OxyContin Abuse & Addiction
OxyContin, a narcotic pain medication prescribed to treat acute pain, is made up of the semisynthetic opioid drug oxycodone. This drug is derived from the opium poppy plant and comes in the form of extended release tablets for oral use.1 On its own, oxycodone is marketed as OxyContin, and it may also be referred to as Oxy, Ox, OC, hillbilly heroin, and kicker.2 The drug has the following effects:1
- Blocking pain sensations by binding to opioid receptors in the brain, slowing down functions of the central nervous system and promoting relaxation.
- Creating a euphoric “high”. The drug is often misused and abused for this purpose.
Patients on OxyContin who have a personal or family history of substance abuse or mental illness may be at higher risk of misusing or abusing the drug, as well as of developing addiction.1 In these cases, addiction treatment can be highly beneficial. Additionally, this is why the use of this drug for pain management in such patients requires intensive counseling about the risks and proper use of the opioid, as well as ongoing monitoring for signs of addiction, abuse, and misuse.1
What Are the Potential Side Effects of OxyContin Use and Abuse?
Physiological effects of oxycodone include:2
- Pain relief.
- Respiratory depression.
- Papillary constriction.
- Cough suppression.
Abusing OxyContin has both short-term and long-term health effects and many potentially dangerous side effects:1
- Side effects may include constipation, nausea, drowsiness, vomiting, fatigue, headache, dizziness, abdominal pain, intestinal blockage, increased rate of fractures.
- When the drug is taken, the central nervous system is suppressed, which means that breathing, blood pressure, heart rate, and core body temperatures are all lowered.
- Movements become sluggish and uncoordinated.
- Thinking and decision-making processes are impaired.
- A person is more prone to accidents or injuries while under the influence of the drug.
- Poor choices can include risky sexual encounters that may result in unwanted pregnancy or the contraction of sexually transmitted or infectious disease, like hepatitis and HIV/AIDS.
What Qualifies as OxyContin Abuse?
Taking a medication when there is no need to do so, or taking it beyond its prescribed dosage or purpose, is considered drug abuse. People may take OxyContin between prescribed doses or more often than is actually necessary when abusing the medication.1 An individual may continue to take the drug after a prescription has run out or go to multiple doctors in a practice called “doctor shopping,” to try and get more prescriptions.3 Anytime the drug is taken in a way it isn’t meant to be, such as chewing it or altering it to smoke, inject, or snort it, it is considered abuse.1
Individuals may go to great lengths to obtain OxyContin, asking friends or relatives for it, buying it on the street, stealing it, or forging prescriptions to get it.4 The National Survey on Drug Use and Health (NSDUH) publishes that the majority of people who misuse prescription medications get them for free from non-medical sources, typically relatives or friends.5
Potential Signs of OxyContin Abuse
Signs of oxycodone abuse may include:1
- Severe mood swings.
- Extreme relaxation or sedation, sluggish movements, and slurred speech.
- Impaired motor coordination and potential falls or accidents as a result.
- Increased risk-taking behaviors and lowered inhibitions.
- Increased secrecy.
- Strange sleep patterns.
- Appetite and weight changes.
- A possible shift in personality.
Does OxyContin Come with Risk of Dependence?
OxyContin can be habit-forming, whether taken as directed or abused. Physical dependence can be formed rather quickly as brain chemistry and circuitry are impacted by the drug. The use of the drug should not be stopped suddenly as dependence can lead to significant withdrawal when the drug wears off. Instead, opioid drugs are often slowly tapered or weaned off in a controlled fashion during OxyContin addiction treatment in order to minimize withdrawal.1
Health Risks of OxyContin Abuse and Addiction
Although OxyContin was reformulated to make the tablet more difficult to manipulate for misuse and abuse, the risk of abuse remains high. How the drug is abused, whether by snorting, smoking, injection or ingestion can lead to a variety of specific health risks. Namely, OxyContin interferes with cardiac, gastrointestinal, and respiratory functions, and prolonged use or abuse can damage these systems. The immune system may be negatively impacted by long-term abuse of this drug as can the musculoskeletal, endocrine, and central nervous systems.1
More than 150,000 people in the United States received emergency medical care in an emergency department (ED) for a negative reaction to the abuse of an oxycodone product in 2011.6 The American Society of Addiction Medicine (ASAM) publishes that around 2 million Americans battled prescription opioid painkiller addiction in 2015.5 The following factors can contribute to a higher risk for addiction:1
- Biological and environmental factors
- Polydrug abuse
- Potential underlying co-occurring mental or medical disorders
Can OxyContin Abuse Lead to Addiction?
