Positive and negative subjective effects of extended-release oxymorphone versus
controlled-release oxycodone in recreational opioid users.
Author(s): Schoedel KA, McMorn S, Chakraborty B, Potts SL, Zerbe K, Sellers EM.
Affiliation(s): Kendle Early Stage, Toronto, Ontario, Canada.
Publication date & source: 2011, J Opioid Manag. , 7(3):179-92
OBJECTIVE: To compare the subjective effects of oxymorphone extended release
(OM-ER) versus oxycodone controlled release (OC-CR).
DESIGN: Randomized, double-blind, crossover study.
SETTING: Inpatient unit.
SUBJECTS: Healthy, nondependent recreational opioid users.
INTERVENTIONS: Single intact oral tablets that were placebo or contained OM-ER
(15 and 30 mg) or OC-CR (30 and 60 mg). Doses were representative of mid-range
doses for chronic pain and were calculated using an established opioid conversion
table.
MAIN OUTCOME MEASURES: Visual Analog Scales, Subjective Drug Value (SDV), and
Addiction Research Center Inventory (ARCI) measured positive, negative, and
balance effects and pupillometry. Equianalgesic comparisons were between OM-ER 15
mg versus OC-CR 30 mg (low doses) and OM-ER 30 mg versus OC-CR 60 mg (high
doses).
RESULTS: Thirty-five subjects received all five treatments. Positive subjective
effects were lower for OM-ER 15 mg versus OC-CR 30 mg and for OM-ER 30 mg versus
OC-CR 60 mg in ARCI Morphine Benzedrine Group (< or = 0.01 for both), Good
Effects (p < 0.001 for both), Rush (p < 0.001 for both), and High VAS (p < 0.001
for both). Nausea was higher with OC-CR (p < or = 0.02), and Bad Effects were
higher for OC-CR 60 mg versus OM-ER 30 mg (p < 0.001). Balance effects were lower
for OM-ER versus OC-CR (Drug Liking, p < 0.001; Overall Drug Liking, p < or =
0.006; SDV, p < or = 0.008), except for Take Drug Again (p < 0.001 for OC-CR 30
mg versus OM-ER 15 mg; p = 0.18 for high-dose group). Euphoric mood, nausea,
somnolence, vomiting, and dizziness were more common with OC-CR than OM-ER.
LIMITATIONS: Single-dose design; use of healthy, recreational opioid users.
CONCLUSIONS: At equianalgesic doses, single oral intact OM-ER produced lower
positive, negative, and balance subjective effects than OC-CR, indicating that
analgesic potency may not necessarily be reflected in subjective/objective
effects.
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