OxyContin, the brandname of a time-released oxycodone medication, is a prescription medication typically used for pain relief. The drug is a Schedule II controlled substance under the U.S. Drug Enforcement Administration (DEA), which means it has a medical purpose but has a strong risk of abuse. Although it has a legitimate role in many pain treatment plans, it also has a high risk of abuse and addiction.
OxyContin is an opioid pain medication, and like all opioid substances, there is a high risk of developing a dependence upon the substance. Oxycodone has been abused for more than 30 years, according to the DEA. However, OxyContin's introduction on the market in 1996 has led to an escalation in the abuse of oxycodone. Street names for the drug include Kicker, OxyCotton, Hillbilly Heroin, and OC.
Prescription drugs have become the most commonly abused drugs, especially opioid pain medication such as OxyContin. The latest data from the Results from the 2012 National Survey on Drug Use and Health, by the Substance Abuse and Mental Health Services Administration (SAMHSA) states that around 20.9 percent of the population (54 million Americans) have abused prescription drugs in their lifetime, 6.4 percent (16.6 million) have in the past year, and 2.6 percent (6.8 million) have in the past month. Pain relievers are by far the most commonly abused prescription medication, with 14.2 percent of the population (37 million people) having abused them in their lifetime, 4.8 percent (12.5 million) in the past year, and 1.9 percent (4.8 million) in the past month.
OxyContin alone has been abused in the past year by 2.5 percent of the population (6.5 milion), in the past year by .6 percent (1.5 million), and in the past month by .1 percent (358,000). For oxycodone products, which includes Percocet, Percodan and Tylox in addition to OxyContin, the number of lifetime abusers rises to 16 million Americans.
OxyContin and other opioid pain killer addiction is not just harming those who take the drugs. With the rise of women becoming addicted to the medication, there has been a rise in babies born addicted to drugs. Every hour in the United States, a baby is born with symptoms of opiate withdrawal.
More and more medication is prescribed every year for a myriad of illnesses and conditions. In 2011, 4.02 billion drug prescriptions were written in the U.S., which was an increase from 2.99 billion, according to the ACS Chemical Neuroscience journal. The most prescribed class of drugs was antidepressants, but pain medication prescriptions were also high.
According the American Society of Interventional Pain Physicians, Americans are the consumers of 80 percent of the opioid pain medication produced worldwide. OxyContin states that they have a small market share of the total opioid market, never exceeding 4.4 percent of the total prescriptions. According to Purdue Pharma, the maker of OxyContin, less than 18 percent of prescriptions for oxycodone products were for OxyContin, which means that 7 out of 10 oxycodone prescriptions were not for OxyContin. However, that does not stop it from being one of the top opioid painkillers abused.
More people die from overdoses of opioid painkillers than from heroin and cocaine combined. Prescription drug-induced deaths have also overtaken automobile accidents for the leading cause of accidental death in America. There has been an exponential increase of drug overdose deaths over the past decade. According to data from the Centers for Disease Control and Prevention (CDC), over the past 11 years there has been a 400 percent increase of overdose deaths in women, and a 265 percent rise in men. Every day, around 45 people die from prescription drugs. Additionally, according to the latest data form the CDC, in 2010, around 16,500 people died from the misuse or abuse of painkillers, including Vicodin, OxyContin, Opana and methadone.
Death is not the only problem caused by opioids; many more people are entering the emergency department at hospitals due to use or misuse of these drugs. In 2011, 1.4 million out of the 2.5 million people who entered the emergency department due to drugs did so due to prescription medication. According to a CDC infograph based on 2008 data, for every death caused by prescription medication, there are 10 admissions to treatment for abuse, 32 emergency department visits due to misuse or abuse, 130 people who have dependency or abuse problems, and 835 people who use the drug for non-medical purposes. About 74 percent of overdose deaths in 2011 were due at least in part to opioid painkillers. Not all of these are attributed to OxyContin, but there is a significant problem with OxyContin abuse and addiction.
What Does OxyContin Do?
OxyContin is typically prescribed as a painkiller, especially for those who have chronic pain. It is often used as an alternative to morphine, especially when such a strong medication is not needed. It is used for daily pain management for a variety of conditions. The drug is mainly composed of oxycodone with some additives. What sets it apart on the market is that it is a time-release drug that delivers the medication throughout the day, which theoretically was supposed to decrease the potential for abuse. However, the original formula made it easy to overcome this anti-abuse mechanism, as it was just a gel surrounding a pill that would easily come away when the pill was crushed. The more recent tablet has made this type of abuse harder, but the potential remains.
OxyContin works as a pain medication because it blocks the opioid receptors in the brain. It is a synthetic opioid and mimics morphine's effects on the brain. It is what is known as an agonist opioid, which are very effective pain relievers. Increased dosage has an increased analgesic effect, which means that the higher dosage, the better a person feels. This is why it works better on chronic pain than some analgesics, such as aspirin or acetaminophen, that have a threshold of efficacy. Although this allows it to be a stronger pain medication, but also increases its risk of abuse.
