- Table of ContentsPrint
- Signs and Symptoms
- Effects of Opana Abuse
- Opana Abuse Treatment
- Opana Statistics
- Teen Opana Abuse
- Resources, Articles and More Information
Opana is the trade name for the prescription medication, oxymorphone, a semi-synthetic opioid painkiller.
In various formulations, oxymorphone has been available on the US pharmaceutical market since 1959. In 2006, the FDA approved two new formulations of this powerful painkiller: Opana (immediate release) and Opana ER (extended release).
Though a potent and effective opioid analgesic, Opana may be intentionally misused and taken recreationally by those seeking a powerful high. People who use Opana report feelings of euphoria and relaxation, in addition to an overall decrease in pain. The drug is classified as a Schedule II substance, meaning it carries a high potential for abuse and dependence. Although Opana tablets are instructed to be taken orally, people abuse the drug in various ways, including via nasal insufflation (crushing and snorting) and needle injection. In December 2011, the FDA approved a reformulated version of the drug that was crush-resistant, in an effort to curb abuse.
With chronic use of Opana, users may develop a tolerance to the drug – spurring a pattern of continuously taking more and more of the drug to experience the same effects. Like other Schedule II drugs, Opana carries a severe risk of psychological and/or physiological dependence and is considered dangerous when misused. If you or someone you love is abusing Opana, learn how to find help.
Due to its potency, Opana is a highly sought-after opiate of abuse and sold under various street names, including:
- Blue heaven.
- Mrs. O.
- New blues.
- Pink lady.
Signs and Symptoms
The most noticeable signs and symptoms of Opana abuse are:
- Crushing, chewing, snorting, or injecting the dissolved form of the drug.
- A strong desire to take the drug despite negative consequences.
- Placing a higher priority on using Opana than attending to responsibilities such as family, friends, and work.
- Repeatedly claiming to have lost a prescription.
- Lying about having pain or exaggerating pain levels to get a prescription for Opana.
Opana abusers sometimes share pills with friends, buy the drug illegally, or engage in “doctor shopping” to obtain more of the drug.
Effects of Opana Abuse
- Slowed respiratory rate.
- Abdominal pain.
Warning Signs of Opana Overdose
- Respiratory depression or arrest.
- Cold and clammy skin.
- Pupil constriction or dilation.
- Cyanosis (bluish tint to fingernails, skin, and lips).
- Muscle weakness.
- Extreme drowsiness.
- Loss of consciousness.
If you think you or a loved one has overdosed on Opana, get emergency help immediately, as an overdose from this drug can be fatal.
Opana Abuse Treatment
Chronic use of Opana can lead to the development of tolerance and physical dependence. Those dependent on Opana will feel as if they require the drug to function normally and will indefinitely experience a characteristic set of opioid withdrawal symptoms any time use is abruptly ended. A number of factors will influence the exact nature of an Opana withdrawal syndrome, including the chronicity of the abuse, the amount of recent use, and other factors like physical and mental health status.
Withdrawal symptoms may include:
- Fast heartbeat.
- Watery eyes.
Acute opioid withdrawal is often uncomfortable enough to trigger relapse in many people, so many recovering users prefer to detox under medical supervision so that professionals can handle any cravings, medical complications, or emotional distress that arises as a result of toxins leaving the body.
Medication-Assisted Treatment for Opana
Therapeutic interventions for opioid dependence often incorporate medication-assisted treatment (MAT) techniques to help manage withdrawal symptoms. These medications may be included in your treatment:
- Methadone – A long-acting synthetic opioid agonist that works to minimize withdrawal symptoms and curb cravings. Methadone is taken orally on a daily basis and is administered in a clinic.
- Buprenorphine – A synthetic opioid that works as a partial agonist to reduce or eliminate withdrawal symptoms. Buprenorphine is available in two formulations – as monotherapy (buprenorphine alone) or as Suboxone, which is a combination of buprenorphine and naloxone. Both are taken orally on a daily basis.
- Naltrexone – A synthetic opioid antagonist that works by completely blocking any euphoric effects of opioids. The long-acting, injectable version of this drug is called Vivitrol and is administered via injection on a monthly basis.
