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Oxycodone Abuse Signs
Oxycodone is a white, odorless crystalline powder derived from the dried latex sap of the opium poppy. It is produced by modifying the alkaloid thebaine, also known as paramorphine, an organic chemical present in opium.
Oxycodone is an active ingredient in a number of commonly prescribed pain relief medications and cough suppressants, belonging to the narcotic (opiate) analgesics class of drugs.
This painkiller diminishes the perception of pain by binding to opioid receptors in the brain, but is also used for non-medical purposes. The federal Centers for Disease Control and Prevention (CDC) estimates that about 12 million people in the United States abuse prescription painkillers, and narcotic painkillers are responsible for more than 15,000 overdose deaths annually. Federal data indicates that of 164 million physician visits for pain in 2010, just under 20 percent resulted in treatment with an opioid pain medication.
Prescriptions for opioid pain medications increased from 11 percent in 2000 to 19 percent in 2010, and efforts to make it harder to get prescriptions for narcotic pain medications appear to have driven many abusers to heroin use. A report from the Substance Abuse and Mental Health Services Administration (SAMHSA) says that four out of five people who start using heroin previously used prescription pain relievers.
Oxycodone is similar to other opiates like morphine, codeine and hydrocodone in its action, and is widely abused as a recreational drug. Use of oxycodone induces sedation, feeling of euphoria and slowing down of breathing. A person abusing oxycodone is likely to take increasingly larger doses to achieve the desired euphoric effect as tolerance builds. However, an overdose of oxycodone poses a serious threat of respiratory depression, which can be fatal.
OxyContin and Percocet are common prescription forms of oxycodone, and are available in tablets of varying strength. When swallowed intact, the oxycodone in these drugs gradually releases in the blood, and allows long-term (up to 12 hours) relief from pain of moderate to severe intensity. However, drugs containing oxycodone have high abuse potential and are responsible for several overdose deaths. Due to its high dependence and addiction rates, all the medications and products containing oxycodone come under the Schedule II controlled substances.
Prevalence of Oxycodone Abuse
Since 1999, there has been a 300% increase in the sale of these strong painkillers, which has led to a notable rise in overdose deaths. In 2011, people who received hospital emergency department treatment for abuse of prescription drugs comprised 56% males and 82% aged 21 years or older. In 2010, of the 22,134 deaths related to prescription drug overdose, 16,651 (75%) involved opioid analgesics, which means nearly three out of four prescription drug overdoses are caused by opioid pain relievers. Between 1999-2010, deaths due to prescription painkiller overdoses among women increased more than 400% compared to 265% among men.
History of Oxycodone
Oxycodone was first synthesized in 1916 from the opiate alkaloid thebaine, by two German scientists. The purpose was to create a synthetic substitute for narcotics like heroin, which had been banned two years earlier because of its addictive property. Initially, oxycodone was used mainly for the treatment of acute postoperative pain, and combinations like oxycodone and acetaminophen were used for relief of moderate pain. Oxycodone was first introduced to American consumers in 1939; however, it was not widely used until 1950, after the release of Percodan, a combination drug containing oxycodone and aspirin.
The potential risks of oxycodone were identified in the 1960s when cases of abuse became evident and the United Nations Office on Drugs and Crime classified it as a dangerous drug as part of The Dangerous Drugs (Amendment) Ordinance. In 1970, oxycodone was designated as a Schedule II drug under the Controlled Substances Act, along with other opiates. The Food and Drug Administration granted market approval for another oxycodone product, Percocet, in 1974. However, it was a prescription drug meant for people suffering from cancer or conditions of chronic pain, and was stocked in small quantities by pharmacists.
In 1996, Purdue Pharma released OxyContin, the first unmixed form of oxycodone with a time-release base intended to prevent abuse. By 2001, OxyContin was the top selling opiate pain reliever in the country. Nevertheless, reports of illicit use and abuse followed the intensive marketing and distribution of the drug, and abuse has become pervasive.
Oxycodone’s Methods of Use
Oxycodone can be administered several ways, including intramuscularly (by injecting into the muscle), intravenously (by injecting into the blood stream), subcutaneously (by injecting under the skin), or orally. Parenteral administration (via injection or infusion) of oxycodone is usually done when patients require parenteral therapy. However, when administered via the parenteral route it becomes twice as potent as oral oxycodone.
Oral OxyContin, which is the most common prescription form of oxycodone, can remain effective for up to 12 hours and is the longest acting oxycodone product available. It is mostly prescribed for relieving moderate to severe pain experienced in chronic or malignant medical conditions. OxyContin is available in strengths of 10, 20, 40 and 80 mg.
In May 2001, the 160 mg tablet of OxyContin was banned due to its high abuse potential. Other medications such as Percocet, Percodan, and Tylox contain small amounts (2.5 to 10 mg) of oxycodone combined with active ingredients like aspirin and acetaminophen. Depending on the patient’s requirement, the doctor may recommend two to four tablets of oxycodone-containing medication daily. Most prescription painkillers are prescribed by primary care and internal medicine doctors and dentists, not specialists. Abusers obtain them from drug dealers, or friends or relatives (with or without asking ).
