The Rise of Prescription Painkiller:
OxyContin was developed by Purdue Pharma L.P., pharmaceutical company in Stamford, Connecticut. A controlled-release formulation of oxycodone hydrochloride, OxyContin was approved by the Food and Drug Administration in 1995 for treatment of moderate to severe pain; it was designed to give a sustained release of its active ingredient, oxycodone, over a period of twelve hours (Pacheco, 2002)
OxyContin History and Growth Background
OxyContin has been placed in Schedule II of Controlled Substances Act of 1970, indicating that while it is very effective, there is still a risk of addiction. It carries a safety warning called the “black box” cautioning users not to crush, chew, or dissolve tablets so as not to cause rapid release of the drug. The safety warning, however, may have unintentionally distributed the information for the misuse of the drug as number cases of OxyContin abuse increase over time (Pacheco, 2002).
OxyContin was released during the time when the medical community is still learning to treat pain; non-cancer pains are usually treated with aspirin which is not very effective especially for chronic pain sufferers. In general, sales of prescription painkillers increased since 1996, relative to other types of prescription medications. Among the prescription painkillers, opioid analgesics had the most rapid growth at 23 percent. Among the opioid analgesics, OxyCOntin had the most significant and rapid growth in prescriptions; between 1996 and 2000,
OxyContin prescription increased by more than 1,800 percent, a staggering number even with the expected growth of a newly released drug. OxyContin sales continued to enjoy very high annual growth rates even after four years from its release; sales from 1999 to 2000 increased by 74 percent (Pacheco, 2002).
In 1996, opioid analgesics were used commonly for the treatment of cancer pain. By 2001, family doctors were the largest prescribers of OxyContin, accounting for 21 percent of the total prescribers, surpassing Oncologists who account for only 3 percent (Pacheco, 2002)
News on OxyContin Addiction
According to Balkrishnan and Jayawant (2005), OxyContin addiction has been talked about for the past few years; while millions of sufferers found relief in OxyContin, first news of OxyContin addiction came during the late 1990s from rural Maine. But it was not until 2003 when a radio host, Rush Limbaugh, admitted his addiction to the drug on his radio talk show that the attention on the drug turned into media frenzy.
News of thefts, robberies, and prescription fraud due to OxyContin addiction came out; legitimate patients had a difficult time getting the drug because pharmacies refused to carry them.
In the National Survey of Drug Use and Health (2010), nearly one million Americans aged 12 and up used OxyContin for non-medical purposes in their lifetime; the number of new users in 2010 was 598,000 with an average age of 22.8 years old at first use. In Florida, for example, 1500 cases of the 9001 drug-related cases are due to OxyContin, an increase of 28 percent from 2009 numbers.
In a survey of 422 people being treated for substance abuse, 204 people or 48 percent said that they had used OxyContin. Twenty-four percent of the 204 people used the drug orally, 37 percent used the drug intranasally by snorting, 22 percent used it both orally and intranasally, and 2 percent used the drug intravenously. A combination of oral, nasal, and intravenous use was reported by the remaining 15 percent (Levy, 2007).
OxyContin is fairly easy to obtain. Abusers reported that they obtained the drug from a dealer, from a prescription, or from someone who has a prescription (Levy, 2007). A number of survey respondents stated that they obtained the drug from online pharmacies as well as “pill mills.” Pill mills are establishments that either have medical professionals who knowingly and excessively prescribe drugs or directly supply the drugs on site. Pill mills are most prevalent in Florida, with over 100 of these clinics dispensing prescription drugs (Collins, 2010).
OxyContin abuse became so widespread that the Drug Enforcement Agency also became involved. They coordinated operations targeting individuals and organizations involved in abuse like illegal sale, pharmacy theft, and prescription fraud. Purdue Pharma has also released a letter addressing all healthcare professionals specifying the dangers of misuse of OxyContin. They also took active part in monitoring medical practitioners who prescribe the drug as well as distributed free tamper-resistant prescription pads (Balkrishnan & Jayawant, 2005)
Effects of OxyContin Use
OxyContin, if used properly, has obvious advantages for patients. Chronic pain sufferers reported relief from pain of up to 15 hours after ingesting a single tablet. The controlled-release feature of the tablet releases appropriate dosages of the drug over the span of 12 hours. However, even legitimate patients may develop tolerance for the drug, needing higher and higher doses to alleviate the pain (Collins, 2010).
