Drugs of Abuse

OxyContin® is a prescription painkiller used for moderate to high pain relief associated with injuries, bursitis, dislocations, fractures, neuralgia, arthritis, lower back pain, and pain associated with cancer. OxyContin® contains oxycodone, the medication's active ingredient, in a timed-release tablet. Oxycodone products have been illicitly abused for the past 30 years.

Oxycodone is a Schedule II narcotic analgesic and is widely used in clinical medicine. It is marketed either alone as controlled release (OxyContin®) and immediate release formulations (OxyIR®, OxyFast®), or in combination with other nonnarcotic analgesics such as aspirin (Percodan®) or acetaminophen (Percocet®). The introduction in 1996 of OxyContin®, commonly known on the street as OC, OX, Oxy, Oxycotton, Hillbilly heroin, and kicker, led to a marked escalation of its abuse as reported by drug abuse treatment centers, law enforcement personnel, and health care professionals. Although the diversion and abuse of OxyContin® appeared initially in the eastern US, it has now spread to the western US including Alaska and Hawaii. Oxycodone-related adverse health effects increased markedly in recent years. In 2004, Food and Drug Administration (FDA) approved for marketing generic forms of controlled release oxycodone products.

Pharmacological effects include analgesia, sedation, euphoria, feelings of relaxation, respiratory depression, constipation, papillary constriction, and cough suppression. A 10 mg dose of orally-administered oxycodone is equivalent to a 10 mg dose of subcutaneously administered morphine as an analgesic in a normal population. Oxycodone’s behavioral effects can last up to 5 hours. The drug is most often administered orally. The controlled-release product, OxyContin®, has a longer duration of action (8-12 hours).

The most serious risk associated with opioids, including OxyContin®, is respiratory depression. Common opioid side effects are constipation, nausea, sedation, dizziness, vomiting, headache, dry mouth, sweating, and weakness. Taking a large single dose of an opioid could cause severe respiratory depression that can lead to death.

As with most opiates, oxycodone abuse may lead to dependence and tolerance. Acute overdose of oxycodone can produce severe respiratory depression, skeletal muscle flaccidity, cold and clammy skin, reduction in blood pressure and heart rate, coma, respiratory arrest, and death.

Chronic use of opioids can result in tolerance for the drugs, which means that users must take higher doses to achieve the same initial effects. Long-term use also can lead to physical dependence and addiction -- the body adapts to the presence of the drug, and withdrawal symptoms occur if use is reduced or stopped. Properly managed medical use of pain relievers is safe and rarely causes clinical addiction, defined as compulsive, often uncontrollable use of drugs. Taken exactly as prescribed, opioids can be used to manage pain effectively.

According to Monitoring the Future (MTF), rates of nonmedical use of prescription painkillers are relatively high among teenagers and include a significant increase in the abuse of OxyContin® among twelfth graders (see Appendix B of the 2006 National Drug Threat Assessment, Table 1 and Table 2).

The 2005 MTF shows annual use of OxyContin® by 12th graders has risen from 4.0 percent in 2002 to 5.5 percent in 2005. OxyContin® use has remained more stable in the lower grades since 2002, with 1.8 percent of 8th-graders and 3.2 percent of 10th-graders reporting annual use in 2005.

Many States have launched efforts to curb the illegal use of OxyContin®. Louisiana, Maine, Virginia, Kentucky, Pennsylvania, and Tennessee have enacted legislation to deal with this issue. California, Hawaii, Idaho, Illinois, Indiana, Kentucky, Massachusetts, Michigan, Nevada, New Mexico, New York, Oklahoma, Rhode Island, Texas, Utah, and Washington have established prescription monitoring programs. Many more States are working to establish legislation and prescription monitoring programs to deal with diverted pharmaceuticals.

DRUG ALERT: Generic OxyContin® Emerges as New Threat

Two tablets of generic oxycodone. One side of each tablet is marked "93" and the other is marked "33."

A pharmaceutical bottle of generic oxycodone.

The general public is by now familiar with the dangers and potential for abuse posed by the extended release drug oxycodone hydrochloride ER, which until recently was only available by the brand name OxyContin® . In March 2004, however, a generic version of OxyContin® became available by prescription as an approved pain medication. Soon after its release in the pharmaceutical market, “generic OxyContin® ” entered the illegal drug market as well. When abused, this drug represents an old threat in a new form – it has the same dangerous effects as OxyContin® when abused, but it looks different.

Many people remain unaware of this threat – poison control centers across the country have received a significant number of calls from citizens asking about this drug. Parents and teachers should familiarize themselves with this new product and be on alert for signs of its abuse. It is important to realize that the generic version may pose more of a threat because it is only available in 80 mg. doses, whereas OxyContin® is available in 10, 20, 40 and 80 mg. doses. Users may mistakenly believe that they are consuming a smaller dose than they actually are, increasing the potential for serious overdose or even death. Below are more important facts about the generic form of OxyContin®.

What is generic OxyContin®?

It is a generic version of the same drug that makes up OxyContin® . It is a time-release pain medication that, when abused, is dangerous and habit-forming.

What are the negative effects of oxycodone abuse?

Generic oxycodone HCl ER abuse produces the same negative side effects as OxyContin® abuse:

Long-term usage can lead to physical dependence.
A large dosage can cause severe respiratory depression that can lead to death.
Withdrawal symptoms include restlessness, muscle and bone pain, cold flashes with goose bumps, and involuntary leg movements.

What does generic OxyContin® look like?

Oxycodone HCl ER comes in small oval, light green tablets. One side of the tablet is labeled “93,” the other side is labeled “33.” (click here for a print friendly version of a tablet and bottle of generic oxycodone.)

Are there legitimate uses for generic oxycodone?

Yes. Oxycodone is prescribed as a pain medication that is not illegal if prescribed and used correctly. Patients who have been prescribed oxycodone or OxyContin® should be careful to safeguard their medication – because of their potential for abuse, these drugs are sometimes stolen from patients.

OxyContin
10mg	160mg
20mg	80mg