Q.) What is OxyContin?
A.) OxyContin, approved by the FDA in 1995, an opium
derivative, which is the same active ingredient in Percodan and
Percocet. OxyContin is intended for use by terminal cancer patients
and chronic pain sufferers. It has been linked to at least 120
overdose deaths nationwide. OxyContin (oxycodone hydrochloride
controlled-release) tablets are an opioid analgesic supplied in 10
mg, 20 mg,40 mg, and 80 mg tablet strengths for oral administration.
The tablet strengths describe the amount of oxycodone per tablet as
the hydrochloride salt. The structural formula for oxycodone
hydrochloride is as follows: The chemical formula is 4,
5-epoxy-14-hydroxy-3-methoxy-17-methylmorphinan-6-one hydrochloride.
Oxycodone is a very strong narcotic pain reliever
similar to morphine. OxyContin is designed so that the oxycodone is
slowly released over time, allowing it to be used twice daily. You
should never break, chew, or crush the OxyContin tablet since this
causes a large amount of oxycodone to be released from the tablet
all at once, potentially resulting in a dangerous or fatal drug
overdose.
Oxycodone is a white, odorless crystalline powder
derived from the opium alkaloid. Oxycodone hydrochloride dissolves
in water (1 g in 6 to 7 mL). It is slightly soluble in alcohol
(octanol water partition coefficient 0.7). The tablets contain the
following inactive ingredients: ammonio methacrylate copolymer,
hydroxypropyl methylcellulose, lactose, magnesium stearate,
povidone, red iron oxide (20 mg strength tablet only), stearyl
alcohol, talc, titanium dioxide, triacetin, yellow iron oxide (40 mg
strength tablet only), and other ingredients.
OxyContin is an opiate agonist. Opiate agonists
provide pain relief by acting on opioid receptors in the spinal
cord, brain, and possibly in the tissues directly. Opioids, natural
or synthetic classes of drugs that act like morphine, are the most
effective pain relievers available. Oxycodone is manufactured by
modifying thebaine, an alkaloid found in opium. Oxycodone has a high
abuse potential.
Oxycodone is a central nervous system depressant.
Oxycodone's action appears to work through stimulating the opioid
receptors found in the central nervous system that activate
responses ranging from analgesia to respiratory depression to
euphoria. People who take the drug repeatedly can develop a
tolerance or resistance to the drug's effects. Thus, a cancer
patient can take a dose of oxycodone on a regular basis that would
be fatal in a person never exposed to oxycodone or another opioid.
Most individuals who abuse oxycodone seek to gain the euphoric
effects, mitigate pain, and avoid withdrawal symptoms associated
with oxycodone or heroin abstinence.
Q.) How is OxyContin
used?
A.) The power painkiller OxyContin is being abused by
more and more people across the nation. The heroin-like effects of
the drug attract both legitimate and illegitimate
users.
When used properly, OxyContin contains a time-release
mechanism that spreads the release of the drug over a 12-hour
period. The time-release mechanism can be circumvented by crushing
the tablet and the drug can be used in one of the following ways:
- The tablets can be chewed
- The tablets can be crushed, then snorted like
cocaine
- The tablets can be crushed, dissolved in
water, then injected like
heroin
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OxyContin abuse is spreading for a variety of reasons.
First, the elevated opiate dosage makes it highly addictive. Second,
in contrast to drugs such as cocaine or heroin that can be laced
with other substances, with OxyContin you know how much of the drug
you are getting; the dosage is consistent, so it is a dependable
high. Finally, OxyContin is covered by most health insurance plans,
so it is significantly cheaper than street drugs. (OxyContin has
been referred to as "hillbilly heroin" or "the poor man's
heroin.")
Q.) What are the effects of
OxyContin?
A.) Respiratory depression is the chief hazard from
all opioid usage. Respiratory depression occurs most frequently in
elderly or debilitated patients, usually following large initial
doses in non-tolerant patients, or when opioids are given in
conjunction with other agents that depress respiration. Common
opioid side effects are constipation, nausea, sedation, dizziness,
vomiting, headache, dry mouth, sweating, and weakness.
Oxycodone should be used with extreme caution in
patients with significant chronic obstructive pulmonary disease and
in patients having a substantially decreased respiratory reserve,
hypoxia, hypercapnia, or preexisting respiratory depression. In such
patients, even usual therapeutic doses of oxycodone may decrease
respiratory drive to the point of apnea. In these patients
alternative non-opioid analgesics should be considered, and opioids
should be employed only under careful medical supervision at the
lowest effective dose. Oxycodone causes miosis, even in total
darkness. Pinpoint pupils are a sign of opioid overdose but are not
pathognomonic. Marked mydriasisrather than miosis may be seen due to
hypoxia in overdose situations.