Individuals who consume the drug for non-medical purposes get euphoric effects, much like the effect of Heroin. With continued use, users may also develop tolerance for the effects of OxyContin and become either dependent or addicted to it. OxyContin side effects include constipation, confusion, headaches, lightheadedness, sedation, sweating, nausea, and vomiting. As with any abused drug, users may suffer from an overdose. An overdose of OxyContin may lead to loss of consciousness, coma, and even death (Weekes, 2006).
Signs of Addiction
Not everyone who uses OxyContin will become addicted. However, once a legitimate patient goes beyond the recommended dosage, addiction is likely to happen. Addiction is also likely to happen because, as stated earlier, OxyContin is easy to obtain.
According to Weekes (2006), there are many physical, emotional, and social signs of addiction. Chronic abusers of the OxyContin can experience withdrawal symptoms similar to Heroin withdrawal if they cannot get the drugs as soon as six hours after their last dose.
OxyContin withdrawal symptoms include hot or cold sweats, joint and muscle pain, nausea and/or vomiting, severe stomach cramps, diarrhea, fatigue, confusion, anxiety, restlessness, leg twitches, heart palpitations, coughing, constant yawning, insomnia, watery eyes, and depression.
It is very easy for OxyContin abusers to overdose on the drug when higher dosage tablets are crushed then ingested. Overdose can lead to loss of consciousness, coma, and even death.
A person with OxyContin addiction may become irrational and irritable, as well as sluggish. It is not uncommon for the addict to lose appetite. Other signs of addiction to OxyContin are compulsive use, withdrawal from social activities he previously enjoyed, and frequent moments of very relaxed state. Another good indication of an addiction is the possession of multiple prescriptions from more than one doctor or buying the drug from pill mills or dealers (Weekes, 2006).
Treatment and Rehabilitation
Treatment for OxyContin addiction is the same as the treatment for other opioids. Treatment will be on two aspects – the physical aspect and the mental aspect.
The firsts step is to treat the physical aspect by detoxification. Detoxification is the process of getting rid of the drug and other harmful toxins from the body. There are two types of detoxification. The first type is the natural detoxification which means that the abuser stops taking the drug and suffers through the withdrawal symptoms for a week or so. The second type is the medically assisted detoxification in which the process is assisted using a variety of medicines like Methadone and Buprenorphine, depending on the need of the person (Weekes, 2006).
Methadone, a maintenance treatment, basically administers opiates under medical supervision. According to Goppel, van den Brink, and van Ree (2003), “addicts who switch from illicit opiates to methadone avoid the highs and lows and the medical risks of intravenous injection and criminal behavior that supports it.” They are less likely to be depressed and more likely to hold a job and maintain family life. The dosages are gradually decreased to make way for the withdrawal process. Buprenorphine, on the other hand, is a tablet that “occupies opiate nerve receptors and produces a mild opiate-like effect.” It tricks the body into thinking that it is still ingesting small doses of opiates while the body detoxifies.
Chronic abusers usually undergo the medically assisted detoxification process as their bodies are the more prone to experience severe withdrawal symptoms.
The second step of OxyContin addiction treatment is treating the mental aspect. Some abusers can become mentally dependent on the drug that even if their body does not crave for OxyContin, they can “convince themselves that they need OxyContin in order to survive.” This usually include individual counseling as well a group counseling to treat the mental addiction and teach the individual skills on how to live a drug-free life.
The best place for treating an OxyContin addiction is in a drug rehabilitation center. A drug rehabilitation center provides a physically safe environment during the detoxification process. Rehabilitation centers are also equipped to medically deal with any complications that may arise during the process. Aside from that rehabilitation centers are also equipped to treat mental addiction by providing a supportive environment.
Balkrishnan, R. & Jayawant S.S. (2005). The controversy surrounding OxyContin abuse: Issues
and solutions. Retrieved from http://www.ncbi.nlm.nih.gov/pmc
Collins, T.R. (2010). Invasion of the pill mills in south Florida. Time, 175 (15)
Goppel , M., van den Brink, W., & van Ree, J.M. (2003). Management of opioid dependence.
Current opinion in Psychiatry, 16(3). Retrieved from http://journals.lww.com/co-psychiatry
Levy, M.S. (2007). An exploratory study of OxyContin use among individuals with substance
use disorders. Journal of psychoactive drugs, 271(6)
Pacheco, R.J. (2002). The use and misuse of OxyContin. Unpublished dissertation. Harvard Law
Substance abuse and mental health services administration (2010). National survey of drug use
and health. Retrieved from http://www.samhsa.gov
Weekes, J. (2006). OxyContin fact sheet. Retrieved from http://www.ccsa.ca