Opioid misuse

Opioid drugs (e.g. morphine) are derived from a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. 

Opioid use in chronic pain treatment is complex and although it does provide benefit, it is also associated with a level of harm for the patient. Prescription opioids present a high degree of abuse liability. Substantial increases in prescription rates and consequent increases in morbidity and mortality are indicative of problematic opioid (mis)use, that can lead to abuse and addiction. In the US, overdose deaths due to prescription opioid pain relievers have more than tripled in the past 20 years (PMID: 24264508). There is growing evidence to suggest a relationship between increased non-medical use of opioid analgesics and heroin (diamorphine) abuse.

The abuse of and addiction to opioids such as heroin, morphine, and prescription pain relievers is a serious global problem that affects the health, social, and economic welfare of all societies, and the consequences of this abuse (e.g. unintentional overdose deaths) are on the rise.

Having partly contributed to the problem (using aggressive marketing strategies for example), the pharmaceutical industry is now working very hard to develop new opioid drug formulations with abuse-deterrent properties, which maintain the maximum relief from suffering whilst minimizing the associated risks and adverse effects. For example, OxyContin is an oxycodone tablet that is coated with a plastic polymer designed to prevent chewing, cutting, or crushing of the tablet, and both Suboxone (buprenorphine and naloxone) and Embeda (morphine and naltrexone) are examples of extended-release opioid agonist-antagonist combinations, in which the antagonist agent is sequestered if the medication is taken as directed, but is released if it is tampered with (e.g, chewed, crushed, or dissolved).