Oxycodone is often abused by crushing OxyContin into a fine powder and snorting it, chewing it or injecting the water dissolved tablets. These methods of intake cause oxycodone to be immediately absorbed by blood, giving effects similar to heroin, and at the same time increasing the risk of an overdose. The mixture of oxycodone and alcohol is a potentially deadly combination because of the risk of respiratory depression.
How Oxycodone is Addictive
As an opiate, oxycodone is similar to heroin in its action. Once absorbed in the blood, it circulates to the brain where it attaches to opioid receptors in the brain and spinal cord, and blocks the transmission of pain messages. This alters the person’s sense of pain, providing relief over an extended period of time. At the same time, oxycodone also causes feelings of euphoria by acting on the reward system in the brain and releasing the neurotransmitter dopamine. However, when swallowed intact and taken under the prescribed limits, the latter effects are more subtle.
Frequent and prolonged use of oxycodone containing medications is associated with tolerance and the need for higher doses to achieve the desired effect. Its long-term use can cause changes in the brain, and the person may find himself or herself unable to discontinue use, indicating oxycodone addiction, or dependence. Patients who have been prescribed oxycodone have a high probability of becoming addicted to the drug if they have a personal or family history of substance abuse (drug or alcohol addiction) or history of mental illness such as depression.
Illicit access is usually achieved by procuring the drug through forged prescriptions, pharmacy theft, illegal drug dealers or by visiting several doctors to get multiple prescriptions. Some use it to control withdrawal symptoms when heroin or morphine is unavailable. When oxycodone use is abruptly discontinued, severe withdrawal symptoms such as anxiety, nausea, insomnia, muscle pain, fever, and other flu-like symptoms are experienced. That is why it is important that a person seeks oxycodone withdrawal treatment.
Oxycodone Addiction Symptoms
The following signs are common among oxycodone abusers and addicts:
- Desire for a higher and frequent dose
- Tolerance for initial doses
- Inability to control the urge to use oxycodone
- Preoccupation with obtaining the drug
- If prescribed, craving for large doses even after pain has subsided
- Symptoms like anxiety, restlessness, fatigue, confusion and apathy
Side Effects and Health Risks of Oxycodone Abuse
Oxycodone is associated with a number of adverse reactions and side effects. Ideally, it should be taken only under medical supervision. When abused by snorting, chewing or injecting, the risk of side effects and overdose increases exponentially.
One of the most hazardous side effects of oxycodone misuse or overdose is potentially life-threatening respiratory depression. It is characterized by a sharp decline in breaths as the person breathes deeply with abnormally long pauses. If not treated immediately, it may lead to respiratory arrest and death. The risk is highest during the initiation of therapy or after a dose increase. People who are not tolerant to high doses of OxyContin should avoid the use of high strength tablets (40 and 80mg) to reduce the risk. Also, patients with chronic obstructive pulmonary disease (COPD), acute or severe bronchial asthma or pre-existing respiratory depression should refrain from taking oxycodone.
Oxycodone may also interact with other central nervous system (CNS) depressants like alcohol and medications taken for sleep disorders, anxiety, depression, seizures and pain management, thereby increasing the risk of life-threatening respiratory depression.
Other serious side effects of oxycodone abuse include:
- Central nervous system depression, indicated by stupor and coma
- Slow heartbeat and low blood pressure
- Severe weakness and feeling of collapsing
- Cold and moist skin
- Breathing problems, behavior difficulties or life-threatening addiction and withdrawal symptoms in the newborn, if used during pregnancy
More common side effects of oxycodone include constipation, nausea, vomiting, drowsiness, dizziness, itching, headache, dry mouth, and sweating. The drug may also impair the thinking ability of an individual. Dizziness and drowsiness following oxycodone intake may cause falls and driving or occupational accidents.
Since some people are allergic to oxycodone, and it can interfere with the treatment of other medical conditions, it is important to share the detailed medical history with the doctor. It can cause more serious side effects in individuals with a history of head injury, brain tumor or seizures, or those who suffer from liver, kidney, gall bladder, pancreas or thyroid problems.
Oxycodone Addiction Treatment
Overall, rehabilitation programs for oxycodone abuse or dependence focus on medication-assisted detox and patient counseling. Medication-assisted oxycodone detox is endorsed by SAMHSA to prevent overwhelming oxycodone detox symptoms, relapse and switching over to another illicit drug. Drugs used for this purpose include methadone, buprenorphine and naltrexone. They help to reduce cravings and restore normal brain activity. However, it is important to know that medication-assisted detox is the initial step in treatment to help addicts with withdrawal. It is not the long-term solution for recovery and needs to be coupled with other recovery oriented therapies for successful addiction treatment.
Oxycodone Rehab Centers at Drug Treatment and Rehab Centers
Drug Treatment and Rehab Centers (DTRC) offers oxycodone addiction treatment options, including residential rehab programs and detox. Patients are screened and treated for all underlying and co-occurring conditions in order to reduce the risk of relapse. Through customized programming that combines individual and group psychotherapy and complementary alternative therapeutic activities such as yoga, meditation, art therapy, equine therapy, and music therapy, the programs at DTRC provide balanced, holistic treatment for the person, not the disorder. Call our Admissions team at (415) 366-6922 to learn more.