The new formulation, however, didn't prevent the Tennessee incidents, a health official noted.
It isn't clear why this blood condition is associated with Opana ER, said Dr. David Kirschke, deputy state epidemiologist for the Tennessee Department of Health. He speculated that something in the drug when injected might have an effect on reducing platelets.
Reformulating these drugs to make them harder to tamper with may reduce the abuse of them, Kirschke said. "Unfortunately, in this case, the condition appears to be associated specifically with the reformulated version of the medication," he said. "It could be that something was done to the pill, which may be what's causing actual illness when they do abuse it."
In light of this report, the CDC is asking doctors to ask patients with TTP-like illness about injection-drug abuse. Also, doctors who prescribe Opana and pharmacists who fill prescriptions for it should tell patients about the risks when the drug is used other than as prescribed.
Abuse of narcotic prescription painkillers is a major public health problem in the United States, according to the U.S. Substance Abuse and Mental Health Services Administration.
Since 2002, some 22 million Americans have begun abusing prescription painkillers, the agency reports.
In 2009 there were nearly 425,000 emergency department visits involving nonmedical or inappropriate use of narcotic painkillers and an estimated 15,600 deaths involving these drugs, according to Dr. Douglas Throckmorton, deputy director for regulatory programs at the Center for Drug Evaluation and Research of the U.S. Food and Drug Administration.
The FDA recently released proposed guidelines to help drug makers develop more tamper-resistant formulas of their narcotic pain drugs.
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