What changed when OxyContin was reformulated in 2010?
Prescription opioid use stopped rising after the abuse-deterrent reformulation — but heroin overdose deaths began climbing the following month, particularly where heroin was already available, suggesting a near one-for-one substitution to more dangerous street drugs.
In August 2010 Purdue introduced an abuse-deterrent version of OxyContin that was harder to crush or dissolve. Research by economists at Notre Dame and elsewhere found that prescription opioid use stopped rising after the change, but heroin overdose deaths began climbing the following month, particularly in areas with greater pre-existing access to heroin and opioids. The authors described a one-for-one substitution of heroin deaths for opioid deaths. Their conclusion was that as long as cheap substitutes such as heroin, and later illicit fentanyl, are available, reformulating painkillers does little to reduce harm. Some commentators have disputed how much of the heroin surge the reformulation caused. But the research suggests that people who had become dependent on OxyContin shifted to more dangerous street drugs.