Opiod Abuse – Oxycontin and Roxies

opiod-oxycontin-roxies-addiction

Volusia county as well as most counties in Florida has seen an amazing new trend in Drug Addiction over the last few years. In the last year of my practice at the Counseling Center of New Smyrna Beach I have seen more teens and young adults struggling with addiction than I have seen in years prior. Most of them are addicted to Alcohol, Marijuana or Pain Killer. The last being the topic I would like to discuss in this article. 

Pain Killers are typically in a class of drugs known as narcotics and are opiod type medications. These drugs are highly addictive, readily available, seen as harmless and are ripping apart families and taking lives everyday. In fact it would not surprise me if the next report I read says that oxyies and roxies have risen to the number one slot of cause of death in all classes of drugs.

In treating dependency or abuse of these or any drug it is important to have accurate information about the drug.


Drug Name: 
Oxycontin, Oxycodone, Roxicodone®, Percocet®, Percodan®, OxyIR®
(oxycodone instant release IR or oxycodone extended release ER) 

Street Name: 
OC's, OXY, OXY's, OXIES, OXYCOTTON, OXY80, PERKS, HILLBILLY HEROIN, ROXIES


Category: 
Oxycodone is an opioid analgesic medication synthesized from thebaine.

 

Drug Type / Action
Oxycodone is a central nervous system depressant. Oxycodone's action appears to work through stimulating the opioid receptors found in the central nervous system that activate responses ranging from analgesia to respiratory depression to euphoria.


Licit Uses
Oxycodone is an effective analgesic for mild to moderate pain control, chronic pain syndromes, and for the treatment of terminal cancer pain. Oxycodone is considered to be similar to morphine, in all respects, including its abuse & dependence liabilities. 


Illicit Uses
Oxycodone is abused for its opiate-like effects. As with most opiates, the adverse effects of oxycodone abuse are dependence and tolerance development. Opiate abusers have been injecting or snorting the crushed and/or dissolved tablets.  The major source of oxycodone to the street has been through forged prescriptions, professional diversion through unscrupulous pharmacists, doctors, and dentists, "doctor-shopping", and large-scale thefts.


User Population
Every age group has been affected by the relative ease of oxycodone availability and the perceived safety of these products by professionals. Sometimes seen as a "white-collar" addiction, oxycodone abuse has increased among all ethnic and economic groups. 


DEA Status
It is a Schedule II (CII) Narcotic. 


Sources of Legal Distribution
It is available only through prescription.  Prescriptions for oxycodone cannot be refilled and can only be filled with a written prescription.


Side Effects Of Oxycodone Usage

Lightheadedness
Dizziness
Drowsiness
Sedation
Nausea
Vomiting
Stupor
Tremor
Par aesthesia
Hypoesthesia
Lethargy
Seizures
Anxiety
Mental
Impairment
Agitation
Cerebral edema
Confusion
Dizziness
Hearing loss
Tinnitus
Hypoglycemia
Hyperglycemia
Acidosis
Alkalosis
Hallucination
Somnolence
Depression
Suicide aspiration
Hypoventilation
Laryngeal edema
Erythematic

Urinary
Rash
Flushing
Proteinuria
Euphoria
Dysphoria
Constipation
Pruritus
Dehydration
Dyspepsia
Taste disturbances
Abdominal pain
Abdominal distention
Sweating increased
Diarrhea
Dry mouth
Flatulence
Gastro-intestinal disorder
Pancreatitis
Intestinal obstruction
Myalgia
Rhabdomyolysis
Miosis
Visual disturbances
Red eye
Bronchospasm
Dyspnea
Hyperpnoea
Pulmonary edema
Tachypnea
Interstitial nephritis
Papillary necrosis 

Allergic reaction
Malaise
Fatigue
Chest pain
Fever
Hypothermia
Thirst
Headache
Accidental overdose
Non-accidental overdose
Hepatitis
Hepatic failure
Jaundice
Hepatotoxicity
Hepatic disorder
Asthma
Bronchospasm
Laryngeal edema
Urticaria
Anaphylactoid reaction
Drug dependence
Drug abuse
Insomnia
Confusion anxiety
Agitation
Depressed level 
of consciousness
Nervousness
Urinary retention
Renal failure 


Withdrawal Symptoms of Oxycodone Usage 

Perpetually being tired
Hot/cold sweats
Heart palpitations
Diarrhea
Rapid breathing
Crying
Runny nose
Hyperactivity
Hot and cold flashes
Aching muscles

Joints and muscles in constant pain
Vomiting
Nausea
Uncontrollable coughing
Agitation
Increased heart rate
Loss of appetite 
Abdominal Cramps

Insomnia
Watery eyes
Excessive yawning
Depression
Fever
Dilated pupils
Tremors
Watery eyes
Excessive yawning
Depression

We are finding an alarming increase in the number of adolescents using oxycodone.

OxyContin use spreads
OxyContin, when it hit the market in 1996, was touted by its maker, Purdue Pharma, as an ideal medicine for people suffering unrelenting pain, especially from cancer.  The controlled-release mechanism meant that people could keep their pain at bay for 12 hours at a time, instead of having pain return every four hours while waiting for the next dose of painkiller to take effect.   After the initial launch, Purdue Pharma, of Stamford, Conn., sought to have OxyContin® more widely prescribed for lesser pain, including the aches caused by common arthritis. 

