Oxycodone Addiction Treatment
Oxycodone is a semisynthetic opioid synthesized from thebaine, an opioid alkaloid found in the opium poppy. While oxycodone was first developed in 1917 in Germany as one of several semi-synthetic opioids, its popularity escalated in the late1990s after the introduction of OxyContin, manufactured by Purdue Pharma. OxyContin is the time-released version of oxycodone, the active drug in painkillers such as Percodan and Percocet. The precise mechanism of how oxycodone works is the subject of ongoing research, although experts know it binds to specific opioid receptors in the central nervous system thought to play a role in pain-numbing effects. It is theorized oxycodone binds to several different receptors, which may explain why it also causes some unwanted side effects.1
OxyContin is classified as an oxycodone systemic drug, which means oxycodone is the primary ingredient. Other brand names in this class include Roxicodone, OxyIR and Percolone. Other types combine hydrocodone with less powerful analgesics.2
- Acetaminophen/oxycodone systemic: Percocet, Endocet, Percocet 5/325 and Percocet 10/325
- Aspirin/oxycodone systemic: Percodan, Endodan, Percodan-Dem and Roxiprin
- Ibuprofen/oxycodone systemic: Combunox2
In April 2016, a twice-daily abuse-deterrent oxycodone medication called Xtampza ER received final approval from the U.S. Food and Drug Administration (FDA). It is prescribed for the management of chronic pain requiring daily, around-the-clock, long-term opioid treatment for which alternative treatment options are inadequate.3
Rise of OxyContin and Oxycodone Addiction
As soon as it was released, Purdue Pharma hailed OxyContin as the latest and greatest “miracle pill” for pain sufferers. Drug company representatives told physicians and consumers that OxyContin was safer than other narcotics because it was time-released, so there was essentially no potential for abuse. Tolerance builds quickly, so many OxyContin users require ever-increasing doses for the same effect. People found ways to abuse it to get high, while others unintentionally became addicted and overdosed.4 Oxycodone abuse is associated with many physical and psychological repercussions. In higher doses it can suppress the respiratory system and cause respiratory depression, which is often fatal.1
Due to insatiable demand for the drug, some individuals with legal prescriptions started selling OxyContin tablets to drug dealers for a profit. Just a few years after its introduction, OxyContin became one of the hottest street drugs available, with addicts chewing, snorting or injecting it for a high some compared to heroin. In fact, research has since revealed the rise of addictive prescription drugs such as OxyContin are largely to blame for the recent heroin epidemic and increase in heroin-related overdoses.4,5
In 2007, Purdue and its top executives paid more than $600 million in fines for misrepresenting the addiction risks of OxyContin. In 2010, the drug was reformulated to prevent it from being easily abused through crushing and snorting, although misuse still continues. The FDA approved new labeling describing the abuse deterrent features and subsequently denied applications for other oxycodone ER formulations without abuse-deterrent features. Purdue has been sued hundreds of times during the last 20 years in regard to its marketing of OxyContin to physicians and the drug’s inherent addiction risk. A lawsuit filed in January 2017 is the first to focus precisely on what the company knew about criminal distribution of the painkiller.4,5
Painkiller Addiction in Older Adults
While younger people intentionally abuse opioid painkillers, the deadly opioid epidemic is also impacting older adults, often silently. Older adults with chronic pain are frequently prescribed opioids without adequate medication management. It is common for seniors to take several medications, increasing the risk of harmful drug interactions. For example, an opioid interacts with a sleep medicine, increasing the risk of sedation and respiratory depression. Signs of painkiller addiction are often missed by physicians. A caregiver or family member may be the first to detect addiction-related changes such as increased anxiety and depression, confusion, disoriented behavior, injuries or falls.6
