Q: What is OxyContin?
Q: How is OxyContin Used?
Q: How is OxyContin Abused?
Purdue Pharma, OcyContin’s manufacturer, has taken steps to reduce the potential for abuse of the medication. Its Web site lists the following initiatives aimed at curbing the illicit use of OxyContin: providing physicians with tamper-proff prescription pads, developing and distributing more then 400,000 brochures to send to pharmacists and healthcare professionals to help educate them about how to prevent diversion, working with healthcare and law enforcement officials to address the problem of prescription drug abuse, and helping to fund a study of the best practices in Prescription Monitoring Programs. In addition, the company is attempting to research and develop other pain management products that will be more resistant to abuse and diversion. The company estimates that it will take significant time for such products to be brought to market. For information, visit Purdue Pharma’s Web site at www.pharma.com
or call them at 203-588-8069.
Q: How Does OxyContin Abuse Differ From Abuse of Other Pain Prescriptions?
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 then OxyContin that is purchased illegally.
Q: What is the Likelihood That a Person for Whom OxyContin Is Prescribed Will Become Addicted?
Q: How Can I Determine Whether a User Is Dependent on Rather Than Addicted to OxyContin?
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 over activity 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.
Treatment and Detoxification Protocols
OxyContin® is a powerful drug that contains a much larger amount of the active ingredient, oxycodone, then other prescription opiate pain relievers. While most people who take OxyContin as prescribed do not become addicted, those who abuse their pain medication or obtain it illegally may find themselves becoming rapidly dependent on, if not addicted to, the drug.
Two types of treatment have been documented as effective for opioid addiction. One is a long-term, residential, therapeutic community type of treatment and the other is long-term, medication-assisted outpatient treatment.
All material appearing in this report was reported from the Center for Substance Abuse Treatment. “OxyContin®: Prescription Drug Abuse.” Substance Abuse Treatment Advisory. Volume 1, Issue 1, April 2001. It is in the public domain and may be reproduced or copied without permission.
This publication can be accessed electronically through the Internet at www.kap.samhsa.gov.
A: OxyContin is a semisynthetic opioid analgesic prescribed for chromic or long-lasting pain. The medication’s active ingredient is oxycodone, which is also found in drugs like Percodan and Tylox. 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 does to bring about pain relief because they lack the timed-release formulation.
A: OxyContin, also referred to as “Oxy,” “O.C.,” and “Killer” on the street, is legitimately prescribed as a timed-release tablet, providing as many as 12 hours of relief from chronic pain. It is often prescribed for cancer patients or those with chronic, long-lasting back pain. The benefit of the medication to chronic pain sufferers is that they generally need to take the pill only twice a day, whereas a dosage of another medication would require more frequent use to control the pain. The goal of chronic pain treatment is to decrease pain and improve function.
A: OxyContin abusers either crush the tablet and ingest or snort it or dilute it in water and inject it. Crushing or diluting the tablet disarms the timed-release action of the medication and causes a quick, powerful high. 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.
A: 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.
A: Most people who take OxyContin as prescribed do not become addicted. The National Institute on Drug Abuse (NIDA) reports: “With prolonged use of opiates and opioids, individuals become tolerant…require larger doses, and can become phusically 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 NODA-sponsored study found that “only four out of more then 12,000 patients who were given opioids for acute pain actually became addicted to the drugs…. 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.
A: 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 then it needed for pain control, especially if they take it to the high. Patients who take their medication in a manner that grossly differs from a physician’s directions are probably abusing that drug.