A review on advanced formulations strategies to prevent prescription drug abuse and their impact

Abstract

The growing issues with prescription drug misuse have required the development of advanced techniques like abuse-deterrent formulations (ADFs). In this abstract we have provided a comprehensive overview of these type of novel formulations and their potential impact on mitigating prescription drug misuse. ADFs is like in modifying the formulations so that it can become a challenge to misuse. Some of the examples, market products and researches are mentioned in this review like; physical and chemical barriers to prevent common abuse methods such as crushing, snorting, or injecting.

By making it more tough to extract active ingredients or achieve euphoric effect, these formulations aim to deter misuse and reduce the potential for manipulation. Another innovation involves prodrugs, which require enzymatic conversion within the body to release the active drug, it will stay inactive in normal conditions which helps in prevention of misuse. We have included some combination formulations like incorporating opioid antagonists in conjunction with the API, have also increased traction. These formulations cut or block the euphoric effects of the medicine.

Further advancements include specialized temper prof coating and matrix system to reduce physical manipulations. The application of ADFs has shown encouraging outcomes, including reduced abuse rates and drug diversion. However, challenges remain as determined individuals may still avoid these deterrents.

Introduction

The universal response to drug abuse has habitually remained unpredictable, despite its significant public health impact. Illicit drugs remain easily available despite efforts to control availability and address associated public health consequences. A very small quantity of certain chemicals can have intense effects on individuals like damaging behavioral capacity, individuality and sometimes lethal. The deficiency or sufficiency of preventive mechanisms remains to impair the condition. In many regions, illicit substances remain more accessible than treatment options. For instance, in the United States, reports have emerged of adolescents as young as 12 are subjected to overdoses (OD) from drugs like fentanyl. This issue is not confined to one region across the Middle East and war-torn regions, refugees are often exploited for drug trafficking. The global challenge of substance abuse remains persistent and complex [1,2,3]. With over 700,000 deaths in the US due to OD since 2000 and a $35 Bn Federal budget for drug control in 2020, the figures are ever escalating. 1.9 million new users are introduced to methamphetamine abuse every year [4].

Law enforcement in Colorado, US claimed to have seized more illegal Fentanyl in the nearly first half of 2022 than the last whole year combined [5]. In Table 1 we have described some statistical data of commonly abused drugs. In many Indian states, as soon as a particular drug product is banned by the law, another alternative drug comes around to fill the vacuum, and the vicious cycle continues forth. Many families in northern India blame the easy accessibility to drugs in the areas as they find themselves unable to sleep every night after losing their sons to drug toxicity and overdose. According to a report entitled “Magnitude of Substance Use in India” published by the Union Ministry of Social Justice and Empowerment in 2019, it has been asserted that even children as young as 10 years old possess knowledge about potential sources to acquire opioids. The report further indicates that approximately 2.1% of the Indian population, which amounts to approximately 2.26 crore individuals, engage in the use of opioids.

These opioids include opium and its derivatives such as poppy husk, as well as a diverse range of pharmaceutical opioids encompassing synthetic drugs. The lack of problem-oriented policing combined with the often-complex regulatory system surrounding these practices exacerbates the situation further. Some claim that before governments in certain countries imposed a ban, less risky products are available without fear. The ban only caused people to run toward riskier and more hazardous substances in search of an alternative. The cause-and-effect relationship in this regard is much more complex. Adolescents resort to drug abuse possibly due to peer influence, disturbed family stability, inability to communicate, and lack of employment. Family can be the cause as well as the driving force of treatment. But only 1 in 7 drug cases receive treatment. The direct social impacts are sometimes irreversible. Family stability, community harmony, and generational continuity are all affected and sometimes destroyed by the substance abuse problem, in addition to health impairment and threats to the quality of life. People would rather not approach the concerned authorities due to the stigma attached to this rampant problem of drug abuse. Women are more severely affected by the tragic outcomes that emerge from an existing drug problem [6].

They are left with no solution but to face violence, child abuse, economic instability, deprivation of basic resources, etc. Among the various forms of opioids, extended-release opioid products have been identified as particularly susceptible to abuse due to their elevated opioid content. This increased potency makes them highly sought after by individuals seeking intense and hazardous euphoric experiences. By circumventing the controlled-release mechanisms of these medications and opting for non-oral routes of administration, individuals subject themselves to heightened risks and potentially life-threatening “highs” [7]. The misuse and abuse of psychotropic medications extend beyond opioids, encompassing a range of drugs (Fig. 1). This issue of drug abuse presents a significant global public health concern, as it contributes to substance abuse disorder, psychiatric disorders, somatic complications, and even mortality [8]. Among the psychotropic medications commonly implicated in misuse and abuse are benzodiazepines, Z-drugs (such as zolpidem and zopiclone), and opioids.

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Chandegra, B., Raval, J. & Prajapati, P. A review on advanced formulations strategies to prevent prescription drug abuse and their impact. Discov Med 1, 123 (2024). https://doi.org/10.1007/s44337-024-00141-4