OxyContin® Information
What is OxyContin?
OxyContin
is the brand name for a semi-synthetic opioid analgesic containing the
active ingredient oxycodone (also found in Percocet, Percodan, and Tylox).
OxyContin is a legal narcotic that is available, by prescription, to
treat severe chronic or long-lasting pain.
However, OxyContin contains between 10 and 160 milligrams of
oxycodone in a timed-release tablet. Painkillers such as Tylox contain 5
milligrams of oxycodone and often require repeated doses to bring about
pain relief because they lack the timed-release formulation.
Street Names
OxyContin is also known as Oxy, O.C., OxyCotton, Oxy 80 (for the 80mg
dose), or "killer".
What does OxyContin look like?
OxyContin
most commonly exists in tablet form. These round pills come in 10mg,
20mg, 40mg, 80mg and 160mg dosages. OxyContin also comes in capsule or
liquid form.
Oxycontin Abuse
Because OxyContin is a controlled-release medication, when used
correctly it provides extended relief of pain associated with cancer,
back pain, or arthritis.
OxyContin abusers either crush the tablet and ingest or snort it or
dilute it in water and inject it. Some abusers even chew it. Crushing or
diluting the tablet disarms the timed-release action of the medication
and causes a quick, powerful high. Eliminating the time-release factor
allows for a quick and intense rush to the brain. Abusers have compared
this feeling to the euphoria they experience when taking heroin. In
fact, in some areas, the use of heroin is overshadowed by the abuse of
OxyContin.
This practice can lead to overdosing on OxyContin's active
ingredient, oxycodone, by releasing too much of the medication into the
bloodstream too quickly. OxyContin is highly addictive -- so higher
doses of the drug must be taken when a tolerance develops. Illicit users
of the drug have risen drastically and steadily over the last few years.
OxyContin Abuse Differs From Abuse of Other Pain Prescriptions
Abuse of prescription pain medications is not new. Two primary
factors, however, set OxyContin abuse apart from other prescription drug
abuse. First, OxyContin is a powerful drug that contains a much larger
amount of the active ingredient, oxycodone, than other prescription pain
relievers. By crushing the tablet and either ingesting or snorting it,
or by injecting diluted OxyContin, abusers feel the powerful effects of
the opioid in a short time, rather than over a 12-hour span. Second,
great profits are to be made in the illegal sale of OxyContin. A
40-milligram pill costs approximately $4 by prescription, yet it may
sell for $20 to $40 on the street, depending on the area of the country
in which the drug is sold.
OxyContin can be comparatively inexpensive if it is legitimately
prescribed and if its cost is covered by insurance. However, the
National Drug Intelligence Center reports that OxyContin abusers may use
heroin if their insurance will no longer pay for their OxyContin
prescription, because heroin is less expensive than OxyContin that is
purchased illegally.
OxyContin Abuse Linked to Crime
Many reports of OxyContin abuse have occurred in rural areas that
have housed labor-intensive industries, such as logging or coal mining.
These industries are often located in economically depressed areas, as
well. Therefore, people for whom the drug may have been legitimately
prescribed may be tempted to sell their prescriptions for profit.
Substance abuse treatment providers say that the addiction is so strong
that people will go to great lengths to get the drug, including robbing
pharmacies and writing false prescriptions.
OxyContin Is Highly Addictive
Most people who take OxyContin as prescribed do not become addicted,
but they may become somewhat physically dependent (there is a
difference).
The National Institute on Drug Abuse (NIDA) reports: "With
prolonged use of opiates and opioids, individuals become tolerant . . .
may require larger doses, and can become physically dependent on the
drugs . . . studies indicate that most patients who receive opioids for
pain, even those undergoing long-term therapy, do not become addicted to
these drugs."
One NIDA-sponsored study found that "only four out of more than
12,000 patients who were given opioids for acute pain actually became
addicted to the drug. In a study of 38 chronic pain patients, most of
whom received opioids for 4 to 7 years, only 2 patients actually became
addicted, and both had a history of drug abuse."
In short, most individuals who are prescribed OxyContin, or any other
opioid, will not become addicted, although they may become dependent on
the drug and will need to be withdrawn by a qualified physician.
Individuals who are taking the drug as prescribed should continue to do
so, as long as they and their physician agree that taking the drug is a
medically appropriate way for them to manage pain.
Determining OxyContin Dependence vs. Addiction
When pain patients take a narcotic analgesic as directed, or to the
point where their pain is adequately controlled, it is not abuse or
addiction. Abuse occurs when patients take more than is needed for pain
control, especially if they take it to get high. Patients who take their
medication in a manner that grossly differs from a physician's
directions are probably abusing that drug.
If a patient continues to seek excessive pain medication after pain
management is achieved, the patient may be addicted. Addiction is
characterized by the repeated, compulsive use of a substance despite
adverse social, psychological, and/or physical consequences. Addiction
is often (but not always) accompanied by physical dependence, withdrawal
syndrome, and tolerance. Physical dependence is defined as a physiologic
state of adaptation to a substance. The absence of this substance
produces symptoms and signs of withdrawal. Withdrawal syndrome is often
characterized by overactivity of the physiologic functions that were
suppressed by the drug and/or depression of the functions that were
stimulated by the drug. Opioids often cause sleepiness, calmness, and
constipation, so opioid withdrawal often includes insomnia, anxiety, and
diarrhea.
Pain patients, however, may sometimes develop a physical dependence
during treatment with opioids. This is not an addiction. A gradual
decrease of the medication dose over time, as the pain is resolving,
brings the former pain patient to a drug-free state without any craving
for repeated doses of the drug. This is the difference between the
formerly dependent pain patient who has now been withdrawn from
medication and the opioid-addicted patient: The patient addicted to
diverted pharmaceutical opioids continues to have a severe and
uncontrollable craving that almost always leads to eventual relapse in
the absence of adequate treatment. It is this uncontrollable craving for
another "rush" of the drug that differentiates the
"detoxified" but opioid-addicted patient from the former pain
patient. Theoretically, an opioid abuser might develop a physical
dependence, but obtain treatment in the first few months of abuse,
before becoming addicted. In this case, supervised withdrawal
(detoxification) followed by a few months of abstinence-oriented
treatment might be sufficient for the non-addicted patient who abuses
opioids. If, however, this patient subsequently relapses to opioid
abuse, then that would support a diagnosis of opioid addiction. After
several relapses to opioid abuse, it becomes clear that a patient will
require long-term treatment for the opioid addiction.
Short-term Effects
The most serious risk associated with OxyContin is respiratory
depression. Because of this, OxyContin should not be combined with other
substances that slow down breathing, such as alcohol, antihistamines
(like some cold or allergy medication), barbiturates, or
benzodiazepines.
Other common side effects include constipation, nausea, sedation,
dizziness, vomiting, headache, dry mouth, sweating, and weakness.
Toxic overdose and/or death can occur by taking the tablet broken,
chewed, or crushed. People who abuse the drug (by removing the
time-release coating) will experience effects for up to 5 hours. The
high that is felt is opiate-like -- a sedate, euphoric feeling.
Long-term Effects
Using OxyContin chronically can result in increased tolerance to the
drug in which higher doses of the medication must be taken to receive
the initial effect. Over time, OxyContin will be come physically
addictive, causing a person to experience withdrawal symptoms when the
drug is not present. Symptoms of withdrawal include restlessness, muscle
and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose
bumps, and involuntary leg movements.
Sources: American Council for Drug Education,
National Institute of Drug Information, US Dept. of Health and Human
Services (SAMHSA).
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