Tampering With Prescription Opioids: Nature and Extent of the Problem, Health Consequences, and Solutions

Am J Drug Alcohol Abuse. 2011 Jul;37(4):205-17. doi: 10.3109/00952990.2011.569623. Epub 2011 Apr 26.


Background: Transdermal and solid oral prescription opioid (PO) formulations can be abused by ingesting (with or without tampering), snorting, or injection (both requiring tampering).

Objective: To determine the patterns of tampering with POs for abuse.

Methods: Information was collected from published studies and databases.

Results: Tampering with POs for abuse is common practice. Ingestion is the most prevalent method of abuse, followed by snorting and injection. From 1992 to 2002, injecting POs has decreased in favor of ingesting and snorting. Methods of abuse vary widely by product. Abuse methods with the highest morbidity are injection and inhalation.

Conclusions: The seriousness of health outcomes associated with tampering with POs warrants the development of PO formulations that prevent or deter tampering.

Publication types

  • Review

MeSH terms

  • Administration, Intranasal
  • Administration, Oral
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / adverse effects*
  • Behavior, Addictive / epidemiology*
  • Behavior, Addictive / mortality
  • Behavior, Addictive / prevention & control
  • Chemistry, Pharmaceutical / methods
  • Chemistry, Pharmaceutical / statistics & numerical data*
  • Databases, Factual
  • Health Surveys
  • Humans
  • Injections, Intravenous / statistics & numerical data
  • Prevalence
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / mortality
  • Substance-Related Disorders / prevention & control
  • Substance-Related Disorders / psychology*
  • United States / epidemiology


  • Analgesics, Opioid