- Introduction of "tamper-proof" OxyContin in 2010 may have compelled addicts to shift to heroin, thereby precipitating a dramatic rise in HCV rates, according to a study from the nonprofit RAND Corporation.
Why this matters
- “While considerable policy attention is being given to managing the opioid epidemic—in particular, the rising mortality rates associated with heroin and synthetic opioids—a “silent epidemic” of hepatitis C has emerged,” the authors write, noting the possibility of a rise in other needle-transmitted infections such as HIV.
- States with above-median OxyContin misuse before the reformulation (2004-2009) experienced a subsequent 222% increase in HCV rates during 2011-2015 (0.350 to 1.128 per 100K population).
- States with below-median misuse experienced only a 75% increase (0.260 to 0.455 per 100K).
- HCV rates (per 100K) were similar for above- and below-median misuse states during 2004-2009 (P=.28), but the gap widened during 2011-2015 (P=.01).
- The gap was initially small following discontinuation of original OxyContin in August 2010, widened rapidly in 2011, and continued to increase through 2013.
- Pattern mimics that of heroin overdoses in high-misuse states.
- HCV rates were similar when states were categorized based on non-OxyContin pain-reliever misuse, pointing to reformulated OxyContin as the driving force.
- Analysis of CDC state-level data for HCV infection rates during 2004-2015, cross-matched with data from the National Survey on Drug Use and Health.
- Funding: None disclosed.
- HCV under- or nonreported to surveillance system.
- Self-reported survey data.