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A painkiller designed to treat moderate to significant pain, Opana contains the active ingredient oxymorphone, which is an opioid narcotic. Coming in both an immediate-release and extended-release formulation (Opana ER), Opana is marketed as tablets containing varying amounts of oxymorphone. Opana is also available in an injectable form.
Opana is often prescribed to treat cancer pain, chronic lower back or arthritis pain, or post-surgical pain. The manufacturer of Opana ER, Endo Pharmaceuticals, publishes that the drug is designed for use in treating significant pain around the clock. Due to the abuse potential of narcotics, and also the risk for overdose and addiction, Opana ER is not recommended for people who can be successfully treated with alternative treatment measures.
Opana (oxymorphone) is classified as a Schedule II controlled substance under the Controlled Substances Act (CSA) by the Drug Enforcement Administration (DEA), which reports that 1.22 million prescriptions for oxymorphone were dispensed in 2011, according to IMS Health. As an opioid agonist, oxymorphone fills opioid receptors in the brain and blocks pain sensations. It also serves to slow down blood pressure, respiration, and heart rate, and to lower body temperature as opioids are classified as central nervous system depressants.
Opana crosses the blood-brain barrier more rapidly than other opioids like oxycodone (OxyContin) and morphine, the journal Therapeutics and Clinical Risk Management publishes, potentially making it more potent. Increased potency can often segue into greater levels of dependence and addiction. Opana is considered to be a highly addictive prescription drug, as regular use can be habit-forming and lead to dependence.
Prescription drug abuse is a major health risk and concern in the United States. The National Institute on Drug Abuse (NIDA) reports that around 20 percent of all Americans (aged 12 and older) have misused a prescription drug at least once. The National Council on Alcoholism and Drug Dependence (NCADD) publishes that prescription drugs are the third most abused substances in the United States, behind only alcohol and marijuana, and that pain relievers are some of the most abused prescription medications.
Opana abuse may begin with a medically necessary and legitimate prescription for the drug. As the brain becomes accustomed to the drug’s effects, drug tolerance can set in. This means that a person will need to increase the dosage in order for it to continue to be effective. A person may then take higher doses, or more frequent ones, than prescribed. Drug dependence is a side effect of regular use of Opana, which can create intense physical and psychological withdrawal symptoms to appear when the drug is no longer active in the bloodstream. Individuals may therefore continue taking Opana after a prescription has run out, exaggerate medical symptoms to try and get more of the drug, or “shop” different doctors to try and obtain more prescriptions for Opana.
Opana can induce a euphoric high when taken recreationally, and the drug may be ingested, crushed and then snorted, or injected when abused. On the street, Opana goes by various names, such as:
The National Drug Intelligence Center (NDIC) reports that Caucasians between the ages of 18 and 25 abuse Opana most often, and Reuters publishes that Opana abuse has hit rural America particularly hard.
Abusing Opana can be extremely risky, as the Drug Abuse Warning Network (DAWN) reports that more than 12,000 people received medical care in an emergency department (ED) for misuse of Opana in 2011, as published by the DEA.
Overdose related to prescription drug abuse is common, as the Centers for Disease Control and Prevention (CDC) reports that close to 14,000 people died from a prescription opioid drug overdose in 2014. Overdoses are often the consequence of breathing rates being suppressed and impaired. A person may struggle to breath or stop breathing when Opana reaches toxic levels in the bloodstream.
Mixing Opana with other drugs or alcohol, or altering Opana ER (e.g., chewing it and swallowing the drug, crushing it to snort it, or dissolving it for injection), heightens the odds for an adverse reaction like overdose. When Opana ER is altered and abused, all of the drug enters the bloodstream at once instead of being released slowly over a period of time. This can overwhelm the system and lead to a potentially life-threatening overdose.
Aside from breathing difficulties, an Opana overdose also causes muscle weakness, constricted pupils, low blood pressure, irregular heart rate, clammy and cold skin, and extreme drowsiness and/or loss of consciousness or coma, per prescribing information published by Endo Pharmaceuticals. An Opana overdose can be reversed with the swift administration of an opioid antagonist like naloxone, which many first responders carry.
Opioid drugs like Opana are considered high-risk substances of abuse, as they can cause a person to become both physically and psychologically dependent with relatively few uses. The American Society of Addiction Medicine (ASAM) reports that in 2014 around 2 million people in the United States (who were at least 12 years old) suffered from addiction involving prescription opioid painkillers.
When someone abuses Opana, changes are made in the brain. The central nervous system is depressed, and brain chemistry is disrupted. Some of the brain’s chemical messengers that are related to emotional regulation, impulse control functions, and the stress response are impacted. Abuse of Opana lowers stress and anxiety, and enhances relaxation. It can cause drowsiness, muscle weakness, slurred speech, sluggish movements, decreased reaction times, and lack of coordination. A rush of euphoria, increased sociability, poor decision-making skills, and lowered inhibitions are also the result of Opana intoxication. Opana abuse can therefore lead a person to engage in hazardous or out-of-character behaviors with potentially negative and far-reaching consequences.
When Opana is abused regularly, changes made to brain chemistry and circuitry become partially fixed, and levels of dopamine are liable to drop significantly when the drug wears off. Withdrawal symptoms that are physically similar to a really bad case of the flu (e.g., sweating, chills, runny nose, shakiness, muscle aches, nausea and vomiting, diarrhea, bone pain, insomnia, and irregular heart rate and blood pressure) and emotionally difficult (e.g., anxiety, depression, trouble feeling pleasure, fatigue, mental “fogginess,” restlessness, cravings, and irritability) are common and can be intense.
Significant withdrawal symptoms and drug dependence can make it difficult for a person to regulate their Opana use, and stopping use of the drug may become hard despite the desire to do so. As a result, medical detox is recommended for opioid withdrawal.
Medical detox performed in a drug treatment facility often uses medications to mitigate withdrawal symptoms and cravings, and to help a person to attain physical stability. Opana may be replaced with longer-acting opioids, like buprenorphine or methadone, and then those medications are tapered off slowly to minimize the cravings and more significant withdrawal symptoms. Detox followed by therapeutic and supportive care provided by trained professionals can help to restore emotional and physical balance.
Opana addiction is a brain disease that impacts behavior as well as brain chemistry. Professional help in the form of a specialized addiction treatment program is often the optimal way to work toward sustained recovery.