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Oxycodone is a very powerful and potentially addictive opioid analgesic medication synthesized from thebaine. It is similar to codeine, but is more potent and has a higher dependence potential.
It is effective orally and is marketed in combination with aspirin (Percodan, Endodan, Roxiprin) or acetaminophen (Percocet, Endocet, Roxicet) for the relief of pain. It is also sold in a sustained-release form by Purdue Pharma under the trade name OxyContin and an instant-release form OxyIR. OxyContin is available in 10 mg, 20 mg, 40 mg, and 80 mg formulations, and, due to its sustained-release mechanism, is effective for eight to twelve hours. In the United States, oxycodone is a Schedule II controlled substance both as a single agent and in combination products containing acetaminophen or aspirin.
Chemical structure
The chemical structure of Oxycodone is the methylether of oxymorphone: 3-Methyl-oxymorphone. It could be also described as 14-Hydroxy-Codeinone.
Medical use
Oxycodone is one of the most powerful medications for pain control that can be taken orally. Percocet tablets (oxycodone with acetaminophen) are routinely prescribed for post-operative pain control. When used at recommended doses for relatively short periods (several weeks), it provides effective pain control with manageable side effects.
Constipation is the most frequently reported side effect, and occurs often enough that most physicians prescribe a laxative for use at the same time. Nausea is also common, requiring antiemetics.
Oxycodone is also used in treatment of moderate to severe chronic pain, particularly for cancer sufferers and individuals with severe back injury. Tolerance and physical dependence occurs after several months of treatment, with larger doses being required to achieve the same degree of analgesia.
According to the DEA and the companies that manufacture the drug, psychological addiction as a result of medical use is extremely rare. However, there are several lawsuits underway brought by plaintiffs who claim that they became addicted to the drug as a result of medical use.
Abuse
The introduction of OxyContin in 2000 resulted in increasing patterns of abuse. Unlike Percocet, whose potential for abuse is limited by the presence of acetaminophen, OxyContin contains only oxycodone and inert filler. Abusers crush the tablets to defeat the time-release mechanism, and snort or inject the resulting powder to achieve rapid absorption into the bloodstream. Abusers have also been known to simply chew the pill or remove the time release coating and swallow. A common myth is that Oxycontin is dangerous only when used with other mood or mind altering drugs. This is false. Due to the high level of narcotic in the drug, Oxycontin can be fatal to anyone who isn't extremely tolerant to narcotic painkillers. And it can make non-tolerant users extremely sick in even its smallest dose of 10mg. It was once felt that "combination" opioids (those that contain one or more additional, non-narcotic ingredients) would be less subject to abuse, since, for example, the amount of acetaminophen present in large overdoses of Percocet would cause stomach upset and liver damage. However, it has been demonstrated that abusers seeking the euphoric "high" are not deterred by the gastrologic symptoms. Similar thinking also once motivated Canadian authorities to package oral methadone for use only in combination with Tang, an orange-flavored beverage powder, in hopes that it would only be taken correctly. However, it was still abused.
Oxycodone has similar effects to morphine and heroin, and appeals to the same abuse community. Armed robberies of pharmacies where the robber demanded only OxyContin, not cash, have occurred and seem to be on the rise. In some areas, particularly the eastern U.S., OxyContin has been the drug of greatest concern to enforcement authorities. Oxycodone abuse has been especially problematic in Appalachia; because of this, the drug has earned the nickname hillbilly heroin.
Because Oxycodone is highly regulated, when acquired illegally it is quite expensive. Street prices in Washington, DC, for example, have been reported to be anywhere from fifty cents to one dollar per milligram.
Like other opium derivatives, oxycodone is fatal at high doses or when combined with depressants such as alcohol. Several documented fatalities from OxyContin abuse have been made public.
On October 10, 2003, talk radio personality Rush Limbaugh made a public admission of addiction to prescription pain medication, including OxyContin, and announced his intention to pursue inpatient treatment. Also in 2003, singer/actress Courtney Love was arrested for OxyContin abuse. On August 4, 2005, 29 people in Miami, Florida were charged with taking part in an illegal drug ring involving OxyContin. The drug was obtained with forged prescriptions. Most of the people charged were workers or former workers in the Miami/Dade School district. If found guilty, they could each face up to 20 years in prison.
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