New formulations of opioid drugs such as oxycodone (also known as the brand OxyContin) were supposed to be safer, but instead caused addiction rates to soar.
A few years ago, long before other tragedies rocked the United States, one of the nation’s main concerns was the opioid epidemic or the opioid crisis. At one time, the main opioid of concern was heroin, but for this crisis, newer and in some ways more dangerous drugs took center stage.
While there are many drugs involved, the one of the first major ones was probably oxycodone, specifically a controlled-release formulation called OxyContin. According to a 2009 report from the American Journal of Public Health, by 2004 OxyContin was “the most prevalent abused prescription opioid.”
Unlike other dangerous drugs such as heroin, crack cocaine, or PCP, however, oxycodone was a legal drug and was obtained legally in many cases.
History of Opioids
Not that opioid abuse began or ended with oxycodone. Opium — the original substance from which all opiates (naturally occurring) and opioids (synthetic and semisynthetic) derive — dates back at least 3,500 years to the sap of the opium poppy.
Morphine, the active ingredient in opium, was isolated in 1803. Morphine by itself is about 10 times as potent as opium. Codeine followed in 1832 but is a weak opioid analgesic (pain-relieving substance) compared to morphine. Heroin was first commercially marketed by the Bayer Company in 1898 and is at least twice as potent as morphine.
While these started out as medicine, their potential for abuse — particularly when prescribed for long-term or chronic pain as opposed to short-term acute pain — made physicians reluctant to prescribe them and led governments to restrict or ban them.
Then, in the mid-1990s, in response to demands for better pain management by individuals with chronic pain, pharmaceutical manufacturers developed so-called safer opioids. Physicians were persuaded and/or became more willing to prescribe this new generation of opioids.
The main opioids being so prescribed were hydrocodone and oxycodone. Both had been around since at least 1920, but now they were made safer by combining them with other analgesics such as aspirin, acetaminophen, and ibuprofen rather than increasing the dosage.
(This also allowed the pharmaceutical companies to patent these new formulations after they could no longer sell their predecessors exclusively.)
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But for most of the opioid crisis, the most abused drug was probably oxycodone, specifically in its OxyContin formulation.
Oxycodone is an opioid that is approximately twice as potent as morphine. In a 1996 study from the Journal of Clinical Pharmacology, researchers reported that oxycodone relieved pain for about seven hours, though other sources have said that four to six hours is more usual. Taken as prescribed, oxycodone seems safe, though the potential to abuse it is possible.
What makes OxyContin more dangerous is that it is a larger dose of oxycodone (up to 30mg compared to 15) in a controlled-release form that lasts 10 to 12 hours (although the patent application claimed at least 12 hours). As a controlled-release product, it delivers a steady dose of oxycodone over a longer period of time.
The problem is, a larger dose of oxycodone can be delivered more quickly in other ways. Instead of a person swallowing the pill whole, they might crush and insufflate (snort) it, delivering the whole larger dose immediately. This method of ingesting it might be more attractive to people with an oxycodone addiction and may be more likely to cause a fatal overdose.
Also, according to a Los Angeles Times report, in laboratory tests, one-third of female subjects received eight hours or fewer of relief from the drug. Half needed another dose of oxycodone before the 12-hour mark.
How Long Does Oxycodone High Last?
How long the high (euphoria) from oxycodone lasts is even shorter. When taking the pills whole, the euphoric effects may last as little as two hours, at which point the craving and oxycodone withdrawal may begin. If crushed for snorting, the pills’ effects may fade after only 20 minutes.
Surprisingly, not everyone who uses oxycodone or opioids in general gets high or feels euphoria. That may be one reason that some people can use drugs occasionally without becoming addicted.
How Long Can Oxycodone Be Detected?
