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An effort to make the opioid painkiller OxyContin harder to abuse drove addicted patients to heroin and caused a dramatic increase in hepatitis C, a new study suggests.
In a classic case of unintended consequences, Connecticut-based Purdue Pharma reformulated its powerful and popular drug OxyContin for the right reasons. It became harder to crush or dissolve, thus making it harder to snort or inject for a fast high.
But that change left millions of addicted patients without their drug of choice, so they turned to another opioid — heroin. Heroin users inject the drug and often share needles, which has spread hepatitis C and resulted in outbreaks of HIV, experts say.
“The fact that we are seeing a rise in hepatitis C infection rates suggests that even if we could stop fatal overdoses, we’re going to have long-term public health consequences, because hepatitis C has long-term and very costly effects,” said the study’s lead researcher, David Powell. He’s a senior economist at the RAND Corporation, a nonprofit research organization.
Powell said the OxyContin reformulation probably wouldn’t have had this effect if there weren’t a readily available, cheap substitute like heroin.
After the reformulation, Powell’s team found that in states with high rates of OxyContin abuse, rates of hepatitis C increased three times faster than in other states.
Although the study can’t prove cause and effect, the researchers said they found a direct link between the changes in OxyContin and the swell of hepatitis C infections.
Hepatitis C causes liver disease. It’s responsible for more deaths in the United States than any other infectious disease — 20,000 in 2015. The rate of new hepatitis C infections remained unchanged for years, but began to rise alarmingly in 2010, when OxyContin was reformulated, the researchers reported.
Many addicts now need treatment for both their addiction and for hepatitis C, Powell said. But today’s hepatitis C drugs are very expensive, which can put them out of the reach of those who need them most.
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