Paul Gileno’s piece is spot on and something that is often forgotten in the prescription drug abuse issue that has swept our nation. He brought up the issue of Abuse Deterrent Formulations (ADF) for certain prescription drugs that are highly abused.

The ADF are much more difficult to break down for snorting or injecting, making it far less desirable to the typical addict.

The reformulation of OxyContin® probably represents the best example considering it was a major drug of abuse until reformulated with an ADF in August 2010. Once the old formulation was no longer on retail pharmacy shelves, the abuse and diversion of OxyContin® took a huge plunge downward. In addition, street values also plummeted and the attraction to this once highly sought after drug became far less with the formulation change.

Of course, multiple doses can be taken at the same time, but those who consistently inject or snort their prescription drug of choice will not be interested in swallowing intact pills or capsules. Obtaining that true “rush” into their bodies requires much more immediate administration found in snorting and injecting the substance.

Although some claim it is merely a coincidence, but just before the reformulation of OxyContin® it was obvious that cartels began to ramp up the availability of cheap heroin. I firmly believe it was good marketing on their part, and since then this nation has been inundated with heroin and heroin overdose deaths.

Some have even blamed the pharma companies for the heroin deaths due to the ADF pharmaceuticals! I find that deduction incredible, but it does exist.

The ADF pharmaceuticals will undoubtedly be more expensive, but sometimes it comes down to pay me now or pay me much more later. The more widespread these ADF’s become available it will have a positive impact on prescription drug abuse, and possibly save countless lives, at least due to prescription drug overdoses.

The one thing we all need to understand is that those burdened with addiction will not simply stop their abuse because of ADF. They will continue to find heroin, and other drugs to satisfy their cravings. This is why most experts agree that in addition to enforcement, rehabilitation and prevention/education represent the three programs that have to work together to make any meaningful difference.

All of this adds up to the most important part of ADF technology and that is it helps to protect legitimate patients’ access to these drugs. The vast majority of controlled substances that are dispensed in the United States end up in the hands of legitimate patients, not abusers.

These patients are the many who desperately need them in an attempt to live a somewhat normal life with chronic pain. They are the citizens that all of us wanting to positively impact the problem should be working toward providing them help and not forgetting them in the push to solve this dilemma.

It will be interesting as more and more pharma companies move forward with ADF for their controlled substances. This not only makes the FDA happy, it will ultimately improve the quality of life for those in pain.

John J. Burke is the past president of the National Association of Drug Diversion Investigators ( ) a non-profit organization, and is the owner and president of Pharmaceutical Diversion Education Inc. of Bethel, Ohio, a company which provides education and consulting work on a wide variety of prescription drug abuse issues to law enforcement, health professionals, and the pharmaceutical industry ( 

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