Educate Yourself

FACTS about DRUGS:

OXYCONTIN
WHAT IS IT?
OxyContin is an extended-release, pain-relief medication, effective for twelve hours. It contains oxycodone, a compound found in other prescription drugs such as Percodan, Percocet, and Tylox. The effects of oxycodone are similar to those of other opiates such as morphine, hydromorphone (Dilaudid), and hydrocodone (Vicodin). First introduced in 1996, OxyContin tablets are color coded according to dosage. By combining high doses of oxycodone with a delayed release mechanism, OxyContin allows patients with moderate to severe pain to obtain sufcient pain relief for longer periods of time using fewer pills. The target population includes cancer patients, those suffering from terminal illness and other chronic severe pain syndromes (Purdue Pharma 2003).

THE RISKS
Dependence on OxyContin is rare for those users who use the drug as recommended. With continued long-term use, however, even appropriate medical users may experience tolerance, and require higher doses to achieve pain relief. As with heroin and other opiates, users of OxyContin may grow increasingly dependent upon its desirable effects and experience profound withdrawal symptoms if the drug suddenly becomes unavailable. Heavy OxyContin users undergoing sudden withdrawal will experience symptoms similar to those observed in heroin addictsvomiting, profuse sweating, stomach cramps, overall body pains, diarrhea, runny nose, tearing, hot and cold ashes, depression, and irritability. For those suffering from OxyContin dependence physicians can temper withdrawal symptoms by slowly discontinuing the drug and methadone and other treatments are often effective. Ingesting, inhaling or injecting crushed OxyContin tablets can result in overdose death, particularly in the non-tolerant user. By defeating the time-release mechanism, users expose themselves to the high doses of oxycodone (ranging from 10 mg to 80 mg) contained in each tablet. DEA ofcials have claimed that OxyContin may have played a role in 464 overdose deaths for the years 2000 and 2001 (Meier 2002). However, a recent review of 1,243 oxycodonerelated deaths in twenty-three states in August 1999 through 2002 revealed only twelve to have been caused solely by OxyContin. In almost all of these cases (97 percent), the victims (continued next page)

SLANG
Oxy, OC, legal heroin, hillbilly heroin, Oxy-40, Oxy-80, Oxycotton.

AVAILABILITY & USE

OxyContin is available by prescription, in 10 mg, 20 mg, 40 mg, and 80 mg tablets. In 2002, 1.9 million Americans reported using OxyContin non-medically at least once in their lifetime (SAMHSA). Those misusing OxyContin may buy the drug illegally or practice doctor shopping or prescription tampering to procure the drug. Sold illegally, the street price for OxyContin ranges from $5-12 for a 10 mg pill (DEA 2003). Illicit users of OxyContin sometimes defeat the delayed-release mechanism by crushing and then chewing, snorting, smoking, or (rarely) injecting the drug to get high. OxyContin misuse is believed to be highest in rural areas characterized by job scarcity, high unemployment, and relatively large elderly and disabled populations (Irwin 2003). The states with the highest misuse rates are West Virginia, Pennsylvania, Kentucky, and Virginia.

RATES OF USE
In 2001, more than 7.2 million prescriptions were written for OxyContin. Since then, the number of prescriptions has dropped somewhat as a result of the negative publicity surrounding nonmedical OxyContin use and increased physician apprehension (Ammann 2003). A 2002 study of American students found that 1 percent of eighth graders, 3 percent of tenth graders and 4 percent of twelfth graders reported non-medical use of OxyContin within the past year (Johnston 2003).

THE RISKS (cont.)

had at least three drugs in their systemmost commonly, benzodiazepines (tranquilizers such as Valium), alcohol, antidepressants, and other narcotics (Drug Policy Alliance 2003). In highlighting the actions of those misusing OxyContin, media sensationalism and governmental overreaction threaten to trample hard fought gains in the eld of pain management. For example, the DEA administrator has suggested rolling back quotas to 1996 levels, which would be a 95 percent cutback from current levels. As a result of such actions, individuals who truly need the drug medically would suffer (Bock 2001). Outside of proper medical usage, possession and sale of OxyContin carries substantial criminal penalties. Reducing risk requires not taking OxyContin unless it is prescribed; using the drug only for the condition prescribed; storing the medicine in a safe place and out of the reach of children; taking the medicine intact to avoid short-circuiting its time-release mechanism; and avoiding combining OxyContin with alcohol and/or other depressant drugs. In the event of an emergency, call 911 immediately and tell paramedics exactly what was used.

THE HIGH
When used properly, OxyContin is very effective in relieving moderate to severe pain. As with other opium-derived drugs, side effects may include possible nausea and vomiting, drowsiness, slowed breathing, cough suppression, and constipation. If crushed and then snorted, smoked, or injected, OxyContin users typically describe the resulting high in language similar to that used for explaining the effects of heroin and other opiates (see http://www.safety1st.org/educate/drugfacts/heroin.html). Users note a feeling of warmth, relaxation, and detachment, with a lessening of anxiety. Physical and emotional aches and pains seem to fade away. These effects start quickly and can last for several hours, depending on the amount of OxyContin taken and the route of administration.

SIGNS OF USE

A person using OxyContin may be sleepy, itchy, have pinpoint pupils, and breathe slowly. Some users may also experience nausea and vomiting similar to that observed with other opiates. Insomnia, loss of appetite, chills, abdominal pain, and anxiety are also possible.

RECOMMENDED READING
Irwin, Kevin & Mark Kinzly. 2003. Oxy-mania: Still Going Strong. Harm Reduction Coalition 15 (Winter). http://www.harmreduction.org/news/winter03/win03KinzlyIrwin.htm.

REFERENCES
Ammann, Melinda. 2003. The Agony and the Ecstasy: How the OxyContin Crackdown Hurts Patients in Pain. Reason Magazine (April 1). Bock, Alan. 2001. A Drug War: The government has turned its attention to the painkiller OxyContin. Is the scare campaign Justied? Orange County Register, August 5, 2001. Drug Enforcement Administration (DEA). 2003 Oxycodone. In Drug Intelligence Brief: Drugs and Chemicals of Concern. http://www.deadiversion.usdoj.gov/drugs_concern/oxycodone/oxycodone.htm Drug Policy Alliance. 2003. Researchers Find OxyContin Not So Deadly. In News, March 12, 2003. http://www.drugpolicy.org/news/03_12_03oxycontin.cfm. (continued next page)

REFERENCES (cont.)
Irwin, Kevin & Mark Kinzly. 2003. Oxy-mania: Still Going Strong. Harm Reduction Coalition 15 (Winter). http://www. harmreduction.org/news/winter03/win03KinzlyIrwin.htm. Johnston, L.D., P.M. OMalley, and J.G. Bachman. 2003. Monitoring the Future national survey results on drug use, 1975-2002. Volume 1: Secondary school students. Bethesda, MD: National Institute on Drug Abuse. http://www.monitoringthefuture.org. Meier, Barry. 2002. OxyContin Deaths May Top Early Count. New York Times, April 15, 2002. Purdue Pharma. 2003. OxyContin Package Insert. http://www.purduepharma.com. Substance Abuse and Mental Health Services Administration (SAMHSA). 2003. 2002 National Survey on Drug Use & Health. Rockville, MD: Ofce of Applied Studies, NHSDA Series H-18, DHHS Publication No. SMA 02-3759.

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FACTS about DRUGS: OXYCONTIN - www.safety1st.org