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Retrospective analysis of trends in dispensing long-acting non–tamper-resistant oxycodone near the Canada–United States border

Gomes T, Paterson MJ, Mukati M, Henry D, on behalf of the Canadian Network for Observational Drug Effect Studies investigators. CMAJ Open. 2015; 3(2):E231-5.

Background — Since 2010, tamper-resistant long-acting oxycodone has been available in both the United States and Canada; however, generic non–tamper-resistant brands of the drug have only been introduced in Canada. We aimed to determine whether the introduction of generic non-tamper-resistant oxycodone in Canada led to increased sales from Canadian pharmacies near the Canada–US border.

Methods — We conducted a retrospective analysis of trends in dispensing of long-acting oxycodone from Canadian community pharmacies in geographic areas contiguous with the Canada–US border between Feb. 1, 2012, and Jan. 31, 2014. We reported the monthly dispensing rates of long-acting oxycodone by province and within each region near the Canada–US border.

Results — During the study period, 8 507 882 long-acting oxycodone tablets were dispensed by Canadian pharmacies in regions near Canada–US border crossings. After the introduction of generic non–tamper-resistant formulations in December 2012, the dispensing rate declined in the border regions of Ontario, British Columbia and Quebec, and rose slightly in Manitoba (4.4%) and New Brunswick (3.6%). Dispensing rates rose by 45.5% in Alberta and 92.3% in Saskatchewan; however, only 3341 of the tablets dispensed were a generic non–tamper-resistant formulation. An examination of the dispensing patterns in 50 border areas after the marketing of non–tamper-resistant brands in Canada showed no patterns suggestive of trafficking.

Interpretation — We found no large increases in the dispensing rates of generic non–tamper-resistant long-acting oxycodone in Canadian pharmacies near Canada–US border crossings such as were seen after the withdrawal of OxyContin in the United States in 2010. Despite our findings, Canadian clinicians and pharmacists should remain cautious in their prescribing and dispensing of non–tamper-resistant formulations of oxycodone because of their high potential for misuse and abuse.

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Keywords: Drug abuse Drug prescribing behaviour Health services misuse Health policy/reform