Four million Americans abuse prescription drugs. This is not a problem of personal weakness, but a national problem of dependence and addiction. The stronger the dug, the greater chance someone will become addicted to it, and as one of the strongest analgesics on the market at present, OxyContin® in particular has been one of the most visible examples of this problem.
An opiate agonist similar to heroin, OxyContin elevates the levels of the neurotransmitter dopamine to produce pleasurable effects. The effectiveness of this drug in achieving its effects in the brain and central nervous system ranks it high on the list of abused drugs. OxyContin tablets possess a time-release protective covering, which allows the drug’s active ingredient, oxycodone, to be slowly released over the period of twelve hours. This makes it the longest lasting oxycodone product presently available. Taken correctly, there is a very low chance of become addicted to the drug, despite how it has been reported recently in the news. Rather, abuse stems mainly from the purposeful breaking of the protective time-release cover over the tablet. Three general ways of breaking this covering is from chewing the pill, crushing it and snorting it, or crushing and dissolving the tablet in water in order to inject it. The oral bioavailability of this drug ranges from 60% - 87%, as oxycodone is very efficiently absorbed when present in the context of OxyContin. Much of this is due the fact that there is little first-pass metabolism that takes place. However, oxycodone eventually undergoes heavy metabolism and has several metabolites which are themselves analgesics, but much less effective than the original form.
Street Names:
Oxy Oxycottons
OC Hillbilly Heroin
Kickers Killers
This graph represents the biphasic release of the
oxycodone within the drug OxyContin.
Addiction has been shown to be quite rare among individuals who use it properly and are managed by a doctor. Dependence does occur with the continued use of this drug and severe side effects result when OxyContin is abruptly stopped. These side effects are typically flu-like and include nausea, weakness, abdominal cramps, vomiting, diarrhea, insomnia, and chills, among others. OxyContin should be gradually discontinued, with tapered doses, to prevent these withdrawal symptoms. Addiction, however, is quite different from dependence. In a recent study by NIDA (National Institute on Drug Abuse) involving more than 12,000 participants correctly using OxyContin, only 4 ever became addicted. Another study involving 38 chronic pain patients (who had taken the drug for over 4-7 years, only revealed 2 who had become addicted to OxyContin, and both of these patients showed a history of drug abuse.
The 12-hour continued release of this drug maintains the amount present in the body at steady level, which is a factor not conducive to becoming addicted. This release is biphasic, producing two very slight increases over the first six hours the drug is taken. It is not realistic to assume that this biphasic nature of oxycodone is the contributing factor in addiction. When the protective covering of the tablet is broken, however, the drug is released into the body rapidly and a euphoric high is produced. It is this misuse of OxyContin which lends itself to addiction. Treatment of addiction is most effective when medication that is either an agonist or partial agonist is involved. Addiction treatment in the United States currently utilizes the agonists Methadone and LAAM (levo alpha acetyl-methadol).