Oxycodone stimulates the opioid receptors throughout the central nervous system, including in the spinal cord and brain. When the drug binds to the receptors, there are various physiological responses in the body beyond just pain relief. It can cause feelings of euphoria, which is one reason for its potential for abuse. This binding can also cause other side effects, some of which are unpleasant and even dangerous, such as dizziness, drowsiness, loss of consciousness, and nausea/vomiting.
Prescriptions for OxyContin can be between 10 and 160 milligrams of oxycodone, depending on the patient's need. This is in comparison to 2.5 to 10 milligrams in other forms of oxycodone medication. It has such a high dosage because it is a time-released formula that can provide up to 12 hours of pain relief. Patients take fewer pills for the same effect. However, it is this high amount of oxycodone in each pill that makes it lucrative for abuse. By crushing the pill and then swallowing, snorting or mixing it with water to inject it, the user overcomes the time-release and receives the effect of the full dosage right away. This produces a high similar to heroin.
OxyContin is prescribed for people who have chronic pain that requires more intense treatment. This pain could be due to injuries, cancer, arthritis, chronic back pain, surgeries or other conditions that cause chronic pain. It is only used for pain that is moderate to severe, is consistently present, and is expected to remain so for a long period of time.
Why is OxyContin Addictive?
All opioid medications and drugs have a high risk of addiction. OxyContin is addictive because the body easily builds a tolerance to and dependency on the drug. A tolerance means that a person needs higher and higher doses of the drug in order to achieve the same results. The body adapts to the drug, because it expects to get a certain amount of the chemical. When the body no longer receives the drug, it causes withdrawal symptoms. This is the body's way of returning to homeostasis; however, it can be unpleasant. Even people who take the medication as prescribed can still have problems with tolerance and withdrawal. That is why it is important to follow the doctor's orders when taking any pain medication, especially OxyContin, not just in the dosage guidelines but also when ceasing to take the medication.
Over the past few years, there has been a rise in heroin addiction, largely due to the increase in prescription opioid medication abuse and addiction. Although OxyContin is not the only reason, it does contribute to the rising heroin problem. When people become addicted to OxyContin and can no longer get a prescription through their doctor, they have to turn to other means to acquire the drug. Typically, they turn to the streets to acquire the drug illegally. However, OxyContin is difficult to acquire, so the street price is very high. Heroin, on the other hand, is widely available, making it much cheaper. The effects between heroin and OxyContin are very similar, so people will choose to buy heroin rather than spend the money on OxyContin.
However, taking heroin instead of OxyContin can lead to even more problems. Heroin is not regulated like OxyContin, so there is no real way to know the dosage is exact. There is a high risk of overdose, especially if a person is not used to taking heroin.
OxyContin addiction rates are rising due to several factors. More and more prescription medication is being prescribed in America, making it easier to get the drug. Additionally, as medical procedures get better, more and more people may go in for surgery and end up with some form of chronic pain requiring treatment. Doctors also spend less time with patients, as their schedule gets more and more crowded. They may not realize that a patient is really there just to receive the medication.
Additionally, as more people have insurance, they can afford to visit the doctor for their pain. There has also been a rise of "Pain Mills," clinics that specialize in pain management, but end up just handing out prescriptions for pain medication. Furthermore, there has been limited regulation in the pharmaceutical and medical industry to reduce the potential for abuse, but that is changing.
The Symptoms of OxyContin Addiction
There are several symptoms that a person may have developed an OxyContin addiction. Any one of these signs should be investigated, although they do not necessarily mean a person has an addiction. The most telltale sign that someone does have a problem is that they are continually trying to procure the prescription, even though they should have enough for their condition or do not medically require the medication.
Some signs are more subtle and demonstrate that a person has built up a tolerance, or is potentially taking too much of the drug. These include:
- Nausea and Vomiting
- Loss of appetite, weight loss
These could also just be side effects of the drug, so a person exhibiting these signs may just need to speak to the doctor about altering the prescription.
The most significant symptoms of an addiction are mainly behavioral. These include:
- Going through the prescription faster than indicated
- Continually making up stories about losing a prescription
- Obsessed with ensuring there is enough of the drug
- Shopping around to different doctors to get more prescriptions
- Engaging in dangerous behavior, typically in order to procure the drug
- Seeming to be in a constant state of sedation
- Problems with the law
- Stealing, including money, valuables and other prescription medication
- Isolating oneself
- No longer engaging in activities that once enjoyed
- Mood swings
- Problems sleeping, or sleeping too much
- Problems at work, school, or with relationships
In addition to the mild side effects already listed, there are several other physical effects of taking OxyContin. Some of these develop even when using the drug as prescribed. However, abusing the drug increases the risk of developing these potentially fatal side effects. Some of them include;
- Anxiety and restlessness
- Abdominal cramps
- Aching muscles
- Flu-like symptoms
- Seizures and convulsions
- Elevated heart rate and blood pressure
- Swelling of the eyes, tongue, or throat
- Difficulty breathing
OxyContin addiction can lead to serious complications. Oxycodone affects the opioid receptors in the nervous system, and it is a depressant. This can lead to slowed breathing, and problems in the heart. An overdose can be fatal, but prolonged use can also cause other medical complications. OxyContin abuse can lead to a collapsed lung and respiratory distress. Abusing OxyContin can also lead to tolerance, which requires a higher dosage of the drug in order to feel the same effects. This can cause a person to take dangerous amounts of the drug, increasing the risk of overdose.