OxyContin first turned up as a serious drug of abuse in rural areas, such as Appalachia, where it was dubbed "hillbilly heroin." It has rapidly spread to densely populated urban areas, including South Florida.  The drug is a form of oxycodone, which is sold under several brand names. Once absorbed into the system, it is impossible to tell OxyContin® from other oxycodone drugs.


Broward County Leads Nation in Amount of Rx Oxycodone
Dispensed Directly by Physicians (2/01/09)

Among the 25 physicians in the United States who received the largest quantities of the powerful narcotic pain medication, Oxycodone for direct dispensing from their offices in the first half of 2008, 18 were from Broward County. The remaining 7 physicians were from 4 other Florida counties. These 17 Broward doctors received 3.383,200 dose units (or tablets) of Oxycodone between January and June of this year. The total dose units do not include the number of dose units dispensed by pharmacies, hospital or other dispensing physicians not among the top 25 in the nation. Oxycodone is the opioid pain medication found in Percocet (with acetaminophen) or Percodan (with aspirin) or OxyContin (sustained release form).

Neighboring Palm Beach County ranked second in the nation with 852,800 dose units received by 3 of the top 25 physicians followed by Miami-Dade County with 393,900 tablets sent to 2 dispensing physicians. Hillsborough County (Tampa area) ranked 4th with 126,990 units to one physician followed by Manatee County (Bradenton area) where one physician received 116,800 dose units.

In 2007 there were 57,066,602 dose units of Oxycodone shipped to Pharmacies, Hospitals and dispensing physicians in Broward County. While many legitimate physicians may directly dispense some medications, most do not offer the highly controlled Schedule II opioids directly to patients. Rather they would write a prescription to be filled at a pharmacy. Physicians directly dispensing Schedule II narcotics are frequently associated with so called "Pain Clinics" offering "pills for pay" unlike legitimate pain management doctors. Pain Clinics have emerged, as Florida has become a key source state for pharmaceuticals diverted from appropriate medical use. Florida's failure to enact a Prescription Monitoring Program over the past 6 years makes it the largest of only a few states without such a system.

There were 119 Oxycodone-related deaths in Broward County in 2007 including 85 where the drug was considered the cause of death and 34 where the drug was detected in the deceased person. Across Florida, there were 1,253 Oxycodone-related deaths including 705 where the drug was considered the cause of death. 


United Way of Broward County Commission on Substance Abuse
From the Office of the Medical Examiner, Palm Beach County, West Palm Beach, FL

Upon reviewing the last 172 deaths involving the use of oxycodone in Palm Beach County, the Palm Beach County Medical Examiner's Office in which post mortem toxicological studies indicated the presence of oxycodone.  Benzodiazepines, detected in 96 cases, were the most common co-intoxicants in the cases of combined drug toxicity, followed by cocaine, which was found in 41. The most frequently encountered benzodiazepine was Xanax (alprazolam). This study confirms that deaths in which oxycodone is a factor are most commonly cases of combined drug toxicity.


A recent Sun Sentinel report
Rx for Death: Patients in pain overdosing in alarming numbers
Sun-Sentinel investigation documented 393 prescription drug-related deaths over the past two years in the seven-county area stretching from Okeechobee to Miami-Dade County.  The drugs showing up most often are OxyContin®. It was present in at least 224 of the 393 deaths.  OxyContin® has become the most frequently prescribed narcotic in the country, with almost 6 million people using it, according to the federal Drug Enforcement Administration. 


Below is a statement for the Drug Enforcement Agency (DEA)
Oxycodone like morphine and hydromorphone, oxycodone is used as an analgesic. It is effective orally and is marketed alone in 10, 20, 40, 80, and 160 mg controlled-release tablets (OxyContin®), or 5 mg immediate-release capsules (OxyIR®), or in combination products with aspirin (Percodan®) or acetaminophen (Percocet®) for the relief of pain. All oxycodone products are in Schedule II. Oxycodone is abused orally, or the tablets are crushed and sniffed or dissolved in water and injected.

Historically, oxycodone products have been popular drugs of abuse among the narcotic abusing population. In recent years, concern has grown among federal, state, and local officials about the dramatic increase in the illicit availability and abuse of OxyContin® products. These products contain large amounts of oxycodone (10 to 160 mg) in a formulation intended for slow release over about a 12-hour period.

Abusers have learned that this slow-release mechanism can be easily circumvented by crushing the tablet and swallowing, smoking, snorting, or injecting the drug product for a more rapid and intense high. The criminal activity associated with illicitly obtaining and distributing this drug, as well as serious consequences of illicit use, including addiction and fatal overdose deaths, is of epidemic proportions in some areas of the United States. 


FACT:
There is significant research that reveals the fact the medical detoxification without a rigorous program of recovery that includes Psychotherapy and Substance Abuse Group Therapy, may have little lasting effect. The rate of recidivism (relapse) is extremely high with those that choose to forego therapy in conjunction with medical detoxification. At the Counseling Center of New Smyrna Beach we have several specialist who treat addiction issues, if we can be of help please feel free to contact us for an appointment. 

The following is a link to the United States Substance Abuse and Mental Health Service Administration. 

http://www.samhsa.gov

Link to an article I wrote on Addiciton. click here...