Generic Name: oxycodone (ox i KOE done) Brand Names: ETH-Oxydose, OxyContin, Oxyfast, OxyIR, Percolone, Roxicodone, Roxicodone Intensol
A narcotic pain killer related to morphine, OxyContin is a powerful pain medication that can be habit forming in some people. The popularity of this drug for abusers has risen in recent years and it has earned the nickname Hillbilly Heroin. As its popularity by drug abusers has gone up, addiction to this drug has also been on the rise. There have been reports that some find it too difficult to obtain the drug and some of those addicted turn to heroin use as it is apparently easier to get.
Those who are prescribed this narcotic pain reliever should never increase the prescribed dosage and should alert their medical doctor if they find the drug has stopped working at the recommended dosage. This could be a sign of tolerance, which is a tell-tale sign of dependence.
Manufactured by Purdue Pharmaceuticals, OxyContin (oxycodone hydrochloride, controlled- release), is a pharmaceutical opioid that contains the active ingredient oxycodone.
Oxycodone is an opioid agonist used for the treatment of pain. It is an analgesic agent which acts directly upon the opioid receptors of the brain, CNS (Central Nervous System) and bodily tissues to produce its analgesic effects.
The chemical formula for oxycodone is 4, 5α-epoxy-14-hydroxy-3-methoxy-17-methylmorphinan-6-one hydrochloride. It is derived from the opium alkaloid thebaine and is a white, odorless and crystalline powder. Formulations of Oxycodone Hydrochloride
Pharmaceutical products containing oxycodone hydrochloride are available in liquid, tablet and capsule. Oxycodone hydrochloride formulations are marketed in the United States as:
• OxyContin controlled-release available in 10, 20, 40, 80 and 160mg tablets
• Oxydose, 20mg/mL, a concentrate solution
• OxyFAST, 20mg/mL, a concentrate solution
• Percolone, 5mg tablets
• Roxicodone, 5mg tablets
• Roxicodone, 5mg/5mL oral solution
• Roxicodone Intensol, 20mg/mL concentrate solution
• M-oxy, 5mg tablets
• Endocodone, 5mg tablets
• OxyIR, 5mg capsules, immediate-release
Related formulations contain oxycodone compounded with other analgesics such as aspirin and acetaminophens and are marketed in the United States as Percodan and Percocet.
OxyContin is the most powerful formulation containing oxycodone hydrochloride. In addition to its popular medical use in pain management, it, and to a lesser degree, other formulations listed here, are significant drugs of abuse and dependence.
Medical Use of OxyContin
OxyContin is a controlled-release formulation of oxycodone hydrochloride. Similar to morphine in its effects, OxyContin is a Schedule II narcotic analgesic used medically for moderate to severe pain management. As a controlled-release formulation, OxyContin is the longest acting narcotic analgesic available. It is typically administered once every 12 hours for continuous around-the-clock pain management.
Labeling of OxyContin
OxyContin tablets and caplets are embossed with “OC”. Each tablet or capsule is also embossed with numbers indicating the dosage in milligrams of the oxycodone contained in each such as 10, 20, 40, 60, 80 and 160.
Indications and Contraindications for Medical Use
OxyContin is used when a patient requires continuous pain management such as in the treatment of severe pain from injuries and fractures, cancer, surgery and other sustained and persisting conditions with severe pain. OxyContin, due to its long-lasting and continuous analgesic effect, is not used as a prn analgesic for episodic pain. OxyContin is approximately two times as strong as orally administered morphine when used in the usual protocol of administration.
Single doses higher than 40mg, such as the 60mg, 80mg and 160mg tablets, are given only to patients with an already established opioid tolerance. Daily doses greater than 80mg are also not given unless there is an opioid tolerance. Individuals without opioid tolerance may experience fatal respiratory depression when administered the higher doses of OxyContin.
OxyContin tablets are administered whole without breaking or crushing. OxyContin tablets are also swallowed whole without chewing. Maintaining the integrity of the solid tablet during administration prevents a rapid release and absorption of oxycodone which can result in fatal overdosing.
The effects of OxyContin include:
• mood alteration (euphoria and dysphoria)
• respiratory depression
• cough suppression
• altered endocrine functioning
• altered CNS functioning
• mental clouding
• gastro-intestinal distress including nausea, vomiting, constipation
Individuals with some medical conditions may not be prescribed OxyContin due to severe health risks. Contraindications include individuals with:
• low blood pressure
• heart disease
• breathing disorders
• liver disease
• kidney disease
• gallbladder disease
Individuals with a history of drug or alcohol problems are at high risk for abuse and dependence during the medical use of OxyContin and other oxycodone formulations. An abuse and/or substance history is a contraindication for use.
Withdrawal symptoms occur with the abrupt cessation of use or a decline in the dosage of use. OxyContin withdrawal is anecdotally reported as severe in physical discomfort with continued use often reactionary to the severe discomfort. OxyContin withdrawal symptoms are similar to those found in the withdrawal syndrome of other opioids and can include:
• body aches
• flu-like symptoms
• runny nose
• sleep disturbance
• appetite disturbance
• muscle spasms
• involuntary muscle movement
OxyContin withdrawal for individuals with pre-existing medical conditions can cause damage to lungs, heart, brain and liver. OxyContin withdrawal can also induce respiratory and cardiac depression and arrest, coma and death.
OxyContin Use during Pregnancy
In utero exposure to OxyContin can result in Neonatal Abstinence Syndrome (NAS), in which newborns experience withdrawal symptoms and require immediate medical attention. Infants born with withdrawal symptoms are at risk for organ damage, cardiac distress and arrest as well as respiratory distress and arrest.
In utero exposure to OxyContin can also cause:
• low birth weight
• congenital deformities
• slowed fetal growth
• placenta abruption
Illicit use of OxyContin
OxyContin and other oxycodone compounds have high abuse and dependency potential and have become prominent illicitly used substances. Since its first introduction in 1996, OxyContin has progressively increased in the number of prescriptions dispensed, relation to addiction treatment admissions, law enforcement involvement, emergency room events, adverse medical incidents and fatalities.
In the abuse of OxyContin individuals may ingest the whole tablet or crush the tablet in order to use the substance intranasally by insufflation or by intravenous injection when dissolved into a solution.
Treatment of OxyContin Abuse and Dependence
Treatment of OxyContin Abuse and OxyContin Dependence includes the use of protocol and modalities generally used for abuse and dependence of other opioids. These include:
• inpatient substance disorder treatment
• medically supervised withdrawal and detoxification
• individual counseling
• group counseling
• family counseling
• relapse prevention planning
• outpatient supportive aftercare and follow-up
• outpatient random drug screens during aftercare and follow-up
Detoxification from OxyContin
Detoxification from OxyContin requires medical supervision and generally proceeds with a tapered administration until cessation. Clonadine, methadone and/or other medications may also be used during withdrawal to attenuate withdrawal symptoms.
Abstinence maintenance after detoxification may include the use of methadone or Suboxone (buprenorphine and naloxone) administered orally and managed in an outpatient setting.