The drug labeling for OxyContin warns users of the high risk for drug dependence and addiction that can occur when taking the product even as directed with a specific and legitimate medical need.1 Namely, when a person takes it on a regular basis, the brain can become tolerant to its effects and more of the drug will be needed with each dose in order for it to keep working as intended.7
Much like is the case with other illicit and licit opioids, addiction to OxyContin is a cluster of behavioral, cognitive, and physiological phenomena resulting from repeated substance use which includes the following:1
- Cravings for the drug
- Difficulties in controlling its use
- Persisting in drug use despite harmful consequences
- Neglect of all other activities, obligations, and interests
- Increased tolerance and physical withdrawal
The risk of overdose and addiction are possible side effects of OxyContin abuse and such risks go up with elevated doses and prolonged use. Additionally, the longer and more often a person takes or abuses the drug, the more they are at risk of developing addiction. However, it is important to note the following:1
- Abuse and addiction are separate and distinct from physical dependence and tolerance.
- Addiction may not be accompanied by concurrent tolerance and symptoms of physical dependence.
- Abuse of opioids can occur in the absence of true addiction.
What Changes Does OxyContin Cause in the Brain?
With increasing dosage and regular use, physical dependence can occur as the chemical changes that the drug makes to the brain become more pronounced:7
- Opioid drugs like oxycodone interfere with the brain’s natural chemical messengers or neurotransmitters. OxyContin changes the rate that some of these neurotransmitters are produced, how they are moved around the brain and central nervous system, and then how they are reabsorbed.
- Levels of these brain chemicals are then impacted by the presence of oxycodone. Neurotransmitters like dopamine, which plays a big role in the brain’s reward processing, learning and memory, and movement centers, are disrupted. The drug elevates levels of dopamine in the brain, causing the high, and when it wears off, these levels can dip drastically, impacting moods and some physical attributes.
- Withdrawal symptoms can start to occur in between doses or when the drug wears off after this physical dependence has formed.
- Physical dependence is often a sign of addiction, but not everyone who is dependent on this drug will suffer from addiction. Addiction is not only a physical brain disease, but also a behavioral disorder.
What Are OxyContin Addiction Treatment Options?
When someone battles addiction, they will not be able to control how much of the drug they take, and they will often take more of it at a time or take it for longer than they intended to.5 A person may make many attempts to stop taking the drug but they may be unsuccessful.
A person may continue to take OxyContin in potentially hazardous situations and regardless of any potential physical, emotional, financial, or social harm that will come from doing so. Other activities and regular obligations are set aside and left unattended to as the majority of a person’s time may now be spent on drug-seeking activities: obtaining, using, and recovering from the drug.1
This is why the only way for individuals struggling with addiction to escape all the hazards of OxyContin abuse and addiction is to start medication-assisted and carefully structured treatment. This way, they can be tapered off the drug in a medically supervised setting.1 After OxyContin is gradually processed out of the body in detox and physical stability is reached, the other facets of addiction can be managed. Addiction treatment for this drug ideally takes place within a complete program which includes:8
- Behavioral therapies.
- Educational programs.
- Support group meetings.
- Relapse prevention tools.
- Aftercare programs.
- Adjunctive therapies and options.
Individuals struggling with addiction to OxyContin have the option to participate in treatment programs that may be either inpatient or outpatient.8
Inpatient programs are generally considered to be more comprehensive as the person can be attended to around the clock.9 Schedules are structured, and mealtimes, meetings, sessions, life skills training, and workshops are all built in. This type of program can allow time for the brain to heal and for healthy habits to be formed and practiced in a safe environment.
Behavioral therapies serve to help individuals:10
- Identify negative and potentially destructive thoughts and habits as well as possible triggers for drug abuse and relapse.
- Learn how to properly manage stress and reduce cravings during group and individual sessions.
- Improve communication with family members through family therapy sessions.
Frequently Asked Questions
- The severity of a person’s withdrawal symptoms depends on:11
- The dose and route of administration.
- Concurrent use of other drugs.
- Frequency and duration of drug use.
- The age, sex, health, and genetic makeup of the user.
