The US Food and Drug Administration recently asked Endo Pharmaceuticals to take their “uncrushable” opioid painkiller, Opana ER, off the market because of public health concerns about the potential for abuse. “FDA requests removal of Opana ER for risks related to abuse” Not only is this the first time the FDA has recalled a drug over fears of abuse, but it’s also interesting because, just several years ago, this type of crush-resistant pill was hailed as a step towards tackling opioid abuse. Of course, that didn’t happen. People didn’t stop abusing Opana ER. Instead of snorting it, they began injecting it. And that was linked to largest outbreak of HIV in Indiana history: “How a painkiller designed to deter abuse helped spark an HIV outbreak”
Addiction isn’t in the substance, so if you change the substance or make it inaccessible, that doesn’t deal with the addiction or what caused it. Believing that changing the drug would somehow stop the addiction is wishful thinking. This idea that the substance is the problem is an outdated way of viewing addiction, it’s a throwback to the prohibition era. The entire system surrounding the addiction needs to change. If you have a doctor or a pharmacist addicted to the money they’re getting from prescribing the drugs, they’re not going to stop prescribing simply because the coating on the drug changed. If you have manufacturers chasing a stock price high, they’re not going to track potentially fraudulent or excessive sales of the drug. And if you’re an individual dealing with an addiction, complicating your relief from the addiction doesn’t make the addiction go away. The problem is not solved. The underlying problem persists and, as we’ve seen in this situation with uncrushable opioids, the problem becomes even more complex.