Journal des médicaments en développement
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Drug Tampering and Abuse Deterrence

David J Mastropietro and Hossein Omidian

There has been a growing response from governments, industries, and academic institutions to address the worldwide incidence of prescription drug abuse. These organizations have addressed this prominent public health concern in different ways. One crucial step has been research and development into developing medications that are considerably more resistant to abuse. These novel medications prevent or discourage abuse and tampering, and consequently referred to most often as abuse-deterrent or tamper-resistant formulations. While prescription drugs used to treat insomnia, anxiety, and behavioral disorders are commonly abused, prescription opioids are most significant. Attempts to produce more rapid “high” or euphoria have resulted in various tampering techniques by abusers. Swallowing multiple dosage forms at once, either intact or crushed (chewed), is relatively considered the most common form of tampering, followed by nasal insufflation and injection. However, the prevalent route used can greatly depend on the drug or dosage form. The simultaneous use of prescription opioids with alcohol has also become a dangerous form of tampering that can lead to serious adverse effects and even death. The objective of this paper is therefore to provide a summary of the types of tampering commonly performed during abuse of prescription drugs that can be useful in developing dosage forms more resistant to multiple forms of abuse.