{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:36:42Z","timestamp":1790613402780,"version":"4.1.0"},"reference-count":59,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T00:00:00Z","timestamp":1733097600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The largest rural outbreak of human immunodeficiency virus (HIV) in the US was centered in Scott County, Indiana, and linked to injection practices involving the opioid Opana ER (oxymorphone extended release [ER] reformulated). We examined supply trends using pharmacy transactions of Opana ER in Scott and all US counties from January 2007 to December 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We calculated the monthly morphine milligram equivalents (MME) of Opana ER (and its competitor OxyContin) in pharmacies using the Automation of Reports and Consolidated Orders System (ARCOS) database from the Washington Post. We modeled the MME rate per capita in Scott County and five geographic comparators in seven distinct time periods including the market introduction of abuse deterrent formulations of both drugs and the HIV outbreak period (circa 2014).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After Opana ER introduction, transaction rates surged in Scott County, where annual OxyContin MMEs were already seven\u2010fold higher than Indiana overall (CY2009: 46.8 vs. 6.8\u2009MME\/pop., respectively). Immediately after OxyContin's reformulation, the Opana ER growth rate in Scott County surpassed all geographic comparators modeled (~27 times faster than the US, 1.28 vs. 0.047\u2009MME\/pop\/month, respectively). By 2012, prior to the outbreak, MMEs from Opana ER almost perfectly replaced the diminishing OxyContin supply. When Opana ER with INTAC was subsequently introduced, pharmacy transactions declined precipitously by nearly 50%, persisting through the HIV outbreak period and market withdrawal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Opana ER rapidly supplanted OxyContin in a vulnerable population that was at heightened risk for HIV who subsequently faced an immediate supply shock after its reformulation. Pharmacy transactions are critical for suspicious order monitoring and pharmacovigilance by US and international agencies especially during deleterious supply shocks in legal and illicit drug markets.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70066","type":"journal-article","created":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T23:48:56Z","timestamp":1733183336000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Oxymorphone and Oxycodone Pharmacy Purchases in US Counties: Prelude to the Largest Rural Human Immunodeficiency Virus Outbreak in US History"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7214-0326","authenticated-orcid":false,"given":"Chris","family":"Delcher","sequence":"first","affiliation":[{"name":"Institute for Pharmaceutical Outcomes and Policy College of Pharmacy, University of Kentucky  Lexington Kentucky USA"},{"name":"Department of Pharmacy Practice and Science College of Pharmacy, University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Statistics College of Arts and Sciences, University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Romanelli","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science College of Pharmacy, University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Logan","family":"Gaskill","sequence":"additional","affiliation":[{"name":"Institute for Pharmaceutical Outcomes and Policy College of Pharmacy, University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary L.","family":"Surratt","sequence":"additional","affiliation":[{"name":"Department of Behavioral Science College of Medicine, University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,2]]},"reference":[{"issue":"16","key":"e_1_2_9_2_1","first-page":"443","article-title":"Community Outbreak of HIV Infection Linked to Injection Drug Use of Oxymorphone\u2014Indiana","volume":"64","author":"Conrad C.","year":"2015","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1515195"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103018(18)30176\u20100"},{"key":"e_1_2_9_5_1","unstructured":"US Centers for Disease Control and Prevention \u201cAtlasPlus \u201d2022 https:\/\/gis.cdc.gov\/grasp\/nchhstpatlas\/tables.html."},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461\u2010017\u20101688\u20107"},{"key":"e_1_2_9_7_1","unstructured":"\u201cScott County Cases by Week \u201dGitHub accessed August 7 2024 https:\/\/github.com\/fcrawford\/indiana\u2010hiv\/blob\/master\/data\/scott_county_cases_by_week.csv."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6626a4"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.390"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.3043"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1204141"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1257\/pol.20170082"},{"key":"e_1_2_9_13_1","unstructured":"Food and Drug Administration \u201cEndo Pharmaceuticals Inc.; Withdrawal of Approval of a New Drug Application for OPANA (Oxymorphone Hydrochloride) Extended\u2010Release Tablets.\u201d(2020)."},{"issue":"4","key":"e_1_2_9_14_1","article-title":"Opana ER Pulled From Market Due to Abuse\u2010Related Disorders","volume":"3","author":"Yan J.","year":"2017","journal-title":"Psychopharmacology"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108618"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12337"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000001034"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000511"},{"key":"e_1_2_9_19_1","unstructured":"U.S. Food & Drug Administration \u201cPress Announcements\u2014FDA Requests Removal of Opana ER for Risks Related to Abuse \u201d2017 https:\/\/www.fda.gov\/NewsEvents\/Newsroom\/PressAnnouncements\/ucm562401.htm."},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001098"},{"key":"e_1_2_9_21_1","unstructured":"\u201cNCHS Data Visualization Gallery\u2014Drug Poisoning Mortality \u201d2023 https:\/\/www.cdc.gov\/nchs\/data\u2010visualization\/drug\u2010poisoning\u2010mortality\/index.htm."