OxyContin Addiction Treatment
OxyContin is the brand name for a time-released opioid painkiller manufactured by Purdue Pharma. It was approved by the U.S. Food and Drug Administration (FDA) in 1995 and marketed to consumers beginning in 1996. OxyContin is prescribed for the long-term relief of moderate to severe chronic pain requiring around-the-clock treatment. Some of its therapeutic uses include the treatment of pain from severe injuries, bursitis, dislocation, fractures, neuralgia, arthritis, spinal conditions and cancer. It is not intended for occasional, “as-needed” pain relief. Other brand names in this class include Roxicodone, OxyIR and Percolone.1,2,3
OxyContin vs Oxycodone
The biggest differences between OxyContin and oxycodone, the ingredient in the brand name, are the time-release component, strength and dosing recommendations. Oxycodone is available by itself and in acetaminophen combination medications (e.g. Percocet). It is released immediately after taking the pill, providing pain relief for about four to six hours. Oxycodone is intended for short-term use only (e.g. after oral surgery). Oxycodone is available in 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg and 30 mg immediate-release tablets manufactured by several companies. Oxycodone hydrochloride oral solutions are available in 5 mg and 100 mg strengths. The latter strength is only intended for people who are opioid tolerant and suffering from severe chronic pain (e.g. cancer-related).4
OxyContin has stronger effects because it contains a pure concentration of oxycodone, with pain relief lasting up to 12 hours. OxyContin is available in 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg and 80 mg extended-release tablets. A 160 mg tablet available in 2000 was suspended in May 2001 due to its severe abuse potential.4
In April 2016, a twice-daily abuse-deterrent oxycodone medication called Xtampza ER received final approval from the 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.5
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. Shortly after OxyContin hit the market, reports of illicit use and abuse began to increase. Due to the insatiable demand for the drug, some individuals with legal prescriptions started selling OxyContin tablets to drug dealers for a profit. Heroin addicts and other drug users discovered that by crushing OxyContin tablets, they could get a much higher dose of the opioid medication. This resulted in a more powerful high than that of traditional fast-acting narcotic medications, and some even compared it to a heroin high. 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.6,7
In 2010, in an attempt to decrease epidemic levels of abuse, Purdue reformulated OxyContin into an abuse-deterrent pill which contains polymer, supposedly making it harder to crush, snort or inject. About 25% of users claim they have figured out how to defeat the deterrent. The FDA approved new labeling describing the abuse-deterrent features and subsequently denied applications from other oxycodone extended-release formulations without abuse-deterrent features. The patent for “Oxy 2.0” is good through 2025.6
In 2007, Purdue and its top executives paid more than $600 million in fines for misrepresenting the addiction risks of OxyContin. 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.6,7
OxyContin abuse is associated with many physical and psychological repercussions. In higher doses it can cause respiratory depression, which can be fatal. 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. Due to severe withdrawal symptoms, professionally supervised detox followed by inpatient rehab or an intensive outpatient program is the preferred method for treating OxyContin addiction.1,2,3
Stats and Facts
- In 1996, Purdue Pharma made $45 million in sales from OxyContin alone. By 2001, $200 million spent on marketing efforts yielded $1.1 billion in sales. Ten years later, sales totaled $3.1 billion with OxyContin accounting for about 30% of the total painkiller market.6
- Prescriptions for OxyContin decreased from 1,608,747 in the second quarter of 2010 to 1,211,593 in the second quarter of 2015.8
- In a retrospective analysis of people discharged from emergency departments for pain-related issues, oxycodone was the most widely prescribed pain reliever, accounting for 52.3% of total dispensed drugs. Of those, 97.9% were for the 5-mg pill.9
- An estimated 70% to 80% of heroin addicts started by using prescription opioids. Currently, one OxyContin pill may cost $20 to $80, whereas a bag of heroin resulting in the same high can cost as little as $5.10
- From 1997 to 2012, hospitalizations attributed to opioid poisonings increased nearly twofold in the pediatric population. In children ages 1 to 4, the increase was 205%; in adolescents ages 15 to 19, the increase was 176%.11
- In 2016, 0.90% of eighth-graders, 2.10% of 10th-graders and 3.40% of 12-graders were past-year users of OxyContin.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 forms of prescription drug abuse. Long-term management by a team of multidisciplinary providers is the 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 February 14, 2017.
- Drugs website. https://www.drugs.com/oxycontin.html Updated February 6, 2017. Accessed February 14, 2017.
- Center for Substance Abuse Research. http://www.cesar.umd.edu/cesar/drugs/oxycodone.asp October 29, 2013. Accessed February 14, 2017.
- Oxycodone vs. OxyContin. Healthline website. http://www.healthline.com/health/pain-relief/oxycodone-vs-oxycontin#Overview1 Published May 23, 2016. Accessed February 14, 2017.
- FDA Gives Final Approval to Abuse-Deterrent Xtampza ER. Medscape website. http://www.medscape.com/viewarticle/862662 Published April 29, 2016. Accessed February 14, 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 February 14, 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 February 14, 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.
- Hoppe JA, Nelson LS, Perrone J, et al. Opioid Prescribing in a Cross Section of U.S. Emergency Departments: The Prescribing Opioids Safely in the Emergency Department (POSED) Study Consortium. Ann Emerg Med. 2015;66(3):253-259.e1. doi:10.1016/j.annemergmed.2015.03.026.
- Molly Triffin. Hospitalizations Among Teens for Opioid Poisonings Increase, Study Shows. Teen Vogue. February 13, 2017. http://www.teenvogue.com/story/teens-opioid-poisonings-painkillers-hospitalizations-teen-story Accessed February 14, 2017.
- Gaither JR, Leventhal JM, Ryan SA, Camenga DR. National Trends in Hospitalizations for Opioid Poisonings Among Children and Adolescents, 1997 to 2012. JAMA Pediatr. 2016;170(12):1195-1201. doi:10.1001/jamapediatrics.2016.2154.
- National Institute on Drug Abuse website. https://www.drugabuse.gov/drugs-abuse/opioids Updated May 2016. Accessed February 14, 2016.