Oxycontin© is the brand name for the opioid oxycodone hydrochloride. It is manufactured by Purdue Pharma and is a long-acting preparation of oxycodone, a drug commonly prescribed to treat pain. The current process for manufacturing the drug includes binding agents which are intended to deter abuse. This is because the drug is extremely addictive and has a well-documented role in America's drug epidemic, which still rages today.
People abuse Oxycontin because of the effects which it produces that are similar to heroin. These include euphoria and sensations of pleasure, relaxation, and sedation. The drug was reformulated in 2010 because, along with the drug's unprecedented use in society, drug users had easily discovered how to thwart its wax binding agents.
This made it as simple as crushing and heating the substance, allowing the user tp to extract the entirety of the active ingredient, oxycodone. Intended to be delivered slowly over 12 hours, the sudden release from snorting, smoking, or injecting the crushed pill gives the user an intense "high" that earned it the nickname "Hillbilly Heroin."
The History of Oxycontin
Oxycodone was first synthesized in Germany in 1916. The first documented use of the drug was in 1917, a year later. The drug eventually became popular in America, where it was used in a preparation primarily intended for battlefield surgeries. It was perhaps the first successful anesthesia administered in an emergency setting that was profoundly effective in inducing deep analgesia and euphoria. Oxycodone was first introduced into the United States market in 1939. In the early 1970s, oxycodone was listed as a Schedule II drug under the Controlled Substances Act.
The drug would go on to be utilized moderately as one of several prescription pain medications used to treat moderate to severe acute pain. But sadly, things would not remain this way.
In the 1990s, Purdue Pharma began a campaign to introduce its newest drug, Oxycontin, into the US market.
The prevailing treatment for chronic pain in terminally ill patients was a morphine preparation known as MS Contin. Several other manufacturers were competing with Purdue for sales of its leading painkiller. Oxycontin was intended to be the company's crown jewel and an opportunity to create a virtual monopoly in the painkiller market.
Exposed internal documents have been made public, confirming the Purdue Pharma's intention to flood the market with the drug, placing incentives on sales and prescribing. The company downplayed the addictive potential of the drug and pushed for the most potent formulations possible. Its plan to corner the market was accomplished by expanding outside of the prescribing limitations of cancer patients only. They urged providers to use Oxycontin to treat chronic pain in non-cancer patients, touting its unique safety for such applications by presenting figures of addiction rates less than 1% for the drug.
In 1995, the drug was released, and it quickly exceeded the first year's sales expectations. Purdue's executives began a practice of inviting physicians for dinners and weekend getaways where they marketed the drug, then monitoring their prescribing habits of Oxycontin. They found that this was a successful tactic, and providers who spent the weekend being treated by them were prescribing the drug at a rate of 2.6 times higher than physicians who didn't get the wine and dine treatment.
Various other illegal and unethical practices were engaged in, catapulting the drug into regular use across the country. From 1996 to 2001, Purdue conducted more than 40 national pain-management and training conferences in several US states. More than 5,000 medical professionals attended these all-expenses-paid retreats, where they were frequently recruited to speak on behalf of the drug as to its efficacy and safety.
Purdue also employed a lucrative bonus-system incentivized sales representatives of the drug to form a competitive and territorial network where they pushed the drug heavily to "win" competitions and make more money.
All of these practices culminated in building a competitive atmosphere in a marketplace where Purdue was developing a monopoly. Other pharmaceutical companies were driven to utilize similar tactics to keep up and not be bankrupt by Purdue's domination of a previous predictable market. This snowball effect has been repeatedly linked to America's opioid epidemic, where Purdue and its brainchild Oxycontin are viewed as significant contributors.
Despite Purdue's marketing tactics, the drug has not lived up to the hype. It has been proven to be no safer or more effective than traditional narcotic pain medications, including immediate-release formulations of oxycodone. And we see this in the rates of opioid addiction that began to skyrocket corollary to Oxycontin's introduction and marketing.
Even a recent study from 2019 shows that the drug has had a significant and lasting impact on addiction in America. The drug has been described as the starting point of the epidemic. A team of economists set out to prove this and hold Purdue accountable. These scholars found that in states where marketing regulations prevented Purdue from unleashing its full Oxycontin blitz, overdose rates from drugs like heroin and fentanyl are currently lower than in states that allowed marketing of Oxycontin over 20 years ago.
Sales of Oxycontin grew from $48 million in 1996 to more than $1.1 billion in 2000. Since its release, Oxycontin has generated more than $30 billion in Purdue sales, making its owners, the Sacklers, one of America's wealthiest families.
Various attempts have been made to fix the problem since it began. Due to the dramatic rise in addiction and overdose deaths related to Oxycontin, manufacturers were required to reformulate it in 2010 to deter abuse.
