Oxycodone Addiction
Oxycodone
History of Oxycodone
Today, heroin is known to be an extremely addictive illegal substance, but in the late 1800s and early 1900s, heroin was marketed by the German corporation, Bayer, as an opioid pain killer. Once the dangers of heroin addiction were discovered, it was banned in the U.S. As a result, two German scientists created oxycodone in 1916, an opioid meant to replace heroin and morphine as a non-addictive pain killer.
Oxycodone Timeline
1916 -Creation
Oxycodone is created in Germany
1939 -U.S. Introduction
Oxycodone is first introduced in the U.S.
1950 -Prescription
Percodan, a combination medication containing both oxycodone and aspirin, is introduced to the U.S. physicians for prescription
1970 -DEA
The Drug Enforcement Administration (DEA) labels oxycodone as a Schedule ll drug in the Controlled Substances Act
1974 -FDA
Percocet, a combination medication containing oxycodone and acetaminphen is approved by the Food and Drug Administration (FDA)
1996 -OxyContin
Purdue Pharma, a pharmaceutical company, releases the drug OxyContin, which is a medication that contains only oxycodone
2007 -Purdue Pharma
urdue Pharma agrees to pay over $600 Million in fines for misleading regulators, doctors, and patients about the addictive properties of OxyContin and its potential for abuse
2019 -Risks
As of June 2019, 48 states, including California, Hawaii, and Maine are suing Purdue Pharma for downplaying the risks of OxyContin and exaggerating its benefits
Types of Oxycodone
There are two types of oxycodone: immediate-release (IR) oxycodone and extended-release (ER) oxycodone. While immediate-release oxycodone (such as the drug Percocet) works more quickly and is used on an as-needed basis, extended-release oxycodone is used for around-the-clock treatment of pain. Extended-release oxycodone (such as the drug OxyContin), releases small doses of oxycodone over a 12-hour period and is typically prescribed to cancer patients, patients who have just had an operation, or patients with chronic (on-going, long-term) pain issues.
Brand Names
Single Agent Drugs that Contain Only Oxycodone
Oxaydo, OxyContin, Oxyfast, Roxicodone, RoxyBond, Xtampza ER
Combination Drugs that Include Oxycodone
Combunox, Endocet, Endodan, Moxduo, Oxycodan, Percocet, Percodan, Primley, Roxicet, Xartemis XR
OxyContin
OxyContin is a popular drug whose only active ingredient is oxycodone. It is an extended-release tablet that comes in 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, and 80 mg doses. Each strength signifies the amount of oxycodone per tablet. Up until 2001, there was a 160 mg dosage available that was suspended as the potential for abuse was too high.
Introduced in 1996 by Purdue Pharma, a privately held pharmaceutical company, OxyContin was strongly marketed and promoted as a new, non-addictive opioid. Between 1996, when it was first introduced, and 2000, sales of OxyContin grew from $48 million to almost $1.1 billion.
While Purdue Pharma promoted the message that the chances of OxyContin abuse and addiction were very low, this was not in fact true. The widespread promotion and availability of OxyContin meant that by 2004, OxyContin had become the leading drug of abuse in the United States.
Percodan
Introduced in the U.S. in 1950, Percodan is an immediate-release combination drug that contains both oxycodone hydrochloride and aspirin (another type of pain medication). It comes in tablet form with each tablet containing 4.8355 mg of oxycodone hydrochloride and 325 mg of aspirin.
Percocet
Introduced in the U.S. in 1974, Percocet is an immediate-release combination drug that contains both oxycodone hydrochloride and acetaminophen (another type of pain medication). It comes in tablet form in the following strengths:
•2.5 mg of oxycodone hydrochloride and 325 mg of acetaminophen
•5 mg of oxycodone hydrochloride and 325 mg of acetaminophen
•7.5 mg of oxycodone hydrochloride and 325 mg of acetaminophen
•7.5 mg of oxycodone hydrochloride and 500 mg of acetaminophen
•10 mg of oxycodone hydrochloride and 325 mg of acetaminophen
•10 mg of oxycodone hydrochloride and 650 mg of acetaminophen
Oxycodone Addiction
Addiction is defined by Medical News Today as “a psychological and physical inability to stop consuming a chemical, drug, activity, or substance, even though it is causing psychological and physical harm.”