Withdrawal from OxyContin can start within 12 hours of the last dose and can be both physically and emotionally intense. The following are common side effects of opioid withdrawal:11
- Runny nose
- Increased tearing
- Agitation and irritability
- Muscle, back, and joint pain
- Nausea and stomach upset, including possible vomiting and diarrhea
- Dilated pupils
In the event of prolonged use of the drug during pregnancy, newborns should also be observed for signs of neonatal opioid withdrawal syndrome which can be life-threatening if undetected and left untreated.1
How Long Can OxyContin Withdrawal Last?
The duration of withdrawal is typically around 7-10 days with protracted withdrawal symptoms lasting a few weeks to months when dependence is pronounced:12
- Acute withdrawal usually peaks in the first 2-3 days, and then, the symptoms generally begin to subside. Low mood, sleep disturbances, and cravings may last a little longer.
- OxyContin withdrawal often mirrors a bad case of the flu physically. Emotionally, cravings, depressed moods, and cognitive deficits are often significant. These side effects are not usually life-threatening, but they can be severe enough to entice a person to keep using the drug, resulting in relapse or even a potential overdose.
It is, therefore, necessary for persons addicted to OxyContin to be tapered off the drug gradually and under medical supervision in appropriate addiction treatment as opposed to discontinuing the drug abruptly.1
- One of the biggest potential risks of OxyContin abuse is fatal overdose. Since the drug slows down the central nervous system, an overdose can cause a person to stop breathing and the heart and cardiovascular system to not work properly.1 In 2015, prescription opioids such caused nearly 20,000 American deaths, as drug overdose fatalities rose to an all-time high in the United States, remaining the number one cause of accidental death.5An overdose is recognizable by the following signs:1
- Difficulty breathing
- Skin cold and clammy to the touch
- Bluish tinge to nailbeds, lips, and skin
- Slow pulse
- Nausea and/or vomiting
- Pinpoint pupils
- Uncoordinated movements
- Mental confusion
- Sedation, loss of consciousness, or even possible coma
An OxyContin overdose can be reversed if swift medical attention is received. The opioid antagonist Narcan (naloxone) can be administered to block the opioids from the receptors in the brain and help to overturn their side effects, but if the brain is deprived of oxygen for too long, brain damage or even death may occur.1
Factors Which Increase the Risk of OxyContin Overdose
Overdose risks are increased in those who have a history of addiction or overdose, have respiratory system issues, and those who use or abuse other central nervous system depressants at the same time (like benzodiazepines or alcohol, for instance).1
Method of abuse, amount used, and the frequency and duration of use can increase the odds for a life-threatening overdose.1 OxyContin is often formulated as an extended-release pain medication and if the drug is altered to be abused, the slow-release format is bypassed and the whole dosage is introduced into the system at once.4 This can have disastrous and tragic effects quickly, leading to a toxic overwhelming of the body and overdose. If overdose is suspected, immediate medical care should be sought as many first responders carry the overdose-reversal drug and can provide prompt care.1
- The remarkable commercial success of OxyContin led to a dramatic increase in rates of abuse and addiction to the drug.4 Abuse of this drug may need to be viewed as part of a broader and longer-term pattern of multiple substance abuse, despite the fact that the media often describe oxycodone users as previously drug-naive individuals who become addicted following legitimate prescriptions for medical reasons.3
The History of OxyContin
OxyContin was initially approved in the U.S. in 1950.1 After its FDA approval in 1995, it was mass-marketed by Purdue Pharma and touted as a painkiller that worked better and lasted longer than others on the market. The drug became one of the biggest selling pain relievers in the United States and has been blamed for inciting a painkiller abuse epidemic in America: the drug would go on to “become a focal point of opioid abuse issues that would continue to escalate into the 2000s and beyond”.13
The drug was marketed for 12-hour pain relief, and its addictive nature was downplayed, which has led to numerous lawsuits, charges, and settlements related to Purdue Pharma over the past several years. Stronger warnings to the label were added later on and an FDA warning letter was issued to the manufacturer for misleading advertisements.13
Making matters worse was the fact that crushing the controlled-release tablet followed by IV injection, oral ingestion or snorting became widespread and led to an increase in the level of abuse.3
As a result, in 2010, in response to the enormous backlash and extremely high rates of diversion and abuse of OxyContin, Purdue Pharma reformulated the drug, and the FDA approved the new abuse-deterrent formulation. The drug now turns to a gelatinous mush when crushed in an attempt to inject, snort, or smoke the resulting powder, making abuse of the drug in the new form still possible, but not as easy to do. Rates of abuse did seem to drop with this safety measure.13
However, opioid addiction was already formed in many cases and people started turning to heroin, an illegal opiate that is often cheaper and easier to obtain.5 Furthermore, the boxed warning on the OxyContin package was inserted which warns users not to use broken tablets, chew, crush, or dissolve the tablets as it may cause rapid release of the drug and even a fatal dose. However, this may have been counterproductive, as it has informed abusers on how to obtain a faster and better high.14
Opioid abuse and addiction are considered to be a major public health crisis in the United States, as they come with a high risk of overdose, the leading cause of accidental death nationwide.5 Deaths from prescription opioids, including oxycodone products, have quadrupled in America since 1999.13 OxyContin is an extremely potent and powerful drug that should only be taken with legitimate medical need and under the close eye of a highly trained medical professional due to high risk of abuse.14
- Even when taken as recommended, OxyContin can result in addiction, abuse, and misuse, and potential outcomes include overdose and death. It is important to take the following precautionary measures to prevent abuse and lower the chances of addiction:1
- The drug must not be shared with others.