This consisted of improving the drug's ability to resist crushing, heat, and various other methods used to extract it or make it immediately available to the body.
This change would later prove to be pivotal in all the wrong ways. Following this reformulation, the use of heroin began to skyrocket in America.
This has been retroactively examined, including overdose death rates and other studies that have shown dramatic increases in infectious diseases like hepatitis, which were a direct result of increased needle usage.
Currently, the reformulation of oxycontin into an abuse-deterrent formula is considered a failure.
Oxycontin still commands a higher street value than similar opioid prescription narcotics. And this added popularity has led drug users to develop ingenious methods to get around these features. The drug is not abuse-proof, and people are still abusing it. Up to one-fourth of people entering treatment are reporting that they've abused the drug's new formulation.
To make matters worse, neither the FDA nor Purdue Pharma is releasing any documentation as to whether the reformulation has effectively reduced abuse, despite multiple requests from different entities.
So, we have a situation where those who became addicted to Oxycontin switched to heroin when the drug was initially reformulated. Since then, heroin addiction has become rampant in the US and led to the introduction of fentanyl and other deadly synthetic opioids. To compound the tragedy, the drug itself is still abusable and is being abused by people who will likely follow the same path of addiction. Heroin is both cheaper and more potent than pharmaceutical opioids.
What Does Oxycontin Look Like?
Oxycontin is available in tablet form, with doses coming in 10, 20, 40, and 80 milligrams. These doses vary in color and size, saying OC on one side and a number on the other, which corresponds with the tablet milligram.
WHITE 10 MG OXYCONTIN PILLS
PINK 20 MG OXYCONTIN PILLS
GOLD 40 MG OXYCONTIN PILLS
Because oxycodone is an opioid, an overdose is often a fatal occurrence. The leading killer with opioids is that they depress breathing, and oxycodone is no different. People who overdose die from respiratory failure primarily.
Other overdose symptoms include pinpoint pupils, slowed or shallow and labored breathing, vomiting, low blood pressure, weak pulse, unresponsiveness, and unconsciousness. The drug user who has ingested too much likely doesn't know it. They quickly become intoxicated, then sedated, and lose consciousness. Thankfully, they are not awake for their last struggles for air.
Like other opioids, Narcan (Naloxone) can be used to treat an overdose. Narcan works to effectively replace opioids in receptors throughout the nervous system, rapidly reversing their effect. This does not mean its foolproof since large doses of Oxycontin may be too much for Narcan the effectively reverse. Oxycodone in particular is so concentrated that unless Narcan is administered rapidly, it can be too late. If too much time elapses, the person's life may be saved, but they will have damage ranging from brain death to nerve and muscle damage from being immobile while unconscious.
Since Oxycontin's introduction in the 1990s, drug overdose death rates for prescription opioids have steadily increased. According to the CDC, from 1999 to 2018, more than 232,000 people died in the United States from overdoses involving prescription opioids. Overdose deaths involving prescription opioids were more than four times higher in 2018 than in 1999.
Addiction to Oxycontin can be terminal if untreated. When a person first begins using the drug, they experience intense reward in the form of euphoria and an escape from reality. Peace of mind is a very common effect of opioids like oxycodone, and the high concentration in Oxycontin makes the drug extremely potent.
This reward is often enough to compel the person to repeat their use of the drug. Addiction can occur when the person discovers that the drug solves some major problem for them. This could be anything from physical pain to mental or emotional conditions which "evaporate" when the drug is consumed. This relief from the problems in their life becomes the basis of addiction. While this may seem like a logical sequence above, particularly since the drug is prescribed to treat pain, to the addicted person, the value of the drug becomes extremely high. This is because physical dependence develops rapidly and is a compelling component of opioid addiction. As the person keeps using the drug, the first indication of addiction is tolerance. Tolerance is a phenomenon where the body adjusts to the drug's continual presence; it requires more and more to produce the same effect. Tolerance is the result of homeostasis, a natural attempt of the body to maintain balance.
But the problem now is that the adjustments the body has made to adjust for the drug's presence take as long to reverse as they did to develop.
So, when the person stops taking the drug or runs out now, they will feel ill. These symptoms of "illness" are known as withdrawal symptoms, and they are particularly terrifying when it comes to opioids.
Oxycontin withdrawal usually begins with feelings of fear anxiety about finding drugs, accompanied by intense cravings. Next, the person will start to feel cold and have chills, yet be sweating profusely. Tremors and shakiness may occur, but feelings of restlessness and crawling skin are common. Insomnia begins immediately and usually persists for several days with disrupted sleep patterns occurring for months after use is discontinued. Joint, bone, and muscle pain are all common symptoms, along with restless extremities and a general feeling that something is very wrong.
