Health officials in Tennessee are reporting cases of a rare
blood-clotting disorder in people who injected the painkiller Opana ER
(extended release), after crushing the pills. Fifteen cases of the
disorder were linked to intravenous drug abuse, and 14 were linked
specifically to Opana ER.
The disorder, thrombotic thrombocytopenic purpura (TTP), is usually seen in about one in 100,000 people, HealthDay
reports. It causes blood clots to form in small blood vessels around
the body. If untreated, the disorder can be fatal. None of the Tennessee
patients died. Seven were treated for sepsis, which is potentially
fatal.
Opana ER is meant to be taken orally. The Centers for Disease Control and Prevention (CDC) notes in its Morbidity and Mortality Weekly Report
that some people seeking euphoria-inducing effects crush the tablets to
snort them or dissolve them for injection. A new formulation of the
drug, designed to make it more difficult to crush or dissolve the
tablets, was released in February 2012.
Dr. Leonard Paulozzi, a medical epidemiologist at the CDC, told
HealthDay that snorting or injecting Opana allows the drug to enter the
bloodstream more quickly. “Apparently, the amount of euphoria associated
with the drug is associated with how fast the drug level rises in your
bloodstream,” he said.
It is not known why the Opana ER might lead to the blood-clotting
disorder, said Dr. David Kirschke, Deputy State Epidemiologist for the
Tennessee Department of Health. The CDC is advising doctors who
prescribe Opana, and pharmacists who fill prescriptions for it, to tell
patients about the risks of the drug when it is used other than as
prescribed.
In October, the Food and Drug Administration warned about the risk of developing TTP from injecting Opana ER.
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