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OxyContin: Pain Relief vs. Abuse

Are worries over abuse having an impact on the drug's legitimate use as a painkiller?
By
WebMD Feature
Reviewed by Louise Chang, MD

From time to time, OxyContin abuse flares up as a hot topic around the water cooler. If it isn't celebrities in the news for abusing the prescription painkiller, it's reports of drug-dealing doctors and overdose deaths. Add to that a law enforcement crackdown on OxyContin, and the result is a backlash affecting legitimate use of the drug: Many chronic pain sufferers won't take OxyContin for fear of becoming addicted, and some health care providers refuse to write OxyContin prescriptions for fear of being prosecuted.

WebMD talked to experts about OxyContin as a legitimate medication for moderate to severe pain, the dangers of abuse, the issue of addiction, and the climate of suspicion that restricts patients' access to the drug.

OxyContin Use and Abuse

OxyContin is the brand name for a timed-release formula of oxycodone, a narcotic analgesic (medication that reduces pain). It's used to relieve pain from injuries, arthritis, cancer, and other conditions. Oxycodone, a morphine-like drug, is found along with non-narcotic analgesics in a number of prescription drugs, such as Percodan (oxycodone and aspirin) and Percocet (oxycodone and acetaminophen).

OxyContin contains between 10 and 80 milligrams of oxycodone in a timed-release formula that allows up to 12 hours of relief from chronic pain. What distinguished OxyContin from other analgesics was its long-acting formula, a blessing for patients who typically need round-the-clock relief.

"If you have pain that's there all the time, four hours goes by very quickly," says cancer specialist Mary A. Simmonds, MD. "If you're not watching the clock, the pain comes back. People tend not to take their pills on time. The pain builds back up, so you're starting over. It's not very good management of pain."

Simmonds gave testimony on the value of OxyContin for alleviating cancer pain at a 2002 Congressional hearing. "For moderate to severe pain, aspirin and Tylenol aren't effective. We do need opioids."

It's the high content of oxycodone that makes OxyContin popular on the street. People who abuse the drug crush the tablet and swallow or snort it, or dilute it in water and inject it. This destroys the time-release mechanism so that the user gets the full effects of the narcotic. Users compare the high to the euphoria of heroin.

"What makes OxyContin dangerous is not only that it's addictive, it can also be lethal," says Drew Pinsky, MD, best known for his Loveline radio show. "It makes you feel you can tolerate more, but it can precipitate respiratory failure, especially when used with other drugs like alcohol or benzodiazepenes."

Street names for OxyContin include OC, Kicker, OxyCotton, and Hillbilly Heroin. According to the U.S. Drug Enforcement Administration (DEA), oxycodone has been abused for more than 30 years. But with the introduction of OxyContin in 1996, there has been a marked escalation of abuse.

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