Opana, or oxymorphone in its generic form, is a potent prescription opioid drug, and its use should be closely monitored by trained medical personnel. Opana can be highly beneficial when used as intended, for the relief of chronic or intense pain, such as that caused by cancer, surgical procedures, and arthritis, when other treatment methods are ineffective.
Opana is an opioid agonist, meaning that it interacts with opioid receptor sites in the brain and increases the amount of dopamine present in the system. Dopamine is a neurotransmitter used by the brain to regulate moods and signal pleasure. The central nervous system is depressed by the presence of Opana, which means that respiration and heart rate, blood pressure, and body temperature are all lowered.
As a Schedule II controlled substance, Opana carries a high risk of abuse, diversion, dependence, overdose, and addiction, the manufacturer of Opana ER (extended release) Endo Pharmaceuticals warns.
Opana may be abused by swallowing the tablet form, by crushing it and then snorting the resulting powder, or by dissolving crushed tablets into liquid and injecting the substance. Opana rapidly crosses through the barrier between the brain and blood, leading to a rapid onset of action and 4-6 hours of effects for the immediate-release formulation, and around 12 hours of effects for the extended-release form, the journal Therapeutics and Clinical Risk Management reports. Snorting or injecting the drug may lead to a quicker, more intense, and shorter-lived high.
Opana intoxication causes a surge of euphoria and induces relaxation. It may also cause breathing difficulties, sluggish movements, slurred speech, constricted pupils, drowsiness, an altered mental state, nausea and vomiting, slowed reflexes, impaired motor skills and coordination, and an inability to make sound decisions. A person may be more social and less inhibited while under the influence of Opana, leading to participation in questionable and/or risky behaviors and actions. Accidents, injury, and the contraction of a sexually transmitted or infectious disease, such as hepatitis or HIV/AIDS, are all potential risk factors of Opana abuse and intoxication.
Overdose and Health Risks of Opana Abuse
According to the Drug Enforcement Administration (DEA), in 2011, over 12,000 people visited an emergency department (ED) for treatment related to an adverse reaction from the abuse of oxymorphone, and over 1,000 exposures of the drug were reported by the American Association of Poison Control Centers that year. Overdose fatalities involving prescription opioids are at an all-time high, as the Centers for Disease Control and Prevention reports that 78 people die from an opioid overdose every day in the United States.
Any use of Opana outside of a legitimate and necessary prescription carries the risk for overdose. Method of abuse and dosage can increase these risk factors as can polydrug (the abuse of multiple drugs simultaneously) abuse. Drinking alcohol or introducing another central nervous system depressant, like a benzodiazepine, greatly increases the odds for a fatal overdose. Chewing Opana ER, or crushing it and then snorting or injecting it, is also highly risky, as this bypasses the slow and controlled time-release formulation of the drug and sends the entire dosage into the bloodstream at once.
Opana overdose is a medical emergency. The following are indications that help is needed:
- Shallow breathing or stopping breathing
- Extreme drowsiness
- Pinpoint pupils
- Chest pain
- Bluish tinge to the skin, lips, and nails
- Cold and clammy skin
- Weak and flaccid muscle tone
- Numbness in extremities, like the fingers, toes, arms, and legs
- Slow and irregular heart rate
- Loss of consciousness
Low blood pressure or hypotension, dry mouth, sedation, constipation, and gastrointestinal upset are also potential side effects and health risks of Opana use and abuse. Chronic opioid drug use may lead to an impaired immune system and lowered testosterone levels as well.
Dependence and Withdrawal Involving Opana
Since Opana acts on levels of dopamine in the brain, which in turn impacts feelings of pleasure, memory, impulse control, and the ability to regulate emotions, regular use of this drug can interfere with normal brain chemistry. With the regular introduction of Opana, the brain may stop making certain chemical messengers, like dopamine, on its own. This results in low levels of the neurotransmitter when Opana processes out of the body and is not present. Drug dependence can set in and withdrawal symptoms often occur when the drug is not active in the bloodstream.
Prescribing information for Opana ER warns of its high potential for dependence and addiction as well as the onset of withdrawal symptoms when the drug wears off. Withdrawal symptoms can be significant. The National Library of Medicine (NLM) reports the following as possible side effects of opioid withdrawal:
- Muscle aches
- Increased tearing
- Dilated pupils
- Chills and goosebumps
- Runny nose
- Stomach cramps
- Nausea and vomiting
Depression, bone and joint pain, tremors, irritability, restlessness, trouble concentrating on and feeling pleasure from things that used to make a person happy, short-term memory issues, drug cravings, and mood swings are additional side effects of opioid withdrawal.
Opana withdrawal can start as soon as the drug stops working in the body, and generally, the side effects peak in a day or two and last about 5-7 days on average.
The amount of Opana a person took on a regular basis, as well as how long they took it for and the method of intake, can impact the duration and severity of withdrawal. Environmental, genetic, and biological factors as well as polydrug abuse can also play a role in Opana withdrawal.
Since the side effects of withdrawal can be so significant both physically and mentally, individuals dependent on the drug should not stop taking it suddenly. Medical detox offers the safest environment to process the drug out of the body, and in some instances, replacement medications may be prescribed.
Drug dependence and addiction are not the same thing. Drug dependence is a physical manifestation of chronic drug use and can occur even when a drug is used as directed with a prescription. Dependence refers to chemical changes in the brain and the manner in which brain circuitry is altered with chronic use. Addiction is defined as a brain disease, and dependence and withdrawal symptoms are often symptoms of the disorder; however, addiction involves more than just chemical changes in the brain and body.
Addiction is also related to behavioral changes and alterations, and it can impact a person socially, financially, personally, and emotionally. Someone who struggles with addiction to Opana likely experiences difficulties in personal relationships and may get into legal trouble. Job loss, a decline in school grades, social withdrawal, familial strife, and homelessness can be potential consequences of addiction. A person battling Opana addiction may spend most of their time thinking about the drug and how to get it as well as using and recovering from its use. Finances may become strained, and individuals may no longer find pleasure in recreational or social activities they once enjoyed.
When someone suffers from addiction, they may make multiple attempts to stop taking Opana and be unable to control how much and how often they take the drug. Malnutrition, poor sleep habits, and a decline in personal hygiene and physical health can result.