Abuse Deterrent Formulation Opioids

Challenge accepted! Our country has made numerous strides in advancing patient care and more, particularly attempting to ensure that lives within our national opioid crisis are saved and/or improved. One of those positive strides involves the FDA approval of abuse-deterrent formulation (ADF) prescription opioid medications, with the aim of preventing the transition from the misuse and/or abuse of prescription opioid medications to illicit (and possibly laced) diacetylmorphine (aka heroin). How do these formulations work, one might ask? What ADF opioid medications are not only available on the US market, but also specifically approved as an ADF opioid medication? Are these ADFs really foolproof? Well, the street chemists of our country have already accepted the challenge to be knowledgeable on all the above, now it’s our turn as healthcare professionals to get up to speed on these risk reduction entities. Put the potato batteries, M&M’s, and baking yeast aside: it’s time to get down and dirty to understand just how these ADF opioids work, and where their respective place in pain management treatment lies.

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Mark Garofoli,


Mark Garofoli, PharmD, MBA, BCGP, CPE is a Clinical Pain Management Pharmacist at the WVU Medicine Center for Integrative Pain Management, a faculty member in the WVU School of Medicine Pain Fellowship Program, and a Clinical Assistant Professor and Director of Experiential Learning for the West Virginia University (WVU) School of Pharmacy (SoP). Dr. Garofoli received his PharmD at the University of Pittsburgh SoP in 2004 and his MBA from Strayer University in 2008. He is board certified in Geriatric Care (BGCP) along with being a certified pain educator (CPE) and certified tobacco treatment specialist (CTTS). Dr. Garofoli began his career with CVS Health in community pharmacy management, then worked as a Humana Healthcare MTM clinical pharmacist, leading to the development of patient-centered and managed care centered programs and the Safe & Effective Management of Pain West Virginia guidelines. Mark has consulted as a CDC grant reviewer, a professional journals reviewer, a civil and criminal expert witness, and is the host of the “PAIN POD” on the Pharmacy Podcast Network with an international audience of 80,000 healthcare professionals. Mark’s professional passions lie within pain management and addiction patient care and education for healthcare professionals and society alike, in essence, trying to make a difference.

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