Since the introduction of OxyContin in 1995, there has been a dramatic increase in abuse of this narcotic. Unlike hydrocodone and its derivatives, whose potential for abuse is limited by the presence of aspirin/paracetamol, OxyContin contains only oxycodone. The drug is easily abused by simply crushing the tablets and either ingestion, injection, inhalation or placed rectally. The drug can have serious side effects when injected as it has a prolonged extended action.
Oxycontin is frequently made more available by “doctor shopping,” where individuals, who do not have a legitimate illness, repeatedly visit many doctors to acquire large amounts of controlled substances. Other methods of obtaining oxycontin include pharmacy diversion, robbery, fake/stolen prescription, the internet and improper prescribing practices by physicians.
Recent reports indicate that non medical use of Oxycontin is relatively high among teenagers. The increased misuse of the drug has led to a numerous emergency admissions and even deaths. Many States have introduced legislation to decrease the illegal use of Oxycontin. Numerous States have also introduced prescription monitoring and banned the sale of the drug over the internet. Despite all the increased efforts by the FDA, DEA, and state/local authorities, the illicit use of Oxycontin is at an all time high. Over the last decade the increased illicit use of oxycontin has led to the manufacture of “fake” oxycontin pills all over north America.
Sudden stoppage of oxycontin can result in serious withdrawal symptoms. The withdrawal syndrome may be characterized by restlessness, lacrimation, restlessness, anxiety, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other symptoms also may develop, include irritability, vague pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate.
Both physicians and pharmacies now maintain careful record-keeping of prescribing information, including quantity, frequency, and renewal requests. Adequate evaluation of the patient, proper prescribing practices, frequent assessment of pain, proper dispensing and storage are recommended steps that may help limit the abuse of OxyContin.
Side effects
Respiratory depression is a major severe complication of oxycontin. Respiratory depression is a cause of concern in elderly or debilitated patients, and usually follows after the use of large initial doses in non tolerant patients, or when other opioids are given concurrently. In the community, the majority of OxyContin-related deaths have occurred in individuals who were ingesting large quantities of oxycontin in combination with either alcholol or benzodiazepines.
Oxycontin should be used with extreme caution in patients with significant lung disorders such as chronic obstructive pulmonary disease, heart failure or pre-existing respiratory depression. In such patients, even usual therapeutic dose of oxycontin may suppress the respiratory drive to the point of arrest.
OxyContin may cause severe hypotension. There is an added risk to individuals whose ability to maintain blood pressure has been compromised by a depleted blood volume, or after concurrent administration with drugs such as phenothiazines or other agents which compromise vasomotor tone. Oxycontin, should be administered with caution to patients in circulatory shock, since vasodilatation produced by the drug may further reduce cardiac output and blood pressure.
Like other opioid narcotics, oxycontin can be fatal at high doses or when combined with other brain depressants such as alcohol.
Precautions
Oxycontin, like all opioid analgesics, has a narrow therapeutic index in certain patient populations, especially in those taking other CNS depressant drugs. Its use should be reserved for cases where the benefits of opioid analgesia outweigh the known risks of respiratory depression, altered mental state, and postural hypotension. The administration of oxycontin may obscure the diagnosis or clinical course in patients with acute abdominal conditions. Oxycontin may aggravate convulsions in patients with seizure disorders, which is why they should seek a professional medical detox center.
