Risk for Intentional Tapentadol Abuse Analyzed With the RADARS Poison Center Program

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A schedule 2 opioid, tapentadol acts as a µ-opioid receptor agonist and as an inhibitor of noradrenaline reuptake.
A schedule 2 opioid, tapentadol acts as a µ-opioid receptor agonist and as an inhibitor of noradrenaline reuptake.

The following article is part of conference coverage from the PAINWeek 2018 conference in Las Vegas, Nevada. Clinical Pain Advisor's staff will be reporting breaking news associated with research conducted by leading experts in pain medicine. Check back for the latest news from PAINWeek 2018.

LAS VEGAS — Data from the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) Poison Center Program suggest that, despite its low rate of abuse, tapentadol may still represent a public health burden — albeit low — according to research presented during the 2018 PAINWeek conference, held September 4-8.

A schedule 2 opioid, tapentadol acts as a µ-opioid receptor agonist and as an inhibitor of noradrenaline reuptake. This dual function of the molecule is thought to reduce the common side effects of opioid therapy. The current study sought to compare the abuse liability of tapentadol with that of 6 other opioids tracked in the RADARS Poison Center Program (tramadol, morphine, hydromorphone, oxymorphone, hydrocodone, and oxycodone) from the 4th quarter of 2011 to the 2nd quarter of 2016. The rates of intentional abuse were calculated based on total number of prescriptions, total number of dosage units, and population.

Through the study time period, there were 87 instances of intentional tapentadol abuse cases reported. Adjusted for population, the overall rate of tapentadol abuse was lower than the rates seen with the other 6 opioid products (0.007 to 0.036 per 1,000,000 population), with an average quarterly rate of 0.015 per 1,000,000 population (95% CI, 0.012-0.019 per 1,000,000 population). The rates of abuse for other opioids evaluated ranged from 7.414 to 84.322 times higher per 1,000,000 population for oxymorphone and oxycodone, respectively. When data were adjusted to account for drug availability, tapentadol was not found to have the smallest or the largest rate of abuse. The quarterly average rate of intentional tapentadol abuse per 100,000 doses dispensed was 0.028 (95% CI, 0.023-0.035) compared with the lowest rate of 0.020 per 100,000 doses for hydrocodone (95% CI, 0.019-0.020) and the highest rate of 0.166 the largest for oxymorphone (95% CI, 0.153-0.179).

"It is critical to assess utilization rates in the context of population rates and raw abuse endorsements in order to obtain a clear understanding of the overall abuse of a product. RADARS Poison Center program data suggest that tapentadol intentional abuse presents a low but present public health burden," concluded the study authors.

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Reference

Iwanicki J, Vosburg S, Severtson G, et al. Assessment of tapentadol API abuse liability with the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System Poison Center Program. Presented at: Pain Week 2018; September 4-8, 2018; Las Vegas, Nevada.

For more coverage of PAINWeek 2018, click here.

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