Reply to Commentary

      We appreciate the thoughtful commentary on our article by Dr. Jamison. He raises several points that deserve to be highlighted. As pointed out in his commentary, despite our early findings of less abuse overall and less nonoral abuse of reformulated OxyContin (ORF), abusers can be inventive in finding ways to misuse substances, and abuse of this or any reformulated opioid analgesic is still possible by swallowing the tablets whole. We certainly agree with these points and are currently engaged in further monitoring abuse of ORF in the National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO) system by any route, abuse by oral and nonoral routes, as well as abuse by specific routes of administration. It should be noted that, as shown in Figs. 1 and 2 of our report, rates of abuse of ORF have remained remarkably stable in the first 20 months after its introduction. This may reflect an inability of abusers to find a way to defeat the reformulation. Results of ongoing observations will be published in a follow-up analysis.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The Journal of Pain
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Butler S.F.
        • Budman S.H.
        • Fernandez K.C.
        • Fanciullo G.J.
        • Jamison R.N.
        Cross-validation of a screener to predict opioid misuse in chronic pain patients (SOAPP-R).
        J Addict Med. 2009; 3: 66-73
        • Butler S.F.
        • Budman S.H.
        • Fernandez K.C.
        • Houle B.
        • Benoit C.M.
        • Katz N.
        • Jamison R.N.
        Development and validation of the Current Opioid Misuse Measure.
        Pain. 2007; 130: 144-156
        • Butler S.F.
        • Fernandez K.
        • Benoit C.
        • Budman S.H.
        • Jamison R.N.
        Validation of the revised Screener and Opioid Assessment for Patients with Pain (SOAPP-R).
        J Pain. 2008; 9: 360-372
        • Cassidy T.A.
        • McNaughton E.C.
        • Butler S.F.
        • Budman S.H.
        Poster presentation.
        PAINWeek, Las Vegas, NV2012
        • Cicero T.J.
        • Ellis M.
        • Surratt H.
        Effect of abuse-deterrent formulation of Oxycontin.
        NEJM. 2012; 367: 187-189
      1. Coburn T, Gottlieb S: Prescription for Trouble. The American Magazine, Dec 18, 2012, 1-6

      2. Coplan PM, Kale H, Sandstrom LE, Chilcoat HD: Changes after reformulation of extended-release oxycodone in calls to US Poison Centers for oxycodone and heroin. International Association for the Study of Pain. 14th Annual World Congress on Pain, Milan, Italy, August 27-31, 2012 [Abstract PF012]

      3. Davis J, Severtson SG, Bartelson BB, Munoz A, Schneider MF, Surratt, Chilcoat H, Coplan P, Green JL, Dart RC: Reduction in extended release (ER) oxycodone diversion rates following the introduction of a reformulated ER oxycodone product. International Association for the Study of Pain. 14th Annual World Congress on Pain, Milan, Italy, August 27-31, 2012 [Abstract PF087]. Abstract retrieved from IASP Abstract database at

      4. DeVeaugh-Geiss A, Leukefeld C, Havens J, Coplan P, Chilcoat H: Opioid abuse in Kentucky after OxyContin® reformulation. In: American Academy of Pain Management’s 23rd Annual Clinical Meeting Abstract Book: AAPM, p 7, 2012 [Abstract #13]

      5. FDA Advisory Committee Transcript Joint Meeting of the Anesthetic and Life Support Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee Meeting Announcement. Thursday, October 21, 2010. Available at:

      6. Sessler N, Baumgartner TF, Coplan P: Changes in number of spontaneous adverse event reports of drug abuse, intentional drug misuse, medication error, and overdose after reformulation of OxyContin. PAINWeek Abstract Book p. 125, 2012 [Abstract 100]

      7. Sessler NE, Downing J, Kale H, Harding B, Baumgartner T, Coplan P: Effects of reformulating extended-release oxycodone on fatal adverse event reports. PAINWeek Abstract Book p. 153, 2012 [Abstract 101]

        • Severtson S.G.
        • Bartelson B.
        • Chilcoat H.
        • Coplan P.
        • Surratt H.
        • Dart R.C.
        A comparison of the street price of original and reformulated OxyContin® and immediate release (IR) oxycodone products.
        J Pain. 2012; 13 ([Abstract #201])
        • Severtson S.G.
        • Bartelson B.B.
        • Davis J.
        • Munoz A.
        • Schneider M.F.
        • Coplan P.
        • Chilcoat H.
        • Green J.L.
        • Dart R.C.
        Difference in rates of abuse following reformulation of extended release (ER) oxycodone using data from the RADARS System Poison Center Program.
        Pharmacoepi & Drug Safety. 2012; 21 ([Abstract #467])
      8. Skinner BJ: Weighing the cost of generic OxyContin. Opinion. The National Post:17-18, September 17, 2012

      9. Skinner BJ: Net societal economic impact in Canada from withholding regulatory approval for generic OxyContin. Toronto, Ont, CA, Canadian Health Policy, September 12, 2012