While it is less likely for a patient who has been prescribed oxycodone under a physicians’ care to experience oxycodone addiction (since they are more likely to be monitored and controlled), those who use or abuse oxycodone outside of a physicians’ care are much more likely to experience oxycodone addiction. One of the reasons that oxycodone addiction is highly possible is that it has many similarities with other drugs of abuse such as alcohol, heroin, and marijuana in that it increases dopamine levels which increase a person’s pleasure. This means that over time, oxycodone use changes the brain, making it difficult for users to stop using it on their own. If a user does stop using oxycodone, especially suddenly, there is a high likelihood that the user will experience withdrawal symptoms.
How Much Does Oxycodone Cost on the Street?
While an 80mg OxyContin pill costs about $6 at a pharmacy, it sells for around $80 on the street. In comparison, 80mg of heroin sells for approximately $45 on the street.
How Oxycodone is Taken
Oxycodone medication can be taken in a number of ways: it can be injected into the muscle, into the bloodstream, under the skin, or taken orally by swallowing tablets or pills.
Oxycodone should be taken exactly at the right amount and duration as prescribed.
Crushing, chewing, breaking, or dissolving oxycodone medications can lead to a potential overdose. Inhaling the crushed powder or mixing it into a liquid to inject into the vein can lead to an overdose or death.
If a person has:
•A head injury, brain tumor, or seizures
•Liver or kidney disease
•Urination problems
•Drug or alcohol addiction, mental illness
•Thyroid disorder
•Gallbladder or pancreas
•Lung disease
•Adrenal disease
Opioid medications can interact with other drugs and cause dangerous side effects. Medication that might potentially interact with oxycodone:
Drug Interactions
•Other opioid medications
•Prescription cough medication
•Sedative medications (such as alprozolam, Xanax, clonazepam, Klonopin, diazepam, Valium, lorazepam, Ativan, temazepam, Restoril)
•Sleeping pills
•Muscle relaxants or tranquilizers
•Medication for depression, anxiety, or other mental illnesses
•Medication for Parkinson’s disease
•Migraine medication
•Medication used to prevent nausea and vomiting
•Cold or allergy medications
•Asthma medication
•Medications for motion sickness, irritable bowel syndrome
Effects of Oxycodone
•Drowsiness or tiredness
•Headache
•Nausea
•Red eyes
•Difficulty urinating
•Dizziness or faintness
•Constipation
•Vomiting
•Stiff muscles
•Confusion and difficulty concentrating
•Negative mood
•Mild allergic rash or hives
•Stomach pain
•Itching
•Dry mouth
•Excess sweating or flushing
•Slow pulse
•Dental problems
•Mood swings
•Reduced sex drive
•Decreased level of testosterone in males
•Menstrual problems in females
•Needing to use more of the medication to get the same effect (tolerance)
•Financial, work, or social problems
Rates of Use and Abuse
The consumption of oxycodone increased by almost 500% from 1999 to 2011.
The number of people who admitted to using OxyContin for non-medical purposes increased from about 400,000 in 1999, to 1.9 million in 2002 and 2.8 million in 2003 in the U.S.
By 2010, over 6 million people in the U.S. reported using OxyContin for non-medical purposes.
3 tons (2722kg) of oxycodone were consumed worldwide in 1990, and by 2009, this number rose to 77 tons (69,853 kg). Of these 77 tons of oxycodone, Americans consumed 81% (62 tons/56,245 kg), making them the leaders in oxycodone consumption worldwide.
The National Survey on Drug Use and Health showed that about 27.9 million people aged 12 or older (10.4% of the population) had used oxycodone products as of 2015.
