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OxyContin®:
Addiction Treatment
OxyContin® Frequently Asked Questions
Q: What Is the Likelihood That a Person for Whom
OxyContin Is Prescribed Will Become Addicted?
A: Most people who take OxyContin as prescribed
do not become addicted. The National
Institute on Drug Abuse (NIDA) reports: "With
prolonged use of opiates and opioids,
individuals become tolerant require larger
doses, and can become physically dependent on
the drugs.... Studies indicate that most
patients who receive opioids for pain, even
those undergoing long-term therapy, do not
become addicted to these drugs."(3)
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Q: What is Oxycontin?
A: OxyContin is a semisynthetic opioid analgesic
prescribed for chronic or long-lasting pain. The
medication's active ingredient is oxycodone,
which is also found in drugs like Percodan and
Tylox. However, OxyContin contains between 10
and 160 milligrams of oxycodone in a
timed-release tablet. Painkillers such as Tylox
contain 5 milligrams of oxycodone and often
require repeated doses to bring about pain
relief because they lack the timed-release
formulation.
Q: How Is OxyContin Used?
A: OxyContin, also referred to as "Oxy," "O.C.,"
and "killer" on the street, is legitimately
prescribed as a timed-release tablet, providing
as many as 12 hours of relief from chronic pain.
It is often prescribed for cancer patients or
those with chronic, long-lasting back pain. The
benefit of the medication to chronic pain
sufferers is that they generally need to take
the pill only twice a day, whereas a dosage of
another medication would require more frequent
use to control the pain. The goal of chronic
pain treatment is to decrease pain and improve
function.
Q: How Is OxyContin Abused?
A: OxyContin abusers either crush the tablet and
ingest or snort it or dilute it in water and
inject it. Crushing or diluting the tablet
disarms the timed-release action of the
medication and causes a quick, powerful high.
Abusers have compared this feeling to the
euphoria they experience when taking heroin. In
fact, in some areas, the use of heroin is
overshadowed by the abuse of OxyContin.
Purdue Pharma, OxyContin's manufacturer, has
taken steps to reduce the potential for abuse of
the medication. Its Web site lists the following
initiatives aimed at curbing the illicit use of
OxyContin: providing physicians with
tamper-proof prescription pads, developing and
distributing more than 400,000 brochures to send
to pharmacists and healthcare professionals to
help educate them about how to prevent
diversion, working with healthcare and law
enforcement officials to address the problem of
prescription drug abuse, and helping to fund a
study of the best practices in Prescription
Monitoring Programs. In addition, the company is
attempting to research and develop other pain
management products that will be less resistant
to abuse and diversion. The company estimates
that it will take significant time for such
products to be brought to market. For more
information, visit Purdue Pharma's Web site at
www.purduepharma.com or call them at
203-588-8069.
Q: How Does OxyContin Abuse Differ From Abuse of
Other Pain Prescriptions?
A: Abuse of prescription pain medications is not
new. Two primary factors, however, set OxyContin
abuse apart from other prescription drug abuse.
First, OxyContin is a powerful drug that
contains a much larger amount of the active
ingredient, oxycodone, than other prescription
pain relievers. By crushing the tablet and
either ingesting or snorting it, or by injecting
diluted OxyContin, abusers feel the powerful
effects of the opioid in a short time, rather
than over a 12-hour span. Second, great profits
are to be made in the illegal sale of OxyContin.
A 40-milligram pill costs approximately $4 by
prescription, yet it may sell for $20 to $40 on
the street, depending on the area of the country
in which the drug is sold.(1)
OxyContin can be comparatively inexpensive if it
is legitimately prescribed and if its cost is
covered by insurance. However, the National Drug
Intelligence Center reports that OxyContin
abusers may use heroin if their insurance will
no longer pay for their OxyContin prescription,
because heroin is less expensive than OxyContin
that is purchased illegally.(2)
Q: Why Are So Many Crimes Reportedly Associated
With OxyContin Abuse?
A: Many reports of OxyContin abuse have occurred
in rural areas that have housed labor-intensive
industries, such as logging or coal mining.
These industries are often located in
economically depressed areas, as well.
Therefore, people for whom the drug may have
been legitimately prescribed may be tempted to
sell their prescriptions for profit. Substance
abuse treatment providers say that the addiction
is so strong that people will go to great
lengths to get the drug, including robbing
pharmacies and writing false prescriptions.
One NIDA-sponsored study found that "only four
out of more than 12,000 patients who were given
opioids for acute pain actually became addicted
to the drugs…. In a study of 38 chronic pain
patients, most of whom received opioids for 4 to
7 years, only 2 patients actually became
addicted, and both had a history of drug
abuse."(4)
In short, most individuals who are prescribed
OxyContin, or any other opioid, will not become
addicted, although they may become dependent on
the drug and will need to be withdrawn by a
qualified physician. Individuals who are taking
the drug as prescribed should continue to do so,
as long as they and their physician agree that
taking the drug is a medically appropriate way
for them to manage pain.
Q: How Can I Determine Whether a User Is
Dependent on Rather Than Addicted to OxyContin?
A: When pain patients take a narcotic analgesic
as directed, or to the point where their pain is
adequately controlled, it is not abuse or
addiction. Abuse occurs when patients take more
than is needed for pain control, especially if
they take it to get high. Patients who take
their medication in a manner that grossly
differs from a physician's directions are
probably abusing that drug.
If a patient continues to seek excessive pain
medication after pain management is achieved,
the patient may be addicted. Addiction is
characterized by the repeated, compulsive use of
a substance despite adverse social, psychologic,
and/or physical consequences. Addiction is often
(but not always) accompanied by physical
dependence, withdrawal syndrome, and tolerance.
Physical dependence is defined as a physiologic
state of adaptation to a substance. The absence
of this substance produces symptoms and signs of
withdrawal. Withdrawal syndrome is often
characterized by overactivity of the physiologic
functions that were suppressed by the drug
and/or depression of the functions that were
stimulated by the drug. Opioids often cause
sleepiness, calmness, and constipation, so
opioid withdrawal often includes insomnia,
anxiety, and diarrhea.
Pain patients, however, may sometimes develop a
physical dependence during treatment with
opioids. This is not an addiction. A gradual
decrease of the medication dose over time, as
the pain is resolving, brings the former pain
patient to a drug-free state without any craving
for repeated doses of the drug. This is the
difference between the formerly dependent pain
patient who has now been withdrawn from
medication and the opioid-addicted patient: The
patient addicted to diverted pharmaceutical
opioids continues to have a severe and
uncontrollable craving that almost always leads
to eventual relapse in the absence of adequate
treatment. It is this uncontrollable craving for
another "rush" of the drug that differentiates
the "detoxified" but opioid-addicted patient
from the former pain patient. Theoretically, an
opioid abuser might develop a physical
dependence, but obtain treatment in the first
few months of abuse, before becoming addicted.
In this case, supervised withdrawal followed by
a few months of abstinence-oriented treatment
might be sufficient for the nonaddicted patient
who abuses opioids. If, however, this patient
subsequently relapses to opioid abuse, then that
would support a diagnosis of opioid addiction.
After several relapses to opioid abuse, it
becomes clear that a patient will require
long-term treatment for the opioid addiction.
Source: CSAT
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