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OxyContin: Use, Abuse, and Rehabilitation

OxyContin, a trade name for an OxyCodone pill, was created by Purdue Pharma in 1995 and launched to the general public in 1996 after the FDA recognized a high level of inadequate treatment for patients suffering from chronic or severe pain. This also came during a time when diversion, and abuse, of prescription drugs was increasing, thus OxyContin and all drugs with oxycodone serving as the active ingredient were listed as Schedule II drugs in America; this means that the drug has a high potential for abuse, yet still maintains an accepted medical use in the United States.

OxyContin’s Maligned History

OxyContin was heralded as a major breakthrough in treatment for patients who were suffering from either severe or chronic pain, in large part because it was a pill that would slowly release its active ingredient over the course of a twelve-hour period. This would allow patients to take fewer pills, thus lessening the chances of over-use, and also allowed patients to sleep through the night. Unfortunately, the pills’ time-release qualities were quickly discarded in favor of a quick, powerful high for opioid addicts and those seeking to abuse the drug.

The problem was compounded in 2001 when the media showed startlingly gruesome stories of the drug’s abuse. The attention turned to a veritable frenzy when radio host Rush Limbaugh admitted to abusing the drug on his talk show during the fall of 2003. The effect following these aforementioned media reports was astounding; emergency rooms in America were crowded with OxyContin overdose admissions and the popularity of the drug surged among the general population. OxyContin itself gained the nickname ‘hillbilly heroin’ due to its chemically similar structure to other opioids.

As a frame of reference, both the United States government and several independent researchers have attempted to track the levels of OxyContin abuse across the years and general population:

  • A government-funded study found that in 1999, an estimated four million Americans aged 12 and above used some form of oral sedatives or opioids in a fashion not intended by drug manufacturers or the prescribing doctor.
  • By 2003, two years following the explosion of media coverage on the topic, that number had risen to an estimated 13.7 million Americans.
  • A survey conducted in 2005 found that 5.5% of 12th grade students reported using OxyContin for nonmedical reasons.
  • In 2006, a similar survey identified that approximately 8.3% of the United States’ population aged 12 and older had abused (used improperly) at least one pill of OxyContin during a given month.

These statistics are all encompassing; that is, those who are abusing OxyContin are doing so through a variety of methods. They may be buying it off the street or getting it from a friend, there are certainly drug-seekers looking to abuse medications like OxyContin, but many patients who either have previously or are currently going through an inpatient therapy for addiction became addicted to OxyContin in an ‘iatrogenic’ fashion. Essentially, they became addicted through regular use to treat their chronic or severe pain; they became addicted accidentally, through no fault of their own.

This characterizes the highly publicized “slippery slope” of addition to pain medications. In fact, a 2003 paper co-written by members of the DEA and several high-ranking universities found that the majority of long-term patients utilizing OxyContin were not abusing the drug. Yet, what we see is that those who maintain sustained use of the drug can find themselves dependent on the drug to some degree during their prescribed course of medicine. The degree of dependence varies dramatically depending on the individual, of course, and studies have shown that the addiction rates among genuine users varies anywhere from 3-10% depending on which study is being considered, and whether the patient has a history of addiction or not. It should also be noted that this is not including short-term patients utilizing OxyContin, for example, post-surgical patients, but rather those who utilize the medication for its benefits to their chronic pain.

Ten Years On

Today we are roughly a decade into the battle against prescription medications, and OxyContin has largely maintained its status as the poster child for abuse of pain medications. Unfortunately, the status of the fight against these drugs has not changed a great deal. In 2011, the Center for Disease Control declared an “epidemic” of overdose deaths that were related to opioid medications, including OxyContin. The report states that these medicines “…were involved in 14,800 deaths (73.8%) of 20,044 prescription drug overdose deaths.” This, according to the Center for Disease Control, is an increase of approximately ten thousand overdose deaths since statistics published in 1999.

It is nearly impossible to compare these numbers against the availability of the drug, which has most likely increased over the course of the last decade. This means that the overdose mortality rate is difficult to pinpoint due to inexact measurements of drug availability in comparison to death rate of users. A highly increased supply of the drug, for example, would dictate a higher number of deaths similar to what the CDC has found, but because it is impossible to find exact data, it is very difficult to see whether the percentage of users suffering from these overdoses is increasing, decreasing, or reaching a plateau.

New developments in OxyContin have sought to combat drug seeking behavior, however, namely in the form of how the pill is constructed. When attempting to quickly get ‘high’ from OxyContin, the user would generally manipulate the pill by crushing it, chewing it, or dissolving it. The newest form of OxyContin attempts to combat these forms of manipulation by transition into a sticky, gummy substance when altered from its pill form. This makes it more difficult to crush and inhale, or chew, or dissolve. While not perfect, it should be a step in the right direction as far as combating purely abusive behavior.

This does not, however, solve the issue of long term, accidental addiction that users may suffer from through no fault of their own. It is these users, who develop problems with the drug through normal use, which researchers are now focusing their efforts on in an attempt to combat the naturally addictive properties of OxyContin.

Oxycontin Treatment

Abuse of any substance is never easy to break. Statistics show that people are more likely to slip into re-use of the drug again, as opposed to maintaining their sobriety, when attempting to quit without professional help. There have been numerous articles written regarding the pain and intolerable nature of opiate withdrawal, and while it is not generally fatal, it is incredibly difficult to endure alone.

It is for this reason that rehabilitation programs are generally recommended as the preferred method of treating OxyContin addiction. Not only is the opiate detoxifying process both a mental and physical reaction, but when combined with the intensity of the process, it is highly recommended that this process is completed with specially trained professionals. Due to each individual’s unique reaction to withdrawal, it is always possible that other, more severe, medical complications can occur. It is also important to remember that addictions are very personal matters, but they do not solely affect one person, and instead branch out to touch the lives of everyone a patient comes into contact with.

If a patient finds they feel dependent on their medication, it is important to see their health professional to find a corrective course of action. It may be as simple as fine-tuning dosages or changing medications, but many patients will find that rehabilitation is the best course of action. According to government statistics, in the United States approximately 6% of all rehabilitation patients are undergoing treatment for opiate dependency; this equates to roughly 1.41 million patients per year seeking treatment. The drug treatment community has responded to by fine-tuning treatments for patients suffering from addiction to prescribed medication, especially pain medications, and due to the high influx of addicted patients over the course of the past decade, a great deal of progress has been made in the course of treatment available to those in need. A distinct advantage that rehabilitation programs offer is extended care, ensuring a clean break and continued support.

Unfortunately OxyContin addiction continues to thrive across the United States, but the silver lining lies in the insight that drug rehabilitation professionals have gained into the rehabilitation process. Measures are being taken to proactively fight against those who would abuse OxyContin intentionally, but with the medication’s naturally addictive properties, we may never be able to fully rid ourselves of the problem while it is still being prescribed.

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