4.3 million of these people reported having misused these products in the past year, representing 1.6% of the U.S. population aged 12 or older.
Between 2000 and 2009, the average size of an oxycodone prescription increased by 69.7%.
Withdrawal
The extended use of oxycodone can lead to the development of withdrawal symptoms when oxycodone use is stopped. Withdrawal occurs when the body becomes used to and adapts its functioning to a certain drug. When that drug is no longer taken, the body craves it in order to function, which results in unpleasant withdrawal symptoms. Withdrawal from oxycodone use can result in the following symptoms:
Physical
•Writhing
•Tremors
•Nausea
•Diarrhea
•Muscle aches
•Sweating
•Coughing
•Runny nose
•Weight loss
•Cramping/aches
Emotional/Psychological
•Cravings
•Mood swings
•Anxiety
•Depression
Oxycodone Addiction Treatment
Naloxone is not so much of a treatment medication as it is more of a first aid response to an overdose. If a person has overdosed on oxycodone, they are likely to stop breathing as oxycodone suppresses the central nervous system. Naloxone can be administered by injection or nasal spray and reverses the lack of breathing. Naloxone only lasts for about 30-90 minutes on the brain and is used as a first-aid treatment before first responders arrive or the patient is taken to a hospital. Naloxone is a prescription drug that is non-addictive.
How much do medication treatments cost?
Methadone treatment, including medication, and psychosocial and medical support services, costs approximately $126 per week or $6,552 per year.
Buprenorphine treatment, including medication and twice-weekly visits, costs approximately $115 per week or $5,980 per year.
Naltrexone treatment, including medication, drug administration, and related services costs approximately $294 per week or $14,112 per year.
While these costs may seem high, they are often much lower than costs associated with the criminal justice system, treating babies who are born dependent on oxycodone, treating people with infectious diseases that result from needle sharing, treating overdoses, and treating injuries associated with addiction and/or overdose.
Counseling and Behavioral Therapies
To effectively treat addiction to oxycodone, the following therapies and supports are recommended.
Cognitive-behavioral therapy (CBT)
Helps patients recognize and stop negative patterns of thinking and behavior. CBT teaches patients coping skills, hot to manage stress, and how to change thinking patterns that lead to opioid abuse.
Motivational enhancement therapy
Or Motivational Interviewing (MI) help patients lead their own process of change and stay motivated insticking to a treatment plan.
Group counseling
Helps patients feel less alone. It provides patients with the support of others who are experiencing the same thing. Group counseling can be motivational when hearting success stories of other people who have gone thought the same thing.
Family counseling
Includes family members who the patient is close with and can be beneficial in helping repair and improve family relations, which can often become strained as a result of addiction.
Narcotics Anonymous
A popular 12-step abstinence-based peer support group.
Individual counseling
Helps patients set goals, discuss setbacks, celebrate progress, discussing legal concerns or family problems.
Contingency management
Helps patients by giving them incentives/rewards for positive behaviors such as not using oxycodone.
Medication-Assisted Therapy
Medication-Assisted Therapy (MAT) combines the use of medications with counseling and behavioral therapies to provide a well-rounded, “whole-patient” approach to treatment. Research indicates that the combination of treatments is the most successful in treating opioid addiction and can lead to long term success in recovery. MAT provides a more comprehensive program that is individualized to each patients’ needs. The goal of MAT is a full recovery from addiction. The approach has been shown to improve patient survival, decrease opioid use and other potential criminal activity, increase patients’ ability to gain and maintain employment, and improve birth outcomes among women with substance use disorders.
Residential and Hospital-Based Treatment
Residential programs combine housing and treatment services for those who might need around the clock care. It is great for those who benefit from living with their peers and supporting one another through recovery. Hospital-based programs combine health care and addiction treatment services for people with medical problems. Treatments may include medication, counseling, and behavioral therapies.
Misconceptions About Oxycodone
Misconceptions about Opioid Addiction
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