NIH Looks to Drug Reformulation, Social Media to Combat Opioid Abuse and Misuse

Posted 16 May 2013 | By Alexander Gaffney, RAC 

The US Food and Drug Administration (FDA) may be at the forefront of trying to prevent the misuse and abuse of opioid painkillers, but as two Federal Register notices this week point out, it's not the only agency involved with trying to mitigate risk.

On 16 May 2013, the National Institutes of Health (NIH) published two documents in the Federal Register, the government's point of publication for official announcements, indicating that it wants to do more to combat prescription drug abuse, and particularly opioid abuse.

NIH's Challenge: Stop Non-Abuse Addiction of Opioids

The NIH's first announcement regards a call for "new ideas for prescription drugs oral overdose protection." In other words, if you can't keep them from wanting to abuse the drugs, the hope is that you can find a way to keep them from being able to do so successfully.

"Surprisingly, the individuals who abuse prescription drugs, particularly teenagers, believe that these substances are safer than illicit drugs because they are prescribed by a healthcare professional," NIH wrote. "However, they are just as dangerous and deadly as illegal drugs when used improperly and for non-medical reasons."

According to NIH's notice, the problem requires a response from two distinct angles: finding new ways to diminish the effects of a drug, and finding ways to eliminate overconsumption of intact opioid pills.

The problem is not unrelated to the efforts of FDA, which has been trying to promote the use of what it calls abuse-deterrent qualities for painkiller medications. For example, in April 2013 the agency banned generic versions of oxycodone from the market after it determined that drugs without abuse-deterrent qualities were, by virtue of their abuse potential, not "safe" for use.

NIH's announcement takes note of the same basic problem: abusers right now can crush, dissolve and consume excessive amounts of opioid products, allowing them to achieve a "rush" or "high" from the drug as it is absorbed more quickly than intended.

The variety of potential pathways for abuse has created another problem, NIH said. While many researchers have been focused on ways to prevent the abuse of drugs by limiting their ability to be crushed, little has been done to prevent the potential abuse conducted by consuming the drug normally or in excessive quantities, both of which can lead to addiction or accidental overdose.

"The misuse of prescription drugs by persons who over-consume prescribed medications remains less of a research focus," NIH observed. The agency wants to change that paradigm by creating a "Challenge"-a solicitation for ideas, basically-to combat overdosing resulting from an intact product.

"Submitted ideas should take into consideration that the proposed approach should also maintain the original drug efficacy, be devoid of new safety issues for the intended population, avoid harming a potential abuser, and be economically viable," NIH wrote.

Affected drugs include opioids (pain relievers, analgesics), central nervous system (CNS) depressants and stimulants.

NIH's Second Idea: Go Social

NIH's first idea may be focused on practical prevention, but its second method of prevention seems geared more toward the social. Social media, that is.

In its 16 May 2013 Federal Register announcement, the agency said it's looking for someone to make prescription drug abuse infographics for it to use in the hopes of presenting an accurate, informative and engaging way to capturing the public's interest.

The money may be small-just three prizes of $3,000, $2,000 and $1,000 each-but the goal is for those graphics to have an impact far beyond their diminutive cost.

"Infographics are frequently used to communicate complex information in a clear, concise and visually appealing manner to the public," NIH wrote. "Compared to other topical areas (e.g., politics, economics) the usage of infographics in health science is extremely limited, and infographics relevant to substance use and abuse rarely utilize primary data sources."

So could we soon be seeing Buzzfeed-esque lists of top-20 scientifically-accurate opioid abuse prevention tips brought to us in image-meme form featuring cute animals? NIH's notice is an intriguing step toward offering information to the masses in the way in which they prefer to consume it.

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