For severe opioid addiction, professionally supervised detox is typically required to gradually and safely rid the body of residual drugs. Medications used to ease withdrawal include buprenorphine, naltrexone and a combination of both called Suboxone. After detox, a range of behavioral therapies through inpatient rehab or intensive outpatient programs help individuals regain control of their lives while incorporating less addictive pain management solutions.7
Stats and Facts
- Nearly 10 million Americans, or 4.1% of the adult population, used opioid medications in 2012 to 2013 without a prescription or not as prescribed (in greater amounts, more often or longer than prescribed).8
- In 2015, an estimated 97.5 million people ages 12 and older used pain relievers.9
- In 2015, 2.1 million people ages 12 or older misused pain relievers for the first time in the past year.9
- Of the 2.7 million people with a prescription drug use disorder in the past year (2015), 2 million had a pain reliever use disorder.9
- In 2015, 22,598 overdose deaths were attributed to prescription opioid pain relievers.10
- Despite the continued rise in opioid misuse and overdose deaths among adults, past-year misuse of prescription opioids decreased among high school seniors from 8.7% to 4.8%.11
- Prescriptions for OxyContin decreased from 1,608,747 in the second quarter of 2010 to 1,211,593 in the second quarter of 2015. In contrast, other prescription opioids increased by 7% during the same period, with the exception of hydrocodone combination formulations.12
Clients are slowly weaned off opioid painkillers and other addictive drugs. For people with chronic pain, treatments such as acupuncture, medical massage, water/pool therapy and yoga can reduce pain.6 Exercise and other forms of therapy are also helpful for people in recovery for other prescription drug abuse. Long-term management by a team of multidisciplinary providers is key to addressing ongoing pain and preventing relapse.
- How does OxyContin work? Addiction Blog website. http://prescription-drug.addictionblog.org/how-does-oxycontin-work/ Published June 7, 2012. Accessed January 19, 2017.
- Oxycodone. Drugs website. https://www.drugs.com/ingredient/oxycodone.html Accessed January 19, 2017.
- FDA Gives Final Approval to Abuse-Deterrent Xtampza ER. Medscape website. http://www.medscape.com/viewarticle/862662 Published April 29, 2016. Accessed January 19, 2017.
- How OxyContin Became the Most Dangerous and Hottest Selling Narcotic in History. Dr. Mercola website. http://articles.mercola.com/sites/articles/archive/2015/07/18/oxycontin-addiction.aspx Published July 18, 2015. Accessed January 19, 2017.
- Harriet Ryan. City devastated by OxyContin use sues Purdue Pharma, claims drugmaker put profits over citizens’ welfare. Los Angeles Times. January 19, 2017. http://www.latimes.com/local/lanow/la-me-oxycontin-lawsuit-20170118-story.html Accessed January 19, 2017.
- Lisa Esposito. Silent Epidemic: Seniors and Addiction. US News and World Report. December 2, 2015. http://health.usnews.com/health-news/patient-advice/articles/2015/12/02/silent-epidemic-seniors-and-addiction. Accessed January 19, 2017.
- How to Help an Oxycodone Addict. Drug Abuse website. http://drugabuse.com/library/how-to-help-an-oxycodone-addict/ Accessed January 19, 2017.
- Rates of nonmedical prescription opioid use and opioid use disorder double in 10 years. https://www.nih.gov/news-events/rates-nonmedical-prescription-opioid-use-opioid-use-disorder-double-10-years National Institutes of Health website. Published June 22, 2016. Accessed January 19, 2017.
- Prescription Drug Use and Misuse in the United States: Results from the 2015 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration website. https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR2-2015/NSDUH-FFR2-2015.htm Published September 2016. Accessed January 19, 2017.
- Overdose Death Rates. Drug Abuse website. https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates Updated January 2017. Accessed January 19, 2017.
- Teen substance use shows promising decline. National Institute on Drug Abuse website. https://www.drugabuse.gov/news-events/news-releases/2016/12/teen-substance-use-shows-promising-decline Published December 13, 2016. Accessed January 19, 2017.
- Severtson SG, Ellis MS, Kurtz SP, et al. Sustained reduction of diversion and abuse after introduction of an abuse deterrent formulation of extended release oxycodone. Drug Alcohol Depend. 2016 Nov 1;168:219-229. doi: 10.1016/j.drugalcdep.2016.09.018.