OxyContin Addiction

Oxycontin addiction is a physical dependence that is unavoidable when an individual is exposed to high doses of the drug for a extended period of time. The body then adapts and develops a tolerance for Oxycontin. The addiction is so powerful that it produces cravings. These cravings for Oxycontin are the result of its impact on the individual's memory with feelings of pleasantness and euphoria which the individual has come to associate with the taking of Oxycontin. The subconscious memory then motivates the individual to seek this drug because of its false imprint of Oxycontin.

Oxycontin, like other addictive prescription drugs is able to short-circuit your survival system. It artificially stimulates the reward center, or pleasure areas in your brain, without anything beneficial happening to your body. As this happens, it leads to increased confidence in Oxycontin, and less confidence in the normal rewards of life.

OxyContin Abuse

Abuse of the prescription pain reliever OxyContin is a major problem, particularly in the eastern United States. The Drug Enforcement Administration (DEA) reports that, in the United States, oxycodone products, including OxyContin, are frequently abused pharmaceuticals. The pharmacological effects of OxyContin make it a suitable substitute for heroin; therefore, it is attractive to the same abuser population. Law enforcement reports indicate heroin abusers are obtaining OxyContin because the pharmaceutical drug offers reliable strength and dosage levels. In addition, if the abusers' health insurance covers an illness that the drug treats, the insurance provider may cover the cost of the drug. Conversely, OxyContin abusers who have never used heroin may be attracted to the lower priced heroin when their health insurance no longer pays for OxyContin prescriptions or when they cannot afford the high street-level price of OxyContin. OxyContin abusers sometimes commit theft, armed robbery, and fraud to sustain their habits.

It is the euphoric effect and the fact that many people perceive prescription pain killers as "safe" that are likely the reasons why this drug is being abused in such alarming numbers. The users want to receive the pleasurable effects, in the same way that people abuse and become addicted to drugs such as heroin or cocaine. In fact, there are some indicators suggesting that this drug may be used by some as a substitute for heroin.

Alternatively, some people may begin to use them appropriately as prescribed but over time may deviate from the prescribed regimen and may become addicted without intentionally setting out to abuse the drug in the first place. Reports of people becoming addicted to OxyContin, if used as prescribed, are rare.

OxyContin Addiction or Dependence?

Pain patients may sometimes develop a physical dependence during treatment with opioids such as OxyContin. 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 addicted patient:

The patient addicted to OxyContin 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 opiate addicted patient from the former-pain patient.

Theoretically, an OxyContin abuser might develop a physical dependence, but obtain treatment in the first few months of abuse, before becoming addicted. In this case, supervised withdrawal (detoxification) followed by a few months of abstinence-oriented treatment might be sufficient for the non-addicted patient who abuses OxyContin.

If, however, this patient subsequently relapses to OxyContin 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.

Methods of OxyContin Abuse

OxyContin is designed to be swallowed whole; however, abusers ingest the drug in a variety of ways. OxyContin abusers often chew the tablets or crush the tablets and snort the powder. Because oxycodone is water soluble, crushed tablets can be dissolved in water and the solution injected. The latter two methods lead to the rapid release and absorption of oxycodone.

The Economics of OxyContin

OxyContin and heroin have similar effects; therefore, both drugs are attractive to the same abuser population. OxyContin is sometimes referred to as "poor man's heroin," despite the high price it commands at the street level. A 40 mg tablet of OxyContin by prescription costs approximately $4 or $400 for a 100-tablet bottle in a retail pharmacy. Street prices vary depending on geographic location, but generally OxyContin sells for between 50 cents and $1 per milligram. Thus, the same 100-tablet bottle purchased for $400 at a retail pharmacy can sell for $2,000 to $4,000 illegally.

OxyContin is, however, relatively inexpensive for those covered by health insurance, since the insurance provider covers most costs associated with doctor visits and the prescription. Unfortunately, many OxyContin abusers whose health insurance will no longer pay for prescriptions and who cannot afford the high street-level prices are attracted to heroin. For example, in West Virginia the availability of lower cost heroin is attracting many OxyContin abusers who have never used heroin.

OxyContin Addiction Treatment

There are a number of effective options to treat addiction to prescription opioids and to help manage the sometime severe withdrawal syndrome that accompanies sudden cessation of drug use. These options are drawn from experience and clinical research regarding the treatment of heroin addiction. They include medications, such as methadone and LAAM (levo-alpha-acetyl-methadol), and behavioral counseling approaches.

Typically, the patient is medically detoxified before any treatment approach is begun. Although detoxification in itself is not a treatment for opioid addiction, it can help relieve withdrawal symptoms while the patient adjusts to being drug free. Once the patient completes detoxification, the treatment provider must then work with the patient to determine which course of treatment would best suit the needs of the patient.

Methadone Treatment

Medications that were developed through NIDA-supported research, such as methadone and LAAM, can be used as effective treatments for addiction to opiates, if available to the patient. Methadone is a synthetic opioid that alters the effects of heroin and other opioids, eliminates withdrawal symptoms, and relieves drug craving. Treatment with methadone requires daily dosing. It has been used successfully for more than 30 years and has allowed many addicts to lead productive lives.

LAAM Treatment

LAAM can alter the effects of opiates for up to three days. Research has demonstrated that, when methadone or LAAM are given appropriately, they have the ability to counter the euphoria caused by the opiate, if the individual does in fact try to take the drug. Researchers have also developed naltrexone, an opioid blocker that is often employed for highly motivated individuals in treatment programs that promote complete abstinence. Another medication, Naloxone counteracts the effects of opioids and is used mostly to treat overdoses.

Rapid Detox

Rapid detox is the most recent entry into the field of opiate detoxification.  It treats opiate dependency at the receptor level, blocking opioid receptors and precipitating the withdrawal syndrome, while controlling it. This is achieved through use of medications, including anesthetic agents that allow withdrawal to occur, while the patient is unconscious.

Rapid detoxification should only be performed in an intensive care unit of an acute hospital. Procedures that require anesthesia and intubation should be performed in a safe and well-monitored environment.

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Source: National Drug Intelligence Center
OxyContin Diversion and Abuse
January 2001