OxyContin is an analgesic opioid painkiller that contains oxycodone as its active ingredient. Synthesized from thebaine, a constituent of the poppy plant, oxycodone is the substance in OxyContin that makes this drug an opioid that relieves pain. Medications containing oxycodone are prescribed by doctors to patients suffering from moderate to severe pain, according to the U.S. National Library of Medicine.
In the case of OxyContin, oxycodone comes in the form of extended-release tablets or capsules and is given to those who need constant relief from significant pain. These tablets or capsules are taken orally (via the mouth). It is common for individuals who are recovering from surgery to be prescribed this medication.
Oxycodone and medications containing it are classified as Schedule II substances, and they have been since the Controlled Substances Act of 1970. However, like many opioids, OxyContin is a drug that is frequently abused, both by those prescribed the drug as well as those who obtain it through illegal means.
OxyContin and other prescription opioids see high abuse rates in the United States, according to the National Institute on Drug Abuse (NIDA). The number of opioid prescriptions in the country has increased dramatically in the last 20 years, providing more opportunities for abuse to occur. This concept is known as environmental availability. In 1991, the United States saw doctors prescribe opioids to about 76 million patients. By 2013, that number had more than doubled to 207 million. This has also led to a drastic spike in emergency room visits related to opioid abuse, as the occurrence of such visits more than doubled in the relatively short period of 2004 to 2008. In 2010, more than 16,000 overdose deaths related to prescription drugs occurred, and more than 80 percent of those were due to opioid overdose.
Why and How?
OxyContin is abused for its painkilling effects, as well as the general sense of wellbeing and feelings of euphoria it can provide. It is also known to bring on a sense of relaxation. People tend to consume more of the drug in an effort to intensify these pleasurable effects, which is often what leads to abuse. This can happen to those who have been prescribed the drug, as well as those who obtain it illegally.
One reason OxyContin and other prescription opioids see such high abuse rates is the relatively low cost to an individual. NIDA estimates that nonmedical use of prescription opioids costs insurance companies more than $72 billion on an annual basis.
OxyContin is commonly abused either orally or intravenously, according to the Drug Enforcement Administration (DEA). Tablets are sometimes crushed into a powder form and snorted through the nose, as this allows the substance to take effect more quickly than by ingesting a pill orally.
Short-Term Health Effects
Possible side effects of OxyContin use include:
- Slowed heartbeat
- Clammy skin
Oxycodone, and in turn OxyContin, can cause a serious allergic reaction for some people. This reaction is known as anaphylaxis and requires immediate professional medical attention, as it can be life-threatening. Symptoms of anaphylaxis include the appearance of a rash, incessant itching, difficulty swallowing, difficulty breathing, and swelling in the face, mouth or hands. If any of these symptoms present, call 911 right away.
OxyContin should not be used in conjunction with alcohol or other central nervous system (CNS) depressants. This includes antihistamines, sedatives, and tranquilizers. Using OxyContin with such medications or alcohol can enhance the effects of these CNS depressants and put an individual at greater risk for health complications.
Long-Term Health Effects
OxyContin abuse can result in constipation. Constipation occurs when an individual has fewer than three bowel movements per week. Bowel movements that do occur while constipated are often hard and dry in texture, which can make them difficult and painful to pass. Constipation can lead to more serious complications if left untreated. Doctors often recommend adding more fiber into one’s diet to relieve this condition. Increasing consumption of fluids can also help, and sometimes a physician may prescribe a laxative.
Abuse of OxyContin, especially in conjunction with other drugs, can lead to a condition known as serotonin syndrome, according to the U.S. National Library of Medicine. This condition occurs when the body produces too much serotonin, and it can be life-threatening. Symptoms include:
- Increased heart rate
- Muscle spasms
Symptoms usually abate within 24 hours of receiving treatment for serotonin syndrome, making this a very manageable health issue if identified quickly.
Taking OxyContin while pregnant can have serious effects on the fetus. The use of opioids during pregnancy can result in neonatal abstinence syndrome (NAS), a condition that includes a multitude of problems that can occur related to the baby. Symptoms of NAS vary based on what drug is being used, but they often arise within three days after the birth of the child. Using a drug within a week of delivery can cause the newborn to have a physical dependence on the substance at birth. Men who take excessive amounts of oxycodone have been known to become infertile, meaning that they are unable to have children.
Tolerance is a serious long-term effect of OxyContin abuse. Tolerance occurs when a person takes a substance for a long period of time and sees the effects of the drug diminished as a result. The individual no longer responds to the drug as they did when they first started taking it. This leads a person to increase the dosage of the substance, which can be extremely dangerous. While their body may have become more tolerant to the effects of the drug, it may not become as tolerant to the potentially lethal properties of the substance.