Addiction treatment post-detox may occur on an inpatient or outpatient basis. Inpatient facilities are the more structured option of the two. Outpatient programs allow you the flexibility to live at home and check in with a counselor at the facility on a daily basis. Each type of facility offers pros and cons and it is important to choose the best program to fit your needs.
Residential treatment centers, also known as inpatient treatment, offer intensive, around-the-clock care. Individuals live at the facility for the duration of their treatment so they can completely focus on their recovery. Inpatient facilities also offer programs to address underlying mental and behavioral issues related to the addiction.
A typical day will look different based on which facility you enter and their corresponding treatment philosophy; however, an example day might include:
- Group therapy – In group therapy, you will share your experience with others who are facing similar struggles as you. This type of therapy brings recovering individuals together under the guidance of a trained facilitator. In a group, people can express themselves while being received by others in a compassionate, nonjudgmental way.
- Family therapy – A person’s behavior is difficult to separate from the context of family and other relationships, and family can play a significant role in the recovery process. Family therapy integrates family members into the rehabilitation process by keeping them informed of treatment goals and interventions, facilitating healthy communication between them and their loved one, and enabling them to play a significant role in their loved one’s sobriety after discharge.
- Individual therapy – This is an opportunity to meet one-on-one with a counselor or therapist. People struggling with an Opana addiction may have a pattern of thoughts, beliefs, behaviors, and/or co-occurring psychiatric disorders that contribute to their drug use. Individual therapy focuses on identifying these patterns to help users learn to work through them in a healthier way.
- Additional therapeutic offerings – This may include education, healthy eating, mediation, etc.
Inpatient programs provide a safe and sober living environment where addicted individuals can find the space to heal.
Outpatient programs provide more flexibility. Individuals can attend to responsibilities at home or work and return to the facility for regularly scheduled treatment. Therapy is a major part of outpatient treatment, and you may participate in individual and group therapy to learn healthy ways to cope with stress and cravings.
The goal of treatment is for you to learn how to live without using the drug. You may attend support groups while in treatment, and this can be a healthy way to build a supportive community around you. Receiving and giving support to others who understand your experience and support your journey towards sober living can make a huge difference in treating your addiction over the long term. While receiving treatment at an outpatient facility you may participate in:
- Individual therapy sessions.
- Group therapy sessions.
- Educational talks about recovery and addiction.
The total number of prescriptions written for oxymorphone in 2007 was 268,000. That number jumped to 1.2 million in 2012. Opana was involved in 4,599 emergency room visits in 2010. By 2011, the number of visits climbed to 12,122, meaning there were 2.6 more times people seeking emergency care due to Opana just one year later (DEA, 2013).
Opana abuse via injectable routes is a growing concern. The risk of co-infection of hepatitis C and HIV/AIDS is high among users. The reformulated version of the drug can be dissolved in water and drawn up through a syringe, and needle sharing is all-too-common among injection users. The number of injections a person may take in a day typically ranges from 4 to 15, with the number of injection partners ranging from one to six (Conrad, 2015). Injection-drug use is risky, no matter the drug of choice and in January 2015, over 150 cases of HIV infection occurred among people who were sharing needles, syringes, and injection equipment to take Opana. Additionally, studies have also found that Opana by injection can lead to blood clotting and permanent organ damage (FDA, 2012).
The use of prescription opioids such as Opana is increasing among pregnant women – whether taken to help manage pain or due to a drug dependency. Prolonged use of Opana can put a child at risk for developing a number of birth complications including neonatal abstinence syndrome (NAS). NAS occurs in 55-94% of newborns who are exposed to opioids in utero and can cause infants to experience withdrawal after birth (Kraft, et al., 2008).
Teen Opana Abuse
In 2015, roughly 5% of high school seniors reported using opioid painkillers such as Opana for nonmedical reasons (NIH, 2015). Teen prescription painkiller abuse is extremely risky and puts teens at future risk of heroin use. In fact, according to statistics from the CDC, past prescription opioid addiction makes you 40 times more likely to develop a heroin dependence.
Painkiller abuse also poses other dangers, such as fatal overdose, and male teens may be especially at risk. Studies found that males aged 15-24 are almost 4 times more likely to die from an opioid overdose than their female counterparts (Calcaterra, Glanz, & Binswanger, 2013).
