OxyContin® Information
What is OxyContin?
OxyContin is the brand name for a semisynthetic 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 diference).
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, psychologic, 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 nonaddicted 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).