Gastrointestinal Tract and Other Smooth
Muscle Oxycodone causes a reduction in motility associated with
an increase in smooth muscle tone in the antrum of the stomach and
duodenum. Digestion of food in the small intestine is delayed and
propulsive contractions are decreased. Propulsive peristaltic waves
in the colon are decreased, while tone may be increased to the point
of spasm resulting in constipation. Other opioid-induced effects may
include a reduction in gastric, biliary and pancreatic secretions,
spasm of sphincter of Oddi, and transient elevations in serum
amylase.
Cardiovascular System Oxycodone may produce release
of histamine with or without associated peripheral vasodilation.
Manifestations of histamine release and/or peripheral vasodilation
may include pruritus, flushing, red eyes, sweating, and/or
orthostatic hypotension.
Concentration--Efficacy Relationships
(Pharmacodynamics) Studies in normal volunteers and patients
reveal predictable relationships between oxycodone dosage and plasma
oxycodone concentrations, as well as between concentration and
certain expected opioid effects. In normal volunteers these include
pupillary constriction, sedation and overall "drug effect" and in
patients, analgesia and feelings of "relaxation." In non-tolerant
patients, analgesia is not usually seen at a plasma oxycodone
concentration of less than 5&endash;10
ng/mL.
As with all opioids, the minimum effective plasma
concentration for analgesia will vary widely among patients,
especially among patients who have been previously treated with
potent agonist opioids. As a result, patients need to be treated
with individualized titration of dosage to the desired effect. The
minimum effective analgesic concentration of oxycodone for any
individual patient may increase with repeated dosing due to an
increase in pain and/or the development of
tolerance.
Q.) Is OxyContin
addictive?
A.) The powerful prescription pain reliever has become
a hot new street drug that has resulted in more than 120 deaths
nationwide. It will give you a high much like HIGH GRADE heroin but
with worse consequences. 5mg of OXY has has as much active
ingredient (oxycodone) as One percocet. So chewing/snorting a 40mg
OXY is like taking 8 percocets at once or a 80mg Oxy is like taking
16 percocets all at once. Overdose Symptoms: Slow breathing,
seizures, dizziness, weakness, loss of consciousness, coma,
confusion, tiredness, cold and clammy skin, and small pupils.
OxyContin should be used to fight extreme pain.
Doctors commonly prescribe it to cancer patients as an alternative
to morphine. The drug is addictive, expensive, and when misused, it
can be lethal. OxyContin abuse is becoming an epidemic in several
rural states.
Physical dependence, which is sometimes unavoidable,
develops when an individual is exposed to a drug at a high enough
dose for long enough that the body adapts and develops a tolerance
for the drug. This means that higher doses are needed to achieve a
drug's original effects. If the patient stops taking the drug,
withdrawal will occur. Just like heroin it is almost impossible to
do alone as the withdrawal symptoms of OxyContin are worse than
heroin and last longer. Professional help from a heroin detox center
is the best and safest way to do this but there is NO painless way.
Drug craving is the result of the drug's imprinting in
the memory of a pleasant association of euphoria with the drug. The
subconscious memory then motivates the individual to seek this drug
because of the false imprint. The brain, in effect, has been trained
that using the drug is the fastest way to feel good. This learning
process then produces a new appetite or drive to seek the drug which
we call craving. This craving is most often activated by, a) memory
of pleasure, b) when we feel bad and have a habit of using the drug
to rapidly feel good, c) when we are in a situation with people,
places and activities in which a previous habit pattern of drug use
has been established.
Prescription drugs, like other addictive drugs, are
able to short-circuit your survival system by artificially
stimulating the reward center, or pleasure areas in your brain,
without anything beneficial happening to your body. As this happens,
it leads to increased confidence in the drug, and less confidence in
the normal rewards of life. This first happens on a physical level.
Then, it affects you psychologically. The big drug lie results in
decreased interest in other aspects of life, as you increase your
reliance and interest in the drug. People, places and activities
involved with using drugs become more important. People, places and
activities or lifestyles that worked through your normal reward
system, before using the drug, become less important to you. After a
while, a heavy drug user will actually resent people, places, and
activities that do not fit in with that drug
use.
Addictive drugs mimic the action of chemicals your
brain produces to send messages of pleasure to your brain's reward
center. They produce an artificial feeling of pleasure. Most
addictive drugs are able to produce pleasurable effects by
chemically acting like certain normal brain messenger chemicals,
which produce positive feelings in response to signals from the
brain.
The result is a dependence on the immediate, fast,
predictable drug which, at the same time, short circuits interests
in and the motivation to make life's normal rewards work. More and
more confidence is placed in the drug while other survival feelings
are ignored and bypassed. The result of this addiction cycle is a
lack of concern for, and confidence in, other areas of
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