.

Results:

A total of 5,210 participants were invited to the study in 3^rd quarter 2021 and 335 have provided completed questionnaires. The sample of invited participants was 61.8% female, 73.1% non-Hispanic White, 9.8% non-Hispanic Black, 9.8% Hispanic, 4.3% another non-Hispanic race, 3.0% multiple non-Hispanic races, and had a median age of 46 years (interquartile range: 37-58).
Final results will be provided in an updated abstract and at the conference.

Conclusion: Results from this study will provide meaningful information and insights about how and why individuals would tamper with ADF opioid products. A comparison between individual abuse-deterrent technologies could elucidate different risk profiles based on the patterns associated with the drug prescribed.

References: 1. Severtson GS, Kreider SED, Amioka EC, Margolin ZR, Iwanicki JL, Dart RC. Postmarketing Analysis of Misuse, Abuse, and Diversion of Xtampza ER. Pain Med. 2020;21(12):3660-3668. doi:10.1093/pm/pnaa272