Drugs With High Abuse Potential Six Times More Likely to Be Approved for Pain Medication, Study Finds

An illustration image shows tablets of opioid painkiller Oxycodone, a prescription drug. Eric Baradat/AFP via Getty Images

A study has found that drugs with high abuse potential are around six times more likely to be approved as compared to drugs with low abuse potential for pain medications.

“The probability of successful development programs was 27.8 percent for high abuse potential compounds and 4.7 percent for low abuse potential compounds,” the authors wrote in the study.

New studies on potentially addictive pain medications have reduced since the peak of the opioid epidemic in 2010. Drugs with higher likelihood of abuse are still more likely to pass clinical trials and get approved, compared to drugs with low likelihood of drug abuse, according to the study.

Though authors could not give a reason for why less addictive drugs are less likely to be approved throughout the development and enter the market, probable reasoning is that the more effective the drug, the greater the impact it will have on brain chemistry, creating reliance. Therefore, powerful painkillers such as oxycodone and hydrocodone are also some of the most abused painkillers, and easily abused drugs have greater potential to hit the market.

High Demand For Novel Pain Medications But Low Output

The demand for pain medications is high, currently around 20 percent of Americans are affected by chronic pain, though the figures are expected to be higher once acute pain is also taken into account.

However, the authors compared pharmaceutical databases both in the UK and in the United States and found that statistically, out of 10 medications going into drug development, only one would enter the market. Drugs with low abuse potential would have a lot lower likelihood of hitting the shelves as compared to drugs that are more powerful.

“On the one hand, we had patients who were simply asking for their pain to be addressed. On the other hand, physicians had very little in their pharmaceutical toolbox that was either remarkably effective, non-addictive or lacked major side effects,” said one of the co-authors Dr. Dermot Maher in a press release on the study.

There are many factors that impact the progression of potential medication, such as funding, lack of efficacy, safety signals, and more.

The authors argue that a major reason is that researchers often do not understand why certain drugs work better than others. This not only impacts clinical decisions during drug development, as well as investment and development confidence, as it leads to investments and development in “more well-understood therapeutic areas,” such as opioid-based pain relievers.

Maher said however that it is possible to develop successful pain medications, reasoning that the medications that were successful were because researchers understood the underlying biological mechanism.

“We can increase our understanding of pain mechanisms and target the development of new pain treatments to address this unmet medical need.”

“The development of effective pain treatments without the potential for abuse should continue to be the pharmaceutical industry’s goal in pain medication development,” the authors concluded.