Shanna Babalonis1,2, Sandra D Comer3,4, Jermaine D Jones3,4, Paul Nuzzo5, Michelle R Lofwall6,5,7, Jeanne Manubay3,4, Kevin W Hatton8, Robert A Whittington3, Sharon L Walsh6,5,7,9,10. 1. Department of Behavioral Science, University of Kentucky, College of Medicine, 845 Angliana Avenue, Lexington, KY, 40508, USA. babalonis@uky.edu. 2. Center on Drug and Alcohol Research, University of Kentucky, College of Medicine, 845 Angliana Avenue, Lexington, KY, 40508, USA. babalonis@uky.edu. 3. Columbia University Irving Medical Center, New York, NY, USA. 4. New York State Psychiatric Institute, New York, NY, USA. 5. Center on Drug and Alcohol Research, University of Kentucky, College of Medicine, 845 Angliana Avenue, Lexington, KY, 40508, USA. 6. Department of Behavioral Science, University of Kentucky, College of Medicine, 845 Angliana Avenue, Lexington, KY, 40508, USA. 7. Department of Psychiatry, University of Kentucky, College of Medicine, Lexington, KY, USA. 8. Department of Anesthesiology, University of Kentucky, College of Medicine, Lexington, KY, USA. 9. Department of Pharmacology, University of Kentucky, College of Medicine, Lexington, KY, USA. 10. Department of Pharmaceutical Sciences, University of Kentucky, College of Pharmacy, Lexington, KY, USA.
Abstract
AIMS: Intravenous (IV) misuse of the µ opioid analgesic oxymorphone has caused significant public health harms; however, no controlled data on its IV abuse potential are available. The primary aims of this pilot study were to directly compare IV oxymorphone to IV oxycodone, morphine, and hydromorphone on a subjective measure of drug liking and to assess relative potency. METHODS: Participants (n = 6) with opioid use disorder, physical dependence, and current IV use completed this two-site, within-subject, double-blind, placebo-controlled, inpatient pilot study. During each session, one IV dose (mg/70 kg) was administered: oxymorphone (1.8, 3.2, 5.6, 10, 18, 32), hydromorphone (1.8, 3.2, 5.6, 10, 18), oxycodone (18, 32, 56), morphine (18, 32), and placebo. Data were collected before and for 6 h after dosing. Primary outcomes included safety/physiological effects, subjective reports of drug liking, and relative potency estimates. RESULTS: All active test drugs produced prototypical, dose-related µ opioid agonist effects (e.g., miosis). Oxymorphone was more potent than the comparator opioids on several measures, including drug liking and respiratory depression (p < 0.05). Across abuse-related subjective outcomes, oxymorphone was 2.3-2.8-fold more potent than hydromorphone and 12.5-14-fold more potent than oxycodone (p < 0.05). CONCLUSIONS: Despite the relatively small sample size, this pilot study detected robust oxymorphone effects. Oxymorphone was far more potent than the comparator opioids, particularly on abuse potential outcomes. Overall, these findings may help explain surveillance reports that demonstrate, after adjusting for prescription availability, oxymorphone is injected at the highest frequency, relative to other prescription opioids.
AIMS: Intravenous (IV) misuse of the µ opioid analgesic oxymorphone has caused significant public health harms; however, no controlled data on its IV abuse potential are available. The primary aims of this pilot study were to directly compare IV oxymorphone to IV oxycodone, morphine, and hydromorphone on a subjective measure of drug liking and to assess relative potency. METHODS: Participants (n = 6) with opioid use disorder, physical dependence, and current IV use completed this two-site, within-subject, double-blind, placebo-controlled, inpatient pilot study. During each session, one IV dose (mg/70 kg) was administered: oxymorphone (1.8, 3.2, 5.6, 10, 18, 32), hydromorphone (1.8, 3.2, 5.6, 10, 18), oxycodone (18, 32, 56), morphine (18, 32), and placebo. Data were collected before and for 6 h after dosing. Primary outcomes included safety/physiological effects, subjective reports of drug liking, and relative potency estimates. RESULTS: All active test drugs produced prototypical, dose-related µ opioid agonist effects (e.g., miosis). Oxymorphone was more potent than the comparator opioids on several measures, including drug liking and respiratory depression (p < 0.05). Across abuse-related subjective outcomes, oxymorphone was 2.3-2.8-fold more potent than hydromorphone and 12.5-14-fold more potent than oxycodone (p < 0.05). CONCLUSIONS: Despite the relatively small sample size, this pilot study detected robust oxymorphone effects. Oxymorphone was far more potent than the comparator opioids, particularly on abuse potential outcomes. Overall, these findings may help explain surveillance reports that demonstrate, after adjusting for prescription availability, oxymorphone is injected at the highest frequency, relative to other prescription opioids.
Authors: Dita Broz; Jon Zibbell; Carrie Foote; Jeremy C Roseberry; Monita R Patel; Caitlin Conrad; Erika Chapman; Philip J Peters; Richard Needle; Cameron McAlister; Joan M Duwve Journal: Int J Drug Policy Date: 2017-12-24
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