Evaluation of Abuse Deterrent Formulations of Oxycodone Products: Real-World Data from an Enriched Population of Substance Users Assessed with the Addiction Severity Index-Multimedia Version (ASI-MV®)

Jody L Green, Taryn Dailey-Govoni, Suzanne K Vosburg Integrated Behavioral Health, Inflexxion, Irvine, CA, 82614, USACorrespondence: Jody L Green, Integrated Behavioral Health, Inflexxion, 2 Park Plaza, Suite 1200, Irvine, CA, 82614, USA, Tel +1 303 618 9044, Email JGreen@inflexxion.comPurpose: The study purpose was to evaluate real-world data on routes of administration (ROAs) employed for nonmedical use (NMU) of XTAMPZA ER compared to other oxycodone extended-release (ER) and oxycodone immediate-release (IR) formulations in a population of adults assessed for substance use.Patients and Methods: A cross-sectional observational study was conducted among adults assessed for substance use and treatment planning using the Addiction Severity Index-Multimedia Version (ASI-MV®) from July 2016 through December 2023. Demographic and substance use history data were summarized to characterize the sample. The primary outcome measure was the prevalence of past 30-day non-oral NMU, assessed first by using Pearson’s chi-square to test differences in prevalence, then by calculating the proportional reporting ratios (PRR) to determine if specific non-oral ROAs were more or less likely to be used for XTAMPZA ER NMU versus comparators.Results: The prevalence of non-oral ROA cases was significantly higher among other oxycodone ER cases (2221/4935, 45.0%) and oxycodone IR cases (10,598/20,394, 52.0%) compared to XTAMPZA ER cases (31/141, 22.0%)(X2=29.43, p< 0.0001 and X2=50.41, p< 0.0001, respectively). Compared to other oxycodone ER, XTAMPZA ER had a 33% lower risk of snorting (PRR: 0.67, 95% CI: 0.47, 0.95) and a 63% lower risk of injecting (PRR: 0.37, 95% CI: 0.19, 0.71). Compared to oxycodone IR, XTAMPZA ER had a 46% lower risk of snorting (PRR: 0.54, 95% CI: 0.38, 0.77) and a 66% lower risk of injecting (PRR: 0.44, 95% CI: 0.23, 0.86).Conclusion: Opioid medications can provide valuable patient benefits with risks best mitigated by using formulations associated with lower likelihood of NMU, particularly via higher-risk non-oral ROAs. These study findings suggest that XTAMPZA ER has a lower risk of NMU via non-oral ROA compared to other oxycodone ER and oxycodone IR products in an enriched population of substance users.Keywords: pain management, opioid, nonmedical use, substance abuse treatment, real-world data, abuse deterrent formulations, routes of administration