Occasional oxycodone users may be less concerned with how long does oxycodone high last and more concerned with how long oxycodone can be detected by a drug test. That depends on many factors, including the testing method:
- Blood tests: 24 hours
- Saliva tests: 1-4 days
- Urine tests: 3-4 days
- Hair tests: 90 days
Other variables can affect detection time, including:
- The health of the liver and kidneys
- The length of time and the frequency of oxycodone use
- Interactions with other drugs or alcohol
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Long Term Side Effects Of Oxycodone
Over time, chronic misuse of oxycodone or other opioids may result in:
- Tolerance, requiring larger or more frequent doses to achieve the same pain relief or euphoria
- Difficulty breathing
- Slowed heart rate
- Liver damage
- Dental problems
- Mood swings
- Reduced sex drive
- Inability to maintain lifestyle (work, relationships, hygiene)
- Death by overdose
One of the most serious side effects of opioid use can be an addiction, which can lead to bad decisions, accidental overdoses, and deaths. People who never used recreational drugs or drank to excess were prescribed a painkiller for a bad back or for recovery from major surgery and became hooked.
Once the potential risk for oxycodone addiction became apparent, regulatory and law enforcement agencies cracked down on over-prescription, closely watching who was prescribing how much and shutting down pill mills (pharmacies that dispensed far more prescription opioids than their population could conceivably use in order to supply addicts and drug dealers).
OxyContin was revamped in 2010 in an attempt to make it safer (which also allowed the manufacturer to hang on to its marketing exclusivity), but as of last year, the federally available statistics didn’t show it.
Oxycodone Abuse Statistics
According to information collated by the National Institute on Drug Abuse, in 2018:
- Roughly one-fourth (21-29%) of Americans prescribed opioids for chronic pain use them other than as directed.
- About one in 10 (8-12%) of Americans prescribed opioids develop an opioid use disorder (OUD).
- While 526,000 Americans had a heroin use disorder (HUD), 1.7 million had a prescription OUD (with some overlap).
- While 4-6% of people with a prescription OUD eventually move on to heroin, 80% of people with a HUD started out by misusing prescription opioids.
- 46,802 Americans (128 per day) died of an opioid overdose.
- Prescription opioid misuse costs the US $78.5 billion due to costs relating to health care, addiction rehab, law enforcement, and lost productivity.
In 2018, the opioid death rate dropped for the first time since the crisis began. Among the group that includes oxycodone, the drop was 14%, but overall, it was less than 2%.
The reason for this reduction? While Oxycodone may have been safer and fewer people may have wanted to get high, it was also more difficult to get a prescription to obtain the drug in the first place.
Addiction evolves. The crackdown on over-generous opioid prescriptions redirected people with substance use disorders to use heroin or to ingest new, more potent opioids such as fentanyl (up to 100 times more potent than morphine) that are easier and cheaper to obtain. Sometimes fentanyl is pressed into pill form and sold as oxycodone.
While one year isn’t enough to be sure, the evidence suggests that opioid addiction rates may be declining, but the abuse of stimulants — cocaine, methamphetamine (meth) — is on the rise, sometimes in combination with fentanyl or another opioid (a formulation known as a speedball).
An addiction to oxycodone or any drug is not just a matter of supply but also demand. A good way to reduce demand is comprehensive addiction rehab and education.
- ncbi.nlm.nih.gov – The Promotion and Marketing of OxyContin
- history.com – Heroin, Morphine and Opiates
- pubmed.ncbi.nlm.nih.gov – Weak Opioid Analgesics
- nature.com – Tracing the US Opioid Crisis to Its Roots
- pubmed.ncbi.nlm.nih.gov – Analgesic Efficacy of Controlled-Release Oxycodone in Postoperative Pain
- latimes.com/ – ‘You Want a Description of Hell?’ Oxycontin’s 12-Hour Problem
- livescience.com – Most People Don’t Actually Feel Euphoric When They Take Opioids, Study Finds
- healthline.com – How Long Does Oxycodone Stay in Your System?
- healthline.com – Hydrocodone/Oxycodone Overdose
- dea.gov – Oxycodone
- statnews.com – Revamped OxyContin Was Supposed to Reduce Abuse, But Has It?
- drugabuse.gov – Opioid Overdose Crisis
- usnews.com – Drug Overdose Deaths Fall for First Time in 28 Years
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