OxyContin and oxycodone are both analgesics (pain-relieving medications) that belong to the class of opiate or narcotic drugs. Opioid drugs are either manufactured directly opiate substances extracted from the poppy plant or synthetic derivatives of them. many of the commonly prescribed narcotic pain medications are classified as Schedule II controlled substances by the United States Drug Enforcement Administration (DEA).
This means that while these drugs have some significant medicinal effects, they are also substances with a significant potential to be abused, and individuals who use or abuse them for significant periods of time are at risk to develop physical dependence on them.
How Are OxyContin and Oxycodone Similar?
Oxycodone and OxyContin are both names given to different pharmaceutical formulations of the same opioid medication.
Both OxyContin and oxycodone work by attaching to specific receptors in the brain that are referred to as endogenous opioid receptors. These brain receptors are designed to have an affinity for neurotransmitters like endorphins and enkephalins. Their activation results in a change in the subjective experience of stress, pain, and anxiety. Narcotic or opiate drugs like oxycodone and OxyContin readily attach to these receptors; different types of narcotic drugs have different chemical compositions that result in them attaching differently. Because these man-made substances are much more potent than endogenous neurotransmitters, the subjective experiences they often produce are much more intense. In addition, repeatedly taking drugs of any type that result in sensations of reinforcement or pleasure also activate other neurotransmitters, particularly the neurotransmitter dopamine. Increases in dopamine are associated with feelings of reinforcement, satisfaction, pleasure, euphoria, and other positive feelings. Many individuals readily begin to associate use of the drug with these effects. This indicates that some individuals may become motivated to take these drugs again to achieve these effects, and this can result in the beginnings of the cycle of substance abuse or the development of a substance use disorder.
Because OxyContin is a time-release form of oxycodone and generally contains higher concentrations of oxycodone than drugs that are not time-release versions, individuals who use the drug in manners inconsistent with its intended use, such as grinding it up and snorting it, mixing it in liquid and injecting it, or using extremely high amounts of the drug, may experience more enhanced effects than individuals who abuse other drugs with oxycodone in them, such as Percocet, even if these drugs are used in a similar manner. This means that for some individuals, OxyContin may have stronger effects and may be more likely to lead to a substance use disorder in a shorter period of time than use of other drugs with oxycodone in them. However, both formulations are equally dangerous and classified by the DEA in the same category as having significant potential for abuse and the development of physical dependence.
In essence, because the two substances are essentially the same chemical substance, the effects of using them are similar with few differences other than those mentioned above. According to a number of sources, such as the books Acute Pain Management: A Practical Guide and Opiate Receptors, Neurotransmitters, and Drug Dependence: Basic Science-Clinical Correlates, these effects include immediate issues, potential side effects, and long-term effects.
Immediate effects that occur who use the drugs, include:
- Feelings of euphoria
- Feelings of relaxation
- Marked reductions in the subjective experience of pain
- Marked reductions in anxiety
- Increased sedation
Side effects that will occur in some individuals include:
- Gastrointestinal issues, such as nausea, stomach cramps, vomiting, and constipation
- Drowsiness, flushing, sweating, dry mouth, and loss of appetite
- Weakness, headache, and dizziness
- Allergic reactions that may present as hives, itching, rash, and swelling of the face, throat, tongue, lips, or extremities
- Respiratory issues that typically include decreased breathing but may include more serious issues with including difficulty swallowing
- Postural hypotension that occurs when individuals rise from a prone position and their blood pressure drops
- Other cardiovascular issues that can include changes in heartbeat or blood pressure
- Extreme lethargy or comatose states (more apt with overdoses)
- Seizures, in rare cases
Long-term issues with the use of OxyContin or oxycodone include:
- Development of a severe tolerance
- Development of withdrawal symptoms (A person who has both tolerance and withdrawal symptoms will have developed physical dependence on the drug.)
- Development of an opiate use disorder
- In rare cases, liver and kidney failure with long-term use
- Changes in the brain that can lead to issues with attention, memory, and problem-solving abilities
If a person uses these drugs according to their prescribed uses and under the supervision of a physician, the potential for developing detrimental long-term effects associated with medicinal use is greatly reduced. Individuals who abuse these drugs for lengthy periods of time are at increased risk to develop these long-term detrimental effects and for overdose due to their tendency to binge on them or mix them with other drugs, such as alcohol. An overdose on narcotic drugs can be potentially fatal.
Comparing Other Drugs
Rates of Abuse
Attempting to compare and contrast rates of abuse between oxycodone and OxyContin would be like attempting to compare rates of consumption of large and medium-sized apples. The data is not of interest to most professional organizations. Essentially, the drugs are the same with a few minor differences for use in medicinal purposes. The national data kept on drug abuse reflects this fact.
The most reliable figures regarding abuse of the drugs comes from the Substance Abuse and Mental Health Services Administration (SAMHSA). According to 2015 figures from SAMHSA, approximately 2 million people were estimated to formally qualify for diagnosis of an opiate use disorder. According to 2004-2011 data from SAMHSA regarding emergency room visits associated with oxycodone products:
- In 2004, 51,418 visits were recorded.
- In 2005, 62,469 visits were recorded.
- In 2006, 77,031 visits were recorded.
- In 2007, 93,936 visits were recorded.
- In 2008, 127,800 visits were recorded.
- In 2009, 176,476 visits were recorded.
- In 2010, 182,748 visits were recorded.
- In 2011, 175,229 visits were recorded.
There was a steady rise in the number of emergency room visits associated with oxycodone use and then the number of visits leveled off from 2009 to 2011. Given the increased restrictions on prescribing practices and special attention now placed on these medications, it could be expected that data for the next recording time period will reflect a similar leveling trend or even a downward trend.
Treatment for Opiate Abuse
The treatment approach for any individual with an opiate use disorder as a result of using OxyContin or other oxycodone products would not significantly differ in its overall plan of action. The treatment program should consist of the following components:
- An initial thorough assessment of the individual’s physical, psychological, and cognitive functioning to identify all the specific issues that need to be addressed
- Proper management of any physical and psychological issues observed in the assessment
- Initial participation in a physician-assisted withdrawal management program
- Participation in substance use disorder therapy
- Participation in support groups, such as 12-Step groups, community center groups, volunteer groups, etc.
- Any other interventions that are needed in the individual case as identified in the initial assessment or in any of the ongoing treatment approaches
- Continuing treatment in the form of long-term aftercare that consists of therapy, social support group participation, etc.
- Participation in treatment for a sufficient length of time
- Support from family and friends