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First-Ever Systematic Analysis of Internet Chatter Yields Scientifically Reliable Data on Prescription Opioid Abuse-Related Mentions
4 May 2006 Findings from the first-ever systematic Internet surveillance program for abusable prescription opioid analgesics suggest that surveillance of Internet chatter yields reliable information about the quantity and nature of discussion about specific products, according to data presented by Inflexxion(R) at the 25th Annual Scientific Meeting of the American Pain Society.
The study, led by Co-Principal Investigators Stephen Butler, Ph.D. and Nathaniel Katz, M.D., M.S., specifically analyzed Internet chatter about three target dugs: OxyContin(R) (oxycodone HCl controlled-release), Vicodin(R) (hydrocodone/acetaminophen) and KADIAN(R) (morphine sulfate extended-release) Capsules, finding that the number of Internet posts endorsing recreational use of KADIAN(R) was significantly less than OxyContin(R) and Vicodin(R) even in proportion to the number of prescriptions written for each product.(1) The study was conducted in response to both growing concern about prescription opioid abuse as well as increasing recognition of Internet monitoring as a potentially informative surveillance tool. Researchers at Inflexxion, Inc. developed the pilot Internet surveillance program to monitor rates and trends in the abuse of specific prescription opioids.
"This study moves one important step further towards a scientific approach to monitoring the Internet for trends in prescription opioid abuse," explained study author Nathaniel Katz, MD, MS, Adjunct Assistant Professor of Anesthesia at Tufts University School of Medicine and Vice President for Medical Affairs at Inflexxion, Inc. "While further work is required, we found that KADIAN(R) was associated with fewer Internet mentions and fewer mentions endorsing abuse than the other products."
From 2002 to 2003, there was a significant increase in lifetime nonmedical use of pain relievers among persons aged 12 or older, from 29.6 million to 31.2 million.(2) The combined cost of prescription opioid abuse for law enforcement, health care providers and employers in 2001 was approximately $9.2 billion.(3)
Program Design
Researchers developed a coding system designed to quantify discussions of abusable pharmaceutical analgesics mentioned in posts to message boards where those who abuse these drugs communicate with one another. Three such Internet message boards were selected for analysis because their participants frequently discuss drug abuse. The entire database of all posts collected from the Web sites during the six months of the study was then analyzed to determine the number of times a target drug was mentioned and the number of posts that contained at least one mention of one of the target drugs. Posts that contained a mention of one of the target drugs were flagged for further analysis.(4)
Researchers used a rating system developed and validated for coding each abuse-related mention as "positive" (endorses or promotes using the drug in any way other than how it is prescribed), "negative" (expresses a barrier to recreational use such as being too dangerous, too expensive, too hard to obtain, etc.) or "both" (posts that contain both positive and negative material related to the drug).(5)
Results
A total of 48,293 individual posts were harvested and analyzed. Of these, 236 individual posts were randomly selected for further analysis, including 100 OxyContin(R) -related posts and 113 Vicodin(R) -related posts. Because there were only a total of 22 posts that contained a mention of KADIAN(R) all were included in the final coding sample. Researchers analyzed the 276 unique verbatim drug mentions within the posts (e.g., posts that addressed only one of the drugs). Of the total 276 mentions of target drugs within the 236 randomly selected posts, 136 (49.3%) were OxyContin(R), 118 (42.8%) were Vicodin(R), and 22 (8%) were KADIAN(R).(6)
Researchers noted one statistically significant difference among the three target drugs: the percentage of KADIAN(R) mentions coded as "positive" (45.5 %) was significantly less than that of OxyContin(R) (68.4%, p=0.036 versus KADIAN(R)), and numerically less than that of Vicodin(R) (57.6%, p=0.291 versus KADIAN(R)).(7)
"While more research is needed, this study demonstrates that Internet posts can be reliably analyzed and can reveal significant trends regarding opioid abuse as viewed through the lens of Internet mentions," concluded Dr. Katz. "These types of data are one tool to help health professionals, policy makers and other stakeholders develop new and better approaches to managing opioid abuse. Other important approaches where progress is being made include improved post-marketing surveillance methods, better interventions when problems are found, and the development of abuse-resistant opioid formulations."
This project was supported by Alpharma Brand Products Division Inc. Alpharma Branded Products has a growing franchise in the chronic pain market with its morphine-based extended release KADIAN(R) product. KADIAN(R) is indicated for the management of moderate to severe pain when a continuous, around-the-clock opioid analgesic is needed for an extended period of time.
KADIAN(R) (morphine sulfate extended-release) Capsules contain an opioid agonist which is a Schedule II controlled substance. KADIAN(R) has an abuse liability similar to other opioid analgesics. This should be considered when prescribing or dispensing KADIAN(R) in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion.
KADIAN(R) capsules are to be swallowed whole and are not to be chewed, dissolved, or crushed. Taking chewed, dissolved, or crushed KADIAN(R) capsules or pellets leads to rapid release and absorption of a potentially fatal dose of morphine.
Patients must not consume alcoholic beverages while on KADIAN(R) therapy. The use of alcohol while taking KADIAN(R) may result in a significant increase in the release rate and absorption of a potentially fatal dose of morphine.
For full prescribing information on KADIAN(R), visit http://www.KADIAN.com.
About Inflexxion Inc.
Inflexxion, Inc. (http://www.inflexxion.com) is a science-based health care technology company. Using computer mediated technologies, Inflexxion brings creative and innovative solutions to consumer and provider education, risk management and quality improvement approaches in all aspects of health care. The company draws upon the unique skills of psychologists, scientists, software engineers and graphic designers, to develop products characterized by their ability to engage the user, change behaviors, and take advantage of multimedia technologies. Inflexxion Inc. is based in Newton, Mass.
KADIAN(R) is a licensed trademark of Alpharma Branded Products Division Inc.; ALPHARMA(R) is a registered trademark of Alpharma Inc.; OxyContin(R) is a registered trademark of Purdue Pharma L.P.; Vicodin(R) is a registered trademark of Abbott Laboratories.
References
(1) Butler S, Katz N, Venuti S, Benoit C, Beaulaurier R. Content
analysis and monitoring of Internet prescription opioid abuse-
related postings. [Poster]. Presented at: American Pain Society 25th
Annual Meeting; May 3-6, 2006; San Antonio, TX.
(2) The National Institute of Health / National Institute on Drug Abuse
Web sites. NIDA InfoFacts: Prescription Pain and Other Medications.
http://www.drugabuse.gov/infofacts/PainMed.html. Last accessed
4/10/06.
(3) White AG, Birnbaum HG, Mareva MN, Daher M, Vallow S, Schein J,
Katz N., Journal of Managed Care Pharmacy. 2005 Jul-Aug; 11(6):
469-79.
(4) Butler S, Katz N, Venuti S, Benoit C, Beaulaurier R. Content
analysis and monitoring of Internet prescription opioid abuse-
related postings. [Poster]. Presented at: American Pain Society 25th
Annual Meeting; May 3-6, 2006; San Antonio, TX.
(5) IBID.
(6) IBID.
(7) IBID.
Source: prnewswire
All trademarks and copyrighted information contained herein are the property of their respective owners.
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