What is Oxycontin?

An Overview of Oxycontin

Oxycontin is a brand name for oxycodone hydrochloride, an analgesic drug prescribed to patients for moderate to severe pain. Oxycontin refers specifically to the time-release version of the drug as manufactured by Perdue Pharma. The drug is available by prescription only for those requiring long-term pain relief throughout the day.[1]

Oxycontin is not designed to be used “as needed for pain”—instead, users are generally recommended to take one pill every 12 hours.[2] The drug’s controlled-release formula is designed for patients who are unable to take a dose of painkiller once every four hours. Oxycontin tablets come in a variety of sizes, from 10mg up to 160,[3] but the drug is also available in liquid and concentrate form.[4] Tablets over 80mg are available only for patients with a demonstrated history of opioid tolerance.[5]

Chemically, Oxycodone is very similar to codeine as well as hydrocodone (Vicodin). As such, those with allergic reactions to codeine should not take Oxycodone. Patients who are suitable candidates for the drug often find Oxycontin useful in managing pain on the recommendation of a doctor.

 

How OxyContin Works

Scientists do not have a complete understanding of precisely how Oxycontin works. In 1997, Australian researchers working with rats found that the drug works on κ-opioid receptors,[6] specifically as a κ2b-opioid agonist.[7] A team of Japanese researchers disagreed, citing their findings that diabetic mice[8] processed the drug differently from non-diabetic mice[9]. The results suggested that different receptors mediate the drug differently depending on the situation.

One thing is certain: Once the drug enters the bloodstream, it targets specific areas of the body,[10] including the spleen, brain, lungs, intestinal tract, liver and skeletal muscles. Patients begin to feel pain relief within one hour,[11] making the drug a powerful aid in pain management.

Effects of Oxycontin

As a central nervous system depressant, the primary effect of Oxycontin is a general reduction in pain. However, a number of short- and long-term side effects are common. Short-term side effects of Oxycontin include:[12]

  • Respiratory depression
  • Nausea
  • Sedation
  • Constipation
  • Vomiting
  • Dizziness
  • Dry mouth
  • Sweating
  • Mood swings
  • Loss of appetite
  • Flushing
  • Weakness
  • Headaches

The drug can also generate long-term side effects, which include:[13]

  • Increased tolerance
  • Physical dependence
  • Addiction
  • Withdrawal symptoms when use decreases

While the addictive properties of Oxycontin have received a great deal of criticism and negative press, the drug is safe for pain management when taken exactly as prescribed[14] and for an appropriate period of time. Certain patients, however, should avoid oxycodone if they have a history of codeine allergies or other conditions, including:[15]

  • Asthma, sleep apnea, COPD and other breathing disorders
  • Underactive thyroid
  • Gallbladder disease
  • Low blood pressure
  • Enlarged prostate
  • Addison’s disease and other adrenal gland diseases
  • Epilepsy and seizure disorders
  • Spinal curvature
  • Trouble swallowing and digestive blockages
  • Previous head injuries or brain trauma
  • Mental illness
  • History or family history of drug and alcohol abuse

Consideration of the drug’s short- and long-term side effects, a complete understanding of the user’s medical history, and the recommendation of a doctor are essential to the proper use of Oxycontin.

Potential For Abuse

Despite its therapeutic benefits, Oxycontin—like all opioids—does have a potential for abuse. Many patients take a higher dose than is recommended. Another common form of Oxycontin abuse is to remove the sustained-release coating of the tablets before use,[16] eliminating the drug’s controlled-release mechanism and allowing the user to obtain a heroin-like rush of euphoria.

Oxycontin abuse is currently most prevalent in several cities in the United States, including Phoenix, Cincinnati, southwest Virginia, southwest Pennsylvania, Philadelphia, southern Maine, New Orleans and eastern Kentucky.[17] Because Oxycontin is relatively easy to acquire and abuse under certain conditions, it has become a common recreational drug.

It is important to distinguish between building up a tolerance to Oxycontin and developing an addiction to the drug. Some patients, for example, worry that they are becoming addicted because their dosage needs to be increased. In some cases, however, it is normal to have a dosage increase. In others, the gradual development of a tolerance can mask an addiction. Distinguishing between the two and accurately understanding a spectrum of Oxycontin use is critical for safe and responsible pain management. Misunderstanding the drug’s uses can lead to problematic outcomes: Recent media attention and a law enforcement crackdown on the drug have led to legitimate patients being refused access.[18]

Oxycontin and the Law

Oxycontin is classified as a Schedule II drug in the United States[19]. A Schedule II classification means that Oxycontin has documented medical uses under close supervision but a high potential for abuse.[20] Penalties for illegal sales vary depending on how much oxycodone an offender has in his possession, but a first offense can result in between five and 40 years.[21] If death or serious injury is involved, the offender might face a minimum sentence of 20 years.

Like many prominent drugs, Oxycontin offers important benefits and critical risks, medically and legally. Those issues make Oxycontin a powerful but controversial pain reliever. A full understanding of the drug’s uses and abuses can help patients, doctors, friends and family understand how to best manage Oxycontin and ensure that patients are approaching the drug appropriately and responsibly.


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