},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3690"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/15360288.2019.1686098"},{"key":"e_1_2_9_24_1","unstructured":"\u201cU.S. Opioid Prescribing Rate Maps | Drug Overdose | CDC Injury Center \u201daccessed September 12 2019 https:\/\/www.cdc.gov\/drugoverdose\/maps\/rxrate\u2010maps.html."},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103686"},{"key":"e_1_2_9_26_1","unstructured":"\u201cOpioid Dispensing Rate Maps | Overdose Prevention | CDC \u201daccessed November 4 2024 https:\/\/www.cdc.gov\/overdose\u2010prevention\/data\u2010research\/facts\u2010stats\/opioid\u2010dispensing\u2010rate\u2010maps.html."},{"key":"e_1_2_9_27_1","unstructured":"S.Rich P.Moody andK.Schaul \u201cHow Deeply Did Prescription Opioid Pills Flood Your County? See Here \u201dWashington PostOctober 14 2023 https:\/\/www.washingtonpost.com\/investigations\/interactive\/2023\/opioid\u2010epidemic\u2010pain\u2010pills\u2010sold\u2010oxycodone\u2010hydrocodone\/."},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108501"},{"key":"e_1_2_9_29_1","unstructured":"S.Rich M. S.D\u00edez andK.Vongkiatkajorn \u201cHow to Download and Use the DEA Pain Pills Database \u201dWashington Post September 13 2023 https:\/\/www.washingtonpost.com\/national\/2019\/07\/18\/how\u2010download\u2010use\u2010dea\u2010pain\u2010pills\u2010database\/<datafile."},{"key":"e_1_2_9_30_1","unstructured":"\u201cUniversity of California at San Francisco Johns Hopkins University. Opioid Industry Documents \u201dThe Washington Post Opioid Collection July 12 2024 https:\/\/www.industrydocuments.ucsf.edu\/opioids\/collections\/washington\u2010post\u2010opioid\u2010collection\/."},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.6989"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000948"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.4020"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2018.01.034"},{"key":"e_1_2_9_35_1","unstructured":"\u201cMedi\u2010Span Generic Product Identifier (GPI) \u201daccessed August 3 2024 https:\/\/www.wolterskluwer.com\/en\/solutions\/medi\u2010span\/about\/gpi."},{"key":"e_1_2_9_36_1","unstructured":"US Centers for Disease Control and Prevention \u201cVulnerable Counties and Jurisdictions Experiencing or At\u2010Risk of Outbreaks \u201daccessed December 19 2020 https:\/\/www.cdc.gov\/pwid\/vulnerable\u2010counties\u2010data.html."},{"key":"e_1_2_9_37_1","unstructured":"R Core Team \u201cR: The R Project for Statistical Computing \u201d2023 https:\/\/www.r\u2010project.org\/."},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517\u20106161.1954.tb00159.x"},{"key":"e_1_2_9_39_1","doi-asserted-by":"crossref","unstructured":"Y.Duan B.Emir G.Bell J.Cabrera andP.Inc \u201ctwopartm: Two\u2010Part Model with Marginal Effects \u201d2022 https:\/\/cran.r\u2010project.org\/web\/packages\/twopartm\/index.html.","DOI":"10.32614\/CRAN.package.twopartm"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2020.102848"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3723"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.12.003"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1507252"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12295"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2019.106268"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1406143"},{"key":"e_1_2_9_47_1","unstructured":"\u201cRural America Finds New Killer in Drug Opana \u201dNBC News March 27 2012 https:\/\/www.nbcnews.com\/id\/wbna46870731."},{"key":"e_1_2_9_48_1","unstructured":"\u201cDEA Attacks Indiana Opana Painkiller Epidemic \u201daccessed July 4 2024 https:\/\/www.dea.gov\/press\u2010releases\/2016\/02\/05\/dea\u2010attacks\u2010indiana\u2010opana\u2010painkiller\u2010epidemic."},{"key":"e_1_2_9_49_1","volume-title":"Agrees to Global Resolution of Criminal and Civil Investigations Into Sales and Marketing of Branded Opioid Drug","author":"Office of Public Affairs","year":"2024"},{"key":"e_1_2_9_50_1","unstructured":"Automation of Reports and Consolidated Orders System (ARCOS) Retail Drug Summary Reports. US Department of Justice. Drug Enforcement Administration. June 10 2018 https:\/\/www.deadiversion.usdoj.gov\/arcos\/."},{"key":"e_1_2_9_51_1","unstructured":"\u201cOpioid Industry Documents \u201daccessed July 12 2024 https:\/\/www.industrydocuments.ucsf.edu\/opioids\/."},{"key":"e_1_2_9_52_1","unstructured":"United States General Accountability Office \u201cActions Needed to Ensure Usefulness of Data on Suspicious Opioid Orders.\u201d(2020)."},{"key":"e_1_2_9_53_1","unstructured":"HealthData.gov \u201cHealthData.gov \u201daccessed August 7 2024 https:\/\/healthdata.gov\/."},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jix307"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2023.00146"},{"key":"e_1_2_9_56_1","unstructured":"K. R.Villa \u201cConsequences of 2014 Legislation on Controlled Substance Dispensing Patterns and Utilization of the Indiana Prescription Drug Monitoring Program: A Three Year Review\u201d(thesis Purdue University Graduate School)."},{"key":"e_1_2_9_57_1","unstructured":"Indiana State Medical Association \u201cIndiana Pain Management Prescribing Final Rule (Summary).\u201d(2016)."},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010018\u20102830\u20106"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2020.102408"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002769"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T03:32:41Z","timestamp":1735788761000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.70066"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":59,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/pds.70066"],"URL":"https:\/\/doi.org\/10.1002\/pds.70066","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]},"assertion":[{"value":"2024-04-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70066"}}