1. subzero58

    hi doc,when oc’s became tamper proof the shift from snorting them will definitely drive illegal drug buyers to one of three places.Illegal Suboxone,where most addicts can buy them for $10/pill.then they are buying benzo’s cause suboxone on it’s own has no high to speak of after a few days. then we have the oc addicts who will try to get into a detox.And we all know what the numbers on staying sober are after 1month,3 months,well you get the idea.when insurance companies are fed up with them revolving door detox centers.the shift to heroin and all them things that most oc users said they would never do and the speed at witch high quality heroin showed up on the streets can not be put down to coincident.then we have the rest of them people who would love to blame anyone but themselves.Suboxone doctors and methadone clinics are the only places left.so now these “pretty addicts” who would have nothing to do with heroin or god forbid shooting up. Now,most will tell you they “pretty addicts” will never do heroin.but I think given enough time we will be seeing a whole new generation of heroin addicts.An increase in Crime,aids and drug related deaths.who knows? God help us all…pete

  2. wsburroughs

    Why not just use the generic oxycodone 30mg tablets? Or switch to dilaudid (hydromorphone) in 4mg or 8mg tablets (dissolve easily in water). Many opiate addicts prefer hydromorphone to oxycodone. There are a plethora of pharmaceutical options so heroin seems like a lousy alternative given purity issues. I think oxycodone HCL addicts are resourceful enough to get their drug of choice and continue shooting it or snorting it. I don’t think the new formulation will cause a big switch to heroin. I think REMS will be a complete failure because addicts will always figure out ways to beat new formulations or find alternative formulations. The FDA clearly doesn’t understand addiction very well if they think new formulations and “lower abuse potential” drugs (whatever those are!?) will solve the problem. To paraphrase Dr. Junig, the only way to beat addiction is either (a) serious desperation-induced recovery efforts, e.g. residential treatment + meetings and step work for life or (b) buprenorphine or methadone for life. Case in point for how clueless the FDA is: just this year they approved EXALGO, a “slow release” hydromorphone (dilaudid) that I predict will be the next Oxycontin. REMS is just symbolic action that allows the FDA to continue approving drugs that cause addiction epidemics. This is all driven by pharmaceutical manufacturer profits. There is no better product than an addictive opiate, especially an expensive (on patent) one. New formulations (e.g. suboxone instead of generic buprenorphine; oxycontin instead of generic oxycodone; exalgo instead of generic hydromorphone) just allow the drug manufacturers to start printing money again on drugs that have been around for decades and are cheap in generic form. But they also do a ton of damage. Let’s remember that diacetylmorphine (heroin) was originally marketed as a “non-addictive” substitute for morphine! A lot of people started taking prescribed oxycontin because Purdue claimed that the slow release formulation made it less addictive. Now we have an epidemic on our hands because oxycodone is arguably cleaner/more addictive/etc to diacetylmorphine in many ways. I think the same thing will happen with EXALGO/hydromorphone and we’ll have yet another pharmaceutical dope plague largely induced by the pharmaceutical manufacturers and the FDA. Opiate addiction is so profitable to the suppliers (legal and illicit) that you’ll never control it on the supply side. The only way to slow addiction is to reduce demand. New formulations just create new addicts. It’s completely delusional on the part of the FDA to think they can control addiction with better formulations/drug combinations/etc. In fact they are contributing to the problem with REMS because it creates a false sense of safety in taking powerful opiates that will induce addiction in many people who take them for medical reasons.

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