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According to a new study by RAND Corporation, the reformulation of OxyContin pain medication in 2010 to make abuse more difficult has directly led to a sharp increase in hepatitis C infections, with drug addicts having gone over medications prescription injectable heroin.
While hepatitis C infection rates increased across the country in the years following the reformulation, researchers found that the above-average OxyContin misuse rates before reformulation were increased three times faster than in other states.
Public health officials have already blamed the increase in the number of cases of hepatitis C to switching from prescription opioids to injectable heroin, but the new study provides the best evidence to date of a direct link between the reformulation of OxyContin and the outbreak of the infection. The results are published in the February issue of the journal Health Affairs.
"These findings show that efforts to discourage the misuse of opioids can have unintended consequences on public health in the long run," said David Powell, lead author of the study and Senior Economist at RAND, a non-profit research organization. "As we continue to develop policies to combat the opioid epidemic, we must ensure that new approaches do not worsen another public health problem."
The hepatitis C virus causes liver disease and is responsible for more deaths in the United States than any other infectious disease, accounting for 20,000 deaths in 2015. While the rate of new hepatitis C has been stable for several years, the infection rate began to increase an alarming rate from 2010.
Injecting drug use has always been identified as a predominant risk factor for hepatitis C, and experts have therefore been asked to determine whether the opioid epidemic may be a factor in the recent upsurge of infection. .
Most of the early years of the epidemic of opioid abuse were motivated by the misuse of prescription pain medications. But one of the most abused drugs, OxyContin was reformulated in 2010, making the pill difficult to crush or dissolve, thus deterring the most dangerous methods of injecting or inhaling abuse .
RAND researchers had previously shown that reformulation of OxyContin had led some non-medical users of the drug to switch to injectable heroin, which led to a surge in heroin overdoses after 2010.
In the latest study, researchers from RAND and the Wharton School of the University of Pennsylvania examined rates of hepatitis C infections in each state from 2004 to 2015, examining the differences between states based on the degree of misuse of the drug before reformulation.
The badysis found that states with abuse greater than the median of OxyContin before reformulation recorded a 222% increase in hepatitis C infections after reformulation, while states with less than the median use of OxyContin experienced a 75% increase in hepatitis C infections during the same period.
Before the reformulation, there was virtually no difference between the rates of hepatitis C infections in the two groups of states.
"Even with recent advances in the treatment of hepatitis C, the dramatic increase in the number of infections represents a major public health problem that can have huge costs in the long run if infected people are not identified and treated, "said Rosalie Liccardo Pacula, a study. author and co-director of the RAND Opioid Policy Information Center and the RAND Drug Policy Research Center.
While drug abuse policy continues to reduce access to abusive prescription opioids, researchers say the study suggests that unintended consequences for public health could occur if drug abusers pbaded to the injected drugs.
"It is important that strategies that limit the supply of abusive prescription opioids be badociated with measures to mitigate the harms badociated with the switch to illicit drugs, such as improving the quality of prescription drugs." access to drug treatment and increased efforts to identify and treat diseases badociated with injecting drug use, "Pacula said.
The National Institute for Combating Drug Abuse supported this study. Abby E. Alpert of the Wharton School at the University of Pennsylvania also co-authored the study.
The RAND opioid Policy and Information Center, supported by the federal government, develops reliable data, rigorous methods, and strategic tools to inform evidence-based opioid policies.
Since 1989, the RAND Drug Policy Research Center has been conducting research to help policymakers in the United States and around the world solve problems related to alcohol, marijuana and other drugs.
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