OxyContin withdrawal can also be unpleasant. Symptoms of withdrawal typically include agitation, muscle aches, anxiety, insomnia, sweating, nausea and vomiting, dilated pupils, abdominal cramping and diarrhea. It can start within 6 to 30 hours after taking the last medication. Although these symptoms are not necessarily life threatening, they can be serious in some situations. When a person stops using OxyContin, they should talk with a medical professional or undergo detox.
Anyone can develop an OxyContin addiction, but some people are more susceptible to others. Those who have had a previous addiction or have a family history of addiction will be more vulnerable. Some people abuse OxyContin due to an untreated mental health condition, such as depression, post traumatic stress disorder, or anxiety disorder. Additionally, a traumatic event or excess stress also makes a person at risk of developing an addiction. Taking increasingly high doses also makes a person susceptible to an addiction.
Treatment for OxyContin Addiction
OxyContin addiction is treatable. There are a variety of programs available to help a person overcome his or her addiction and take back control of his or her life. The best treatment plans will combine a variety of treatments, including psychotherapy and teaching healthy coping mechanisms and stress relief techniques. Because there is often an underlying or co-occurring mental health condition fueling the addiction, it is important to be treated for all conditions simultaneously. Detox is an important first step to overcome OxyContin addiction. Some programs use a medication treatment to help a person overcome their addiction.
A person can choose from many different levels of addiction treatment. There is hospitalization, partial hospitalization, residential treatment, intensive outpatient treatment, outpatient treatment, and self-help. The best chance for recovery is an intensive treatment, such as a residential program at a dedicated treatment facility, that includes a continuum of care and aftercare program. Typically, a person will have to undergo detox prior to starting a program. Some facilities will include detox with the rest of its services, while others send people to another place to detox before they come to their treatment program.
Before treatment can begin, a person has to go through detox. Withdrawal from opioids can be very unpleasant, making it very difficult for people to remain strong during the process. Many people find themselves turning once more to the drug in order to appease the physical symptoms of withdrawal. That is why many detox programs use medication. The most popular forms of medically assisted detox for opioid painkillers, including OxyContin, are methadone (Dolophine or Methadose), buprenorphine (Subutex or Suboxone), and Naltrexone (Depade, Revia, Vivitrol). These are opioids that have a longer lasting effect, so smaller doses can be used. This allows a person to slowly wean off the drug without suffering the effects of detox. Some other medications may also be used to appease any withdrawal symptoms. These methadone, buprenorphine and Naltrexone have a risk of abuse as well. That has led to many critics believing that this treatment just leads to a person giving up one addiction for another.
Some facilities also offer a natural detox program that uses an IV drip filled with vitamins and nutrients, specifically NAD (nicotinamide adenine dinucleotide). This is a coenzyme used in cell metabolism, which creates energy. NAD also is converted to vitamin B3, which assists in the activity of cells and boosts the recovery. This IV treatment restores the neurotransmitters while detoxing the body from the drug. It does so without medication, and with minimal withdrawal symptoms. However, it is relatively new with limited research and few programs offer it.
Psychotherapy is an essential component of any drug addiction program, including OxyContin addiction. The most common form of therapy used in treatment centers is cognitive behavioral therapy, although other forms may also be used. This form of treatment teaches a person to recognize destructive behavioral patterns and replace them with healthier versions. Many programs also teach coping mechanisms, healthy stress relief techniques, and how to cope with strong negative emotions. Psychotherapy is also important for those whose addiction is at least partially fueled by emotional or psychological problems, or trauma.
Preventing OxyContin addiction can help to lower the numbers of those in need of treatment. Preventative measures must be taken both in the pharmaceutical and medical communities and the individual. First, the pharmaceutical industry needs to be better regulated to reduce the risk of abuse. Doctors need to have stronger regulations on when to prescribe the medication.
Government regulations on the prescription of these medications can help to standardize these practices. Doctors also need to have a better system of discovering those who might have a higher risk of abuse. Better communication between doctors and pharmacies can reduce the number of multiple prescriptions on the market. Reducing the reliance on opioid medication for pain management rather than other, less risky methods can also help prevent future addictions.
For individuals, it is important to only take the drug when medically necessary, and to follow all instructions provided by the doctor. Additionally, prescription drugs and other substances should never be used as a way to self-medicate a mental health condition or appease stress.