Sneezing profusely and constantly yawning are unique features of opioid withdrawal, and the person will usually have watery eyes and a runny nose for several days.
Withdrawal may be the largest barrier that separates opioid addiction from other forms of substance abuse. Many people who are addicted to opioids never get off them completely, even if the complete treatment. Opioid maintenance has become a popular approach to treating people who cannot fully detox from opioids. One must endure the process completely without using any opioids, and they will eventually feel normal again without the drug. But this process can sometimes take months depending upon the length and severity of the addiction. This can be extremely discouraging and lead the person to use the only thing that will make them feel better opioids.
Anyone can become addicted to Oxycontin, and there are as many different ways that this can occur as there are unique personalities. A sadly common occurrence is when addiction begins from a legitimate prescription.
Nearly 30% of patients who are prescribed opioids for chronic pain misuse them. And this is not always an effort to get "high." Many people are given powerful prescriptions for drugs like Oxycontin and are not educated about them or warned about addiction risks. We want to trust our doctors, so people often do not question when theirs places them on a drug for far longer than they should.
Many do not even know that opioids should only be used for the shortest amount of time possible.
Often, the patient may simply want greater pain relief, so they take two pills even though the label only says one. This qualifies as misuse and is an easy way to become addicted. Now that they have done this, knowing it was "wrong," the human reaction explains why it wasn't wrong. This self-talk is a mental process known as justification, and it serves to remove their responsibility from the situation. "I've been prescribed more in the past" or "Just this once won't hurt" are examples of this. Now that the person has made it okay in their eyes, it becomes easier to do the same thing again, or worse.
Soon the person discovers that they've taken all the pills well before their refill is due, so they must exaggerate symptoms or lie to get more of them. Addiction has now begun, and the person craves the drug and obsesses over getting more.
When they run out, they begin to have withdrawal symptoms, which causes them to become desperate and now go to extreme lengths to obtain the drug.
A prominent feature of addiction is that the person is using drugs to avoid problems. But drug use breeds problems, especially ones that are financial, legal, and interpersonal. So, the solution becomes the problem itself, and as the person accumulates more problems, they use more and more drugs to escape reality and avoid them. Every time an issue is avoided, it becomes worse and worse until soon, their entire life is a problem, and they cannot bear to experience reality. This is where opioid addiction can become severe and easily result in overdose.
How to help a loved one addicted to Oxycodone/Oxycontin
If someone that you know or love is addicted to Oxycontin, you must act soon. This is a very serious drug that has taken many lives. If you suspect that they are using, it is vital that you confront them and get them the help they need before it is too late.
A common myth about Oxycontin addiction is that it is no longer dangerous since the drug has been reformulated. While the drug is now “abuse-deterrent” and is harder to break down and inject or snort, it is not impossible. Many people have dedicated a lot of time into getting around the buffers that were put in place to curb overdose deaths after the drug singlehandedly fueled the opioid epidemic. They’ve made these findings public on the internet so that anyone who wishes to abuse the drug can do so by following their instructions. So, the reformulation hasn’t exactly been viewed as a success. Oxycontin is still very dangerous and impacts people’s lives every day.
If you are confronting someone about their Oxycontin addiction, keep in mind that they may become aggressive. Opioids have a tendency to cause irrational responses in people, including outbursts of anger or rage. It can be very intimidating but do not let this discourage you from trying to help them. It’s not them, it’s the drugs.
If they do become upset, it is a dead giveaway that you are correct. Becoming defensive is a clear sign that they are using drugs. They will likely point out things that you do wrong and try to blame their life circumstances on you or others rather than admit to drug use. No matter what happens to them, do not become upset or angry. They already know that you are not okay with them using drugs, which is why they’ve lied and kept it hidden. You must make it safe for them to be honest with you. This may take a while and will require you to be patient and creative with how you word things. Try not to tell them what they should think or feel, or that what they think is incorrect. This might be difficult when they try to spin everything back around on you. Just stay calm and keep trying.
Eventually, they will either be honest with you or will get out of the discussion. Should the latter occur, it’s time to get some help. You can always call the number on this page and get some advice on how to proceed since this will likely require intervention. This process may sound intimidating, but there are professionals who can assist you. Should you not need intervention, or not need professional help with one, it will now be time to get them into treatment as soon as possible. Never wait a day longer than you must to get them into the facility. Last-minute tragedies are not uncommon when you consider that most people who know they are going to treatment days in advance will usually try to go out with a “bang”.
Oxycontin addiction is treated in the same way that all opioid addiction is. There are different options for rehabilitation, and it's vital to understand these so that one can make the best choice for their needs.