Physical dependence often occurs due to increased dosage. A person’s body craves the substance, making it extremely difficult for them to function without it in their system. This is when an individual becomes addicted to OxyContin.
Overdose of OxyContin occurs when too much of the drug is consumed, and the body is unable to process it. Symptoms of an overdose include:
- Problems breathing
- Lips turning blue
- Slowed pulse
- Physical weakness
- Decreased blood pressure
- Excessive sleepiness
- Loss of consciousness
An overdose of OxyContin can be exceedingly dangerous and prove fatal. An individual’s brain activity can be slowed to the point where the brain stops telling the body to breathe or pump blood properly.
If an overdose is suspected, medical professionals should be contacted immediately. Lack of breathing or lack of oxygenated blood in the body can have drastic health effects if not treated promptly. It is helpful to provide medical professionals with information concerning the drug abuse. Identifying the exact drug that was ingested, as well as how much and when, is important. Relaying whether or not the individual had a prescription for the medication can also be of use. The person’s age, weight and general condition should be included in the information given when calling 911.
More recently, medical professionals have been using naloxone in the case of opioid overdose. This drug, commonly found under the brand name Narcan, can block and reverse the effects of opioids. Given intravenously, naloxone usually starts working within just a couple minutes and can have lifesaving effects on an individual suffering from an overdose. NIDA estimates that more than 10,000 lives have been saved by naloxone since 1996. The Food and Drug Administration has recently approved the use of a handheld auto-injector for those outside of the medical profession.
Withdrawal from OxyContin
The first step in recovery from OxyContin addiction is to manage the physical dependence that makes an addiction to this drug so debilitating. Withdrawal symptoms may arise as early as just a few hours after the drug was last consumed, depending on the level of physical addiction. These symptoms are often similar to those of heroin withdrawal and can include:
- Physical shaking
- Extreme fatigue
- Achy muscles
- Increased heart rate
- Sweating profusely
Withdrawal from OxyContin is often very painful and can be extremely difficult both physically and mentally. Tapering off opioids is often more effective than going “cold turkey,” which is an abrupt and complete removal of the drug from the system.
Doctors will often prescribe medications to aid in the withdrawal process. Suboxone has been found to be very effective in aiding those suffering from opioid withdrawal. This drug is a combination of naloxone and buprenorphine, and it provides relief from withdrawal symptoms without giving an individual the high that an opioid would normally provide.
Naltrexone is also used in some cases of oxycodone withdrawal. This medication can block the receptors in the brain associated with oxycodone, dulling the effects of the drug. Prolonged use of Naltrexone can help restore the chemical imbalances caused by long-term abuse of oxycodone. Clonidine can also be a useful tool in managing nausea and vomiting that often accompany OxyContin withdrawal.
Once withdrawal symptoms have subsided and the physical dependence on OxyContin has been managed, an individual can begin undergoing treatment for their addiction. Because opioid abuse can change how the brain functions, recovery is often a long and challenging process. According to NIDA, medication-assisted treatment helps people retain what is learned throughout treatment and has been responsible for decreased drug use among those exposed to it.
Medication in conjunction with therapy appears to be the most effective treatment of opioid addiction. Cognitive Behavioral Therapy (CBT) has been found to be successful in treating those addicted to a variety of substances, opioids like OxyContin included. CBT is a type of therapy that focuses on the connection between thoughts, feelings, and actions. CBT asserts that these three things are all closely connected, and the examination of this has proven very useful for those recovering from addiction.
On the cognitive side, CBT often involves changing false perceptions and beliefs that cause negative reactions in a person. Such beliefs can cause problems for an individual in recovery, and identifying these trends can help to avoid relapse. CBT replaces the negative beliefs and reactions with more reasonable and positive ones.
As for the behavioral end of CBT, therapy is based on the concept that behaviors are learned and can be changed. CBT looks to identify and anticipate behavioral problems and provide people with coping mechanisms to deal with such situations. Anxiety and stress can often lead to relapse, and giving someone the tools to cope with such emotions can help them avoid using again.
CBT is solution-based, which is where it differs from a lot of other psychotherapies. While some other forms of therapy tend to focus on the past, CBT stresses the present and the future. Providing individuals with the ability to help themselves with these problems is a pillar of CBT.
CBT often sees shorter terms than other forms of therapy. One reason for this is the finding that the tools and strategies learned in CBT stick with an individual even after treatment has stopped. This is important in sustaining recovery and a reason that CBT is considered to be so effective.
The combination of CBT, other therapy methods, and medication has proven effective in helping those addicted to OxyContin to achieve long-term recovery. While each element can be somewhat effective on its own, it’s the amalgamation of these options that gives an individual the best chance of managing addiction on a long-term basis.