Are there any extended release opioids that can be crushed without causing harm?
Until recently, there were no extended release opioid products that were safe to crush. In fact, there is a black box warning to caution against crushing or splitting all ER or long acting (LA) dosage units, with the exception of one product as of the publication date. A new microsphere-in-capsule technology known as DETERx is now available for patients with dysphagia or feeding tubes that allows the powdery wax-based content of each capsule to be dispersed in soft foods or drinks, or emptied into feeding tubes. Crushing or any mechanical manipulation does not affect the dosage form or cause rapid release of the product. The DETERx technology is also abuse deterrent in individuals who deliberately attempt to bypass extended-release technology by crushing contents for the euphoric effects from dose dumping. Even with snorting, the DETERx technology does not allow for rapid bioavailability of opened capsules. Oxycodone ER is already available as Xtampza, and a similar dosage form of hydrocodone is on the way.
