Many misconceptions about prescription opioids persist, despite increased media coverage. Some people believe that because they are prescribed under the supervision of a physician, prescription pain relievers are safe. The following oxycodone facts will help you decipher fact from fiction and learn key insights about these powerful drugs.
Is OxyContin Responsible for the Opioid Epidemic?
Opioids of all kinds have claimed more than 190,000 lives in the U.S. since 1999 and 91 Americans die every day from an opioid overdose. Most experts blame OxyContin for setting off the nation’s deadly prescription opioid epidemic, although other drugs like hydrocodone are also implicated in this public health crisis. With that said, OxyContin has certainly been associated with far more negative media attention than other prescription opioids due to hundreds of lawsuits against its maker, Purdue Pharma. The high prevalence of pain itself is also partly to blame. More than 30% of Americans have some form of acute or chronic pain, and the prevalence of chronic pain is more than 40% among older adults. The other group contributing to this epidemic is people who intentionally abuse opioids to experience euphoria.1,2
Opioid analgesics are the most commonly prescribed drug class in the U.S., with 245 million opioid prescriptions dispensed by U.S. pharmacies in 2014. Pharmaceutical companies have engaged in aggressive marketing to physicians and consumers. Many physicians state that they lack confidence about how to safely prescribe opioids, detect abuse/addiction or discuss these issues. Prescribing opioids long term for pain typically requires escalating doses in order to maintain the initial level of pain relief. People suffering from chronic pain often become dependent or addicted to opioids.3 These patients often end up needing treatment for oxycodone or other opioid addiction.
What Is Xtampza ER and Is It Abuse-Deterrent?
Xtampza® ER is a novel, abuse-deterrent extended release formulation composed of microspheres that was developed to prevent common methods of manipulation. In addition to having abuse-deterrent properties, this formula provides alternative modes of administration for people with chronic pain and difficulty swallowing. The flexible-dosing options enable people with swallowing problems to sprinkle the capsule contents (microspheres) onto soft foods (e.g. applesauce, pudding or yogurt) without the need to cut, crush or grind the pills.4
Compared to immediate-release (IR) oxycodone tablets, in trials, this formula was less susceptible to the effects of grinding, crushing and extraction using a variety of tools and solvents. It did not effectively pass through hypodermic needles whether the microspheres were dissolved in water or melted. Chewing or crushing medications before oral administration are methods of manipulation often used by addicts to increase drug exposure. In two studies, crushing or chewing this formula before oral administration did not increase the maximum or overall exposure relative to intact microspheres. Unlike IR oxycodone, intranasal administration (snorting) did not result in higher concentration of oxycodone than oral administration.4
Are Oxycodone and Hydrocodone the Same for Pain Relief?
Oxycodone and hydrocodone are both Schedule II drugs, meaning they have a high potential for abuse. In a study analyzing both drugs, researchers found oxycodone and hydrocodone were equally effective at treating pain caused by fractures. Pain relief was experienced equally 30 and 60 minutes after each of the drugs was taken. The hydrocodone group experienced constipation more frequently than those who were administered oxycodone. Another study found a combination of oxycodone and acetaminophen (e.g. Percocet) was 1.5 times more potent than hydrocodone with acetaminophen (e.g. Vicodin) when taken at equal doses.5
Should Some People Avoid Oxycodone?
People with a family history of drug abuse, alcohol addiction or mental illness or a personal history of addiction to substances, process addictions or eating disorders should avoid taking prescription opioids.6,7 Furthermore, people should not use oxycodone if they are allergic to or have allergies to any narcotic pain medications (e.g. methadone or morphine) or narcotic cough medicines containing codeine, hydrocodone or dihydrocodeine. People with severe asthma or a blockage in the stomach or intestines should also not take opioid pain relievers.6 In addition, anyone with the following problems should notify their prescribing physician before considering taking oxycodone:
- Breathing problems or lung disease
- A history of head injury, brain tumor or seizures
- Urination problems
- Liver or kidney disease
- Addison’s disease or other adrenal gland disorders
- Gallbladder, pancreas or thyroid problems
- Current use of sedatives (e.g. diazepam, alprazolam, lorazepam and others)6
Anyone with the above issues should ask their physician if there is an alternative non-opioid pain medication, such as a prescription-strength anti-inflammatory drug. Moreover, after surgery, an epidural or use of a nerve block or a local anesthetic during the surgery can help reduce pain and reduce the need for opioid analgesics.7
- Drug overdose deaths in the United States hit record numbers in 2014. Centers for Disease Control and Prevention website. https://www.cdc.gov/drugoverdose/epidemic/ Updated June 21, 2016. Accessed January 20, 2017.
- Ryan H, Girion L, Glover S. You Want a Description of Hell?’ OxyContin’s 12-Hour Problem. Los Angeles Times. May 5, 2016. http://static.latimes.com/oxycontin-part1/ Accessed January 20, 2017.
- Volkow ND, McLellan AT. Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies. N Engl J Med. 2016 Mar 31;374(13):1253-63. doi: 10.1056/NEJMra1507771.
- Gudin J. Oxycodone DETERx®: A Novel Abuse-Deterrent, Extended-Release Analgesic Option for the Treatment of Patients with Chronic Pain. Pain Ther. 2016;5(2):171-186. doi:10.1007/s40122-016-0062-1.
- Oxycodone vs. Hydrocodone for Pain Relief. Healthline website. http://www.healthline.com/health/pain-relief/oxycodone-vs-hydrocodone#Comparison2 Published April 7, 2015. Accessed January 20, 2017.
- Oxycodone. Drugs website. https://www.drugs.com/oxycodone.html Accessed January 20, 2017.
- Facts About Opioids – Hydrocodone, Oxycodone, Codeine & Others. Live Science website. http://www.livescience.com/53856-opioid-facts.html Published February 26, 2016. Accessed January 20, 2017.