- The drug must be stored out of reach of children and protected from theft or misuse.
- The drug must be taken orally, in recommended doses and in accordance with the manufacturer’s label.
- The drug must not be taken simultaneously with other medications unless supervised by a healthcare provider.
Raising awareness on how to prevent and detect abuse or diversion of OxyContin and other illicit and licit opioids is key to bringing the national opioid overdose epidemic under control.5
Another major issue affecting the success rate of OxyContin addiction treatment and treatment for addiction to opioids, in general, is that individuals who are admitted to treatment programs represent at best only 10% of those who meet diagnostic criteria for substance use disorder.3
- Since OxyContin withdrawal can be intensely uncomfortable, medical detox is considered the optimal method for safely allowing the drug to process out of the body.15 In a medical detox program, vital signs can be closely monitored and other medications may be used to reduce specific physical or psychological symptoms of withdrawal. During detox, optimally carried out in a specialized addiction treatment facility that can provide care 24/7, OxyContin can be slowly tapered off or replaced with another longer-acting opioid, such as methadone or buprenorphine. These medications used in medication assisted treatment may be used both during detox and during opioid addiction treatment to mitigate cravings and promote further abstinence.10 Combination medications containing the opioid agonist naloxone, as well as the partial agonist buprenorphine, are used later in treatment to enhance compliance.15
- Opioid addiction is a disease that can encompass a wide range of behavioral, social, emotional, and physical attributes, and treatment should therefore be wide-ranging.10 With comprehensive help, individuals can stop all abuse of OxyContin and embrace a stable life in recovery, although multiple courses of treatment may be needed.16 Your first step toward treatment may be calling an opioid addiction hotline. Consult an admission navigator at your desired treatment facility to learn more about treatment program costs and other details.
1. Food and Drug Administration. (2016). Highlights of Prescribing Information for OxyContin Extended Release Tablets.
2. Drug Enforcement Administration. (2020). Drug Sheet: Oxycodone.
3. Deni Carise, Karen Leggett Dugosh, A. Thomas McLellan, Amy Camilleri, George E. Woody, and Kevin G. Lynch. (2009). Prescription OxyContin Abuse Among Patients Entering Addiction Treatment.
4. Art Van Zee. (2009). The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy.
5. American Society of Addiction Medicine. (2016) .Opioid Addiction 2016 Facts & Figures.
6. Substance Abuse and Mental Health Services Administration. (2013). Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits.
7. National Institute on Drug Abuse. (2020). Drugs, Brains and Behavior: The Science of Addiction.
8. National Institute on Drug Abuse. (2020). Types of Treatment Programs.
9. Substance Abuse and Mental Health Services Administration. (2014). What Is Substance Abuse Treatment? A Booklet for Families.
10. National Institute on Drug Abuse. (2020). Principles of Effective Treatment.
11. Drug Enforcement Administration. (2017). Drugs of Abuse.
12. Judith H. Wakim. (2012). Alleviating Symptoms of Withdrawal from an Opioid.
13. Food and Drug Administration. (2016). Timeline of Selected FDA Activities & Significant Events Addressing Opioid Misuse & Abuse.
14. Sujata S. Jayawant, Rajesh Balkrishnan. (2005). The controversy surrounding OxyContin abuse: issues and solutions.
15. Substance Abuse and Mental Health Services Administration. (2006). 4 Physical Detoxification Services for Withdrawal From Specific Substances.
16. National Institute on Drug Abuse. (2020). How can prescription drug addiction be treated?