To be blunt in answering the question proposed by the title – yes – at least, according to the working paper by William Evans and Ethan Lieber of the University of Notre Dame and Patrick Power of Boston University conducted as part of the National Bureau of Economic Research.
When back in 2010 OxyContin was reformulated to make it harder to abuse, it came to light that, while OxyContin decreased in its (ab)use, other opioids came into focus. Substance abusers found a readily available and much cheaper option, heroin. It proved counterproductive to the idea that initially triggered reformulation of OxyContin altogether – to make this opioid less available to addicts and, in doing so, encourage the addicts to stop using. Unfortunately, judging by the observations laid out in the study by the National Bureau of Economic Research “How the Reformulation of OxyContin Ignited the Heroin Epidemic,” it seems that “the uptake of heroin was so complete that no lives were saved at all.” More apparent is it appears that potential OxyContin-induced deaths were replaced by additional deaths through heroin use.
What Made This New OxyContin Formulation Difficult to Use?
The former OxyContin formulation was easy to crush and turn into powder, making it easy for addicts to snort the drug. Moreover, the crushed pill wasn’t difficult to inject as it was converted into a liquefied substance by melting. However, the reformulation of OxyContin brought an entirely new formulation to the table: the pill was no longer easy to snort or inject; instead, it would now turn into a sticky substance when crushed, making it hard to ingest rapidly.
Has Difficulty in OxyContin Usage Been Noted as the Only Factor That Leads to as Many Deaths by Heroin?
As the authors find, the most significant jump in heroin deaths was noticed “in states where heroin was common before the OxyContin reformulation.” To stay away from potentially misinforming the public with incomplete data, Evans, Lieber, and Power took some external factors and potential law enforcement into account hoping to justify the “structural break” that happened in August 2010, the month Purdue Pharma changed the formulation of OxyContin. They found there were none and concluded it was the reformulation of OxyContin that led to an increasing number of heroin deaths. The paper quotes: “We attribute the recent quadrupling of heroin death rates to the August 2010 reformulation of an oft-abused prescription opioid, OxyContin. The new abuse-deterrent formulation led many consumers to substitute to an inexpensive alternative, heroin. Using structural break techniques and variation in substitution risk, we find that opioid consumption stopped rising in August 2010, and heroin deaths began climbing the following month.”
Conclusion: The Questionable Method
In the light of their findings, the authors call into question this method of trying to prevent substance abuse by conducting drug reformulation. Further, in this National Bureau of Economic Research working paper, “How the Reformulation of OxyContin Ignited the Heroin Epidemic,” the authors link their findings and observations to Sam Peltzman landmark paper. It found that an increased number of safety devices in cars is no guarantee for saving lives, indirectly arguing it is people’s responsible driving that contributes to saving of lives.