Oxycontin — What do you know?

Dear The Cat,

Thank you, The Cat, for your curiosity and for perusing the site and noticing a gap in information on this important topic! OxyContin is the brand name for a type of analgesic (meaning pain killer) called oxycodone hydrochloride, which most commonly is prescribed as a pain reliever for individuals with severe and chronic pain. It falls under the class of analgesics known as opioid agonists, which include morphine, heroin, methadone, and codeine, to name a few. Opioids can be distinguished from other painkillers in that they have increasing effect with increased dosages, meaning the more you take, the better you feel. Most other analgesics have a threshold, a dosage at which the maximum effect is reached. This is the reason why opioids can be so effective for managing pain and also so addictive.

You asked about the origins of opioids. They are some of the oldest drugs around, with their use for medicinal purposes predating written history! There are over 120 species of poppy plants, but only two contain substances that have the therapeutic or euphoric effects. So don't snort the poppy seeds off that muffin — they won't give you a high! Opioids can be classified into four broad categories. The ones produced in your own body, commonly known as endorphins, are referred to as endogenous opioids. Natural opiates, which contain alkaloids found in some species of poppy plant, are used to produce morphine and codeine, among others. Semi-synthetic opioids are derived from opiates and include oxycodone and heroin, to name a few. Methadone, often used to treat heroin addiction, is an example of a fully synthetic opioid.

You also asked what constitutes a lethal dose. This depends on such factors as the individual's tolerance and the method of consumption. OxyContin is time-released when taken as directed, as a tablet swallowed whole. But recreational users often crush the tablet to snort or dissolve it in liquid to inject. These other methods cause a more intense and immediate high because they bypass the time-release mechanism so the full dose hits the system at once. When oxycodone binds to opioid receptors located throughout the brain and spinal chord, a variety of bodily responses can occur, including pain relief, feelings of euphoria, relaxation, and slowed breathing.

Chemical dependence and addiction can easily result from taking opioids. Frequent use of the drug causes the user to build a tolerance, thus requiring more and more of the drug to achieve the same sensation. Aside from being dangerously addictive, oxycodone can have negative side effects, especially if taken in large doses. Side effects may include:

• Nausea and vomiting
• Constipation
• Drowsiness
• Dry mouth
• Contraction of the pupil

More severe (and less common) side effects may include:

• Hallucinations
• Difficulty breathing
• Rapid or irregular heart beat
• Hyperalgesia, a condition in which one taking the opioid actually develops more sensitivity to pain.

Symptoms of an overdose may include:

• Breathing that slows to deadly rate
• Seizures
• Fainting
• Coma

Withdrawal symptoms may be severe depending on the degree of dependence:

• Nausea and vomiting
• Dizziness
• Diarrhea
• Insomnia
• Severe headaches
• Depression

When oxycodone is prescribed, your health care practitioner will gradually ease you off the drug, as suddenly stopping can be dangerous.

Despite the need for a prescription, and its classification as a controlled substance, OxyContin is relatively widely available. In the U.S. it is available in tablets of 10, 20, 40, or 80 milligrams. In appearance, it varies in color and size depending on the dosage. It typically has the letters OC imprinted on one side and dosage (10, 20, etc.) on the other. Health care practitioners in the U.S. write out 6 million prescriptions per year. According to the National Household Survey on Drug Abuse, about 1 million U.S. residents aged 12 and older have used OxyContin recreationally at least once in their lifetime. Additionally, the University of Michigan's Monitoring the Future Survey found that four percent of high school seniors in the U.S. reported using the drug at least once.

Despite its addictive potential, it can be a very effective and safe method for pain management when used appropriately as prescribed.