In 2010, concern about the opioid epidemic was largely centered around the misuse of OxyContin. That year, Purdue Pharma, which manufactures the opioid painkiller, reformatted the drug to make it harder to misuse.
However, researchers say this caused people to use heroin instead, which ultimately let to an increase in cases of hepatitis C.
Officials have known that cases of hepatitis C (HCV), which can be passed through intravenous drug use, had increased rapidly beginning in 2010. In a recent study published in Health Affairs, researchers found that HCV spread more quickly in states that previously had higher than average rates of OxyContin abuse. This confirmed the connection between the reformulation of OxyContin and the higher rates of HCV.
David Powell, the study’s lead author, said that the findings prove that well-intentioned policies can have serious effects on public health.
“These results show that efforts to deter misuse of opioids can have unintended, long-term public health consequences,” he said, according to Science Daily. “As we continue to develop policies to combat the opioid epidemic, we need to be careful that new approaches do not make another public health problem worse.”
Previous research has shown that the reformulation of OxyContin—which made it harder to crush, snort or inject—led some people to turn to heroin.
In the recent study, researchers solidified the connection between the reformulation and HCV rates. They found that in states with above-average misuse of OxyContin before the reformulation, rates of HCV increased 222% between 2010 and 2015. In states that had lower than average rates of OxyContin misuse, there was a rise of just 75%.
Rosalie Liccardo Pacula, a study co-author, said that this steep increase in infections was concerning, although it has tapered off in recent years.
“Even with recent advancements in the treatment for hepatitis C, the dramatic increase in infections represents a substantial public health concern that can have tremendous long-term costs if infected people are not identified and treated,” she said.
Pacula cautioned that lawmakers need to consider the unintended consequences that certain drug policies may have, and plan for how those risks will be addressed.
“It is important that strategies that limit the supply of abusable prescription opioids are paired with policies to ease the harms associated with switching to illicit drugs, such as improved access to drug treatment and increased efforts to identify and treat diseases associated with injection drug use,” said Pacula.
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