Citation

Vosburg SK, Severtson SG, Dart RC, Cicero TJ, Kurtz SP, Parrino MW, Green JL. J. Pain 2018; 19(4): 439-453.

Affiliation

Rocky Mountain Poison & Drug Center, Denver Health and Hospital Authority, Denver, CO. Electronic address: Jody.Green@rmpdc.org.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.jpain.2017.11.007

PMID

29224919

Abstract

Tapentadol, a Schedule II opioid with a combination of µ-opioid activity and norepinephrine reuptake inhibition, is used for the management of moderate to severe acute and chronic pain. Its dual-mechanism of action is thought to reduce opioid-related side effects that can complicate pain management. Since approval, tapentadol has been tracked across multiple outcomes suggesting abuse liability, and a pattern of relatively low, although not absent, abuse liability has been found. This retrospective cohort study further details the abuse liability of tapentadol as an Active Pharmaceutical Ingredient (API) when both immediate-release and extended-release formulations were on the market together (4Q2011 to 2Q2016). Tapentadol (API) was compared to tramadol, hydrocodone, morphine, oxycodone, hydromorphone, and oxymorphone across Poison Center, Drug Diversion and Treatment Center Programs Combined data streams from the RADARS System.

FINDINGS suggest the public health burden related to tapentadol to date is low, but present. Event rates of abuse per population-level denominators were significantly lower than all other opioids examined. However, when adjusted for drug availability, event rates of abuse were lower than most CII opioids studied, but were not the lowest. Disentangling these two sets of findings further by examining various opioid formulations, such as extended-release and the role of abuse-deterrent formulations, is warranted.

Copyright © 2017. Published by Elsevier Inc.

Language: en

Keywords

API; Human; Pain management; Prescription drug abuse; Prescription opioid abuse; Prescription opioid analgesic; Tapentadol abuse liability