Traditional treatment models are still the most prevalent, which means twelve-step treatment is a standard option for opioid addiction. Alcoholics Anonymous developed the twelve steps, but they have been adapted to treat virtually any addiction or substance use disorder, including opioids. These generally consist of accepting certain principles or concepts, such as addiction being a disease, the existence of a higher power (God), and many others, which can e disagreeable for some people. This can act as a barrier to treatment for some, but others can adapt to the principle or apply them loosely.
Another treatment model that is becoming very popular for opioid addiction is Medication-Assisted Treatment or MAT. MAT is widely accepted as a harm reduction measure by using opioid medications instead of illicitly obtained drugs or medicines.
Its incorporation as a rehabilitation strategy has drawn controversy. This is primarily because it is viewed as a continuation of addiction rather than rehabilitation.
Non-traditional models can be some of the most effective for treating opioid addiction and can be scarce. These programs have difficulty surviving financially due to their length of stay and intensive care, which puts them at odds with the current industry trend. But regardless, these programs practice total abstinence and work to help the person discover and address their addiction's root causes. They focus on nutrition and do not use replacement medications or narcotics outside of detoxification procedures. This holistic approach can be exactly what is needed for someone prone to relapsing or has a severe addiction.
- Between 8 and 12 percent develop an opioid use disorder.
- An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.
- About 80 percent of people who use heroin first misused prescription opioids.
- Although the US only accounts for approximately 5% of the world's population, the National Institute on Drug Abuse estimates that 81% of the world's oxycodone supply is consumed here.
2018 data shows that every day, 128 people in the United States die after overdosing on opioids. The Centers for Disease Control and Prevention estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including healthcare costs, lost productivity, addiction treatment, and criminal justice involvement. In 2017, more than 47,000 Americans died due to an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid. That same year, an estimated 1.7 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 652,000 suffered from a heroin use disorder (not mutually exclusive).
- The rise in deaths involving heroin or opioids accounts for 75% of the overall increase in deaths from drug poisonings.
- Between 1991 and 2013, opioid prescriptions increased threefold.
- Since its release in 1996, OxyContin has been one of the most successful pharmaceuticals of all time, with worldwide sales totaling $35 billion.
Common Terminology Related to Oxycodone/Oxycontin
|Doctor Shopping||A term used to describe the process of obtaining narcotic prescriptions by seeing multiple different doctors, usually unbeknownst to them, and often my manufacturing or exaggerating complaints. It is a manipulation of the healthcare system to support addiction.|
|Opioids||Natural, synthetic, or semi-synthetic chemicals that interact with opioid receptors on nerve cells in the body and brain and reduce the intensity of pain signals and feelings of pain. This class of drugs includes the illegal drug heroin, synthetic opioids such as fentanyl, and pain medications available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and many others. Prescription opioids are generally safe when taken for a short time and as directed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused and have addiction potential.|
|Opiates||refer to natural opioids such as heroin, morphine and codeine, while the term "opioids" refers to all-natural, semi-synthetic, and synthetic opioids. They are different.|
|Dependence||A state wherein the person's body has become reliant on the external chemicals provided through drugs' consumption. If the drugs are not taken, and the person is dependent on them, they will begin to experience withdrawal symptoms.|
|Withdrawal Symptoms||Those symptoms that a person experiences when they discontinue a drug that they are dependent on. Withdrawal symptoms are always the opposite in function as what the drug caused. For example, a drug that produces sedation will produce insomnia or restlessness as a withdrawal symptom.|
|Chronic pain||Pain that lasts 3 months or more and can be caused by a disease or condition, injury, medical treatment, inflammation, or an unknown reason.|
|Drug misuse||The use of illegal drugs or the use of prescription drugs in a manner other than as directed by a doctor, such as use in greater amounts, more often, or longer than told to take a drug or using someone else's prescription.|
|Illicit drugs||The nonmedical use of a variety of drugs that are prohibited by law. These drugs can include amphetamine-type stimulants, marijuana/cannabis, cocaine, heroin, other opioids, and synthetic drugs, such as illicitly manufactured fentanyl (IMF) and ecstasy (MDMA).|
|Fentanyl||Pharmaceutical fentanyl is a synthetic opioid, approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine. However, illegally made fentanyl is sold through illicit drug markets for its heroin-like effect, and it is often mixed with heroin or other drugs, such as cocaine, or pressed into counterfeit prescription pills.|
|Opioid use disorder (OUD)||A problematic pattern of opioid use that causes significant impairment or distress. Diagnosis is based on specific criteria such as unsuccessful efforts to cut down or control use, or use resulting in social problems and a failure to fulfill obligations at work, school, or home, among other criteria. Opioid use disorder is sometimes used over other terms with similar definitions, "opioid abuse or dependence" or "opioid addiction."|