Overdosing on Opana can lead to death, and it is important to talk to your teenager about drug use if you suspect they have a problem. Try to have an open conversation with your teen about the risks or opioid abuse.
Resources, Articles and More Information
Check out these resources and articles for more information on Opana.
- Drug Enforcement Administration (DEA). Oxymorphone. (April 2013). Retrieved from http://www.deadiversion.usdoj.gov/drug_chem_info/oxymorphone.pdf.
- U.S. National Library of Science. Oxymorphone Hydrocoloride. (May 5, 2014). Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=557e9610-62d7-42bf-90c1-44215bd8c1f8
- U.S. National Library of Science. Oxymorphone. (August 15, 2014). Retrieved from https://www.nlm.nih.gov/medlineplus/druginfo/meds/a610022.html
- Federal Drug Administration. Highlights of Prescribing Information Opana ER. (n.d.) Retrieved from http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/201655s004lbl.pdf
- National Institute of Drug Abuse. HIV Outbreak in Indiana Linked to Abuse of Opana. (n.d.) Retrieved from https://www.drugabuse.gov/emerging-trends/hiv-outbreak-in-indiana-linked-to-abuse-opana
- Craig, D. S. (2010). Oxymorphone extended-release tablets (Opana ER) for the management of chronic pain: a practical review for pharmacists.Pharmacy and Therapeutics, 35(6), 324.
- Federal Drug Administration. Medication Guide Opana ER. (April 2014). Retrieved from http://www.fda.gov/downloads/Drugs/DrugSafety/UCM283820.pdf
- Mayo Clinic. (January 1, 2016). Oxymorphone (Oral Route). Retrieved from http://www.mayoclinic.org/drugs-supplements/oxymorphone-oral-route/side-effects/drg-20071555
- Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report (MMWR). Community Outbreak of HIV Infection Linked to Injection Drug Use of Oxymorphone – Indiana, 2015. (May 1, 2015). Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6416a4.htm
- Zibbell, J. E., Hart-Malloy, R., Barry, J., Fan, L., & Flanigan, C. (2014). Risk factors for HCV infection among young adults in rural New York who inject prescription opioid analgesics. American journal of public health, 104(11), 2226-2232. Retrieved from http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2014.302142.
- National Institute on Drug Abuse. Monitoring the Future 2015 Survey Results. (December 2015). Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/infographics/monitoring-future-2015-survey-results
- Kotbi, N., Han, B., Cheng, D., & Odom, A. E. (2015). Opana (®) ER induced thrombotic thrombocytopenic purpura. International medical case reports journal, 8, 97-98.
- Centers for Disease Control and Prevention (CDC. (2013). Thrombotic thrombocytopenic purpura (TTP)-like illness associated with intravenous Opana ER abuse--Tennessee, 2012. MMWR. Morbidity and mortality weekly report, 62(1), 1.
- U.S. Food and Drug Administration. FDA warns about serious blood disorder resulting from misuse of Opana ER. (November 1, 2012) Retrieved from http://www.fda.gov/drugs/drugsafety/ucm322432.htm.
- Center for Disease Control and Prevention. (2013). Prescription Painkiller Overdoses: A Growing Epidemic, Especially Among Women. Atlanta, GA: Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/vitalsigns/prescriptionpainkilleroverdoses/index.html.
- American Society of Addiction Medicine. Opioid Addiction 2016 Facts & Figures. (n.d.). Retrieved from http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf
- Indian Health Service (IHS). Neonatal Abstinence Syndrome: Indian Health Service (IHS) Best Practices Guidelines. (n.d.). Retrieved from https://www.ihs.gov/odm/includes/themes/newihstheme/display_objects/documents/NAS-Guidelines-Recommendation.pdf
- Patrick, S. W., Dudley, J., Martin, P. R., Harrell, F. E., Warren, M. D., Hartmann, K. E., ... & Cooper, W. O. (2015). Prescription opioid epidemic and infant outcomes. Pediatrics, 135(5), 842-850.
- Conrad, Caitlin, et al. "Community outbreak of HIV infection linked to injection drug use of oxymorphone—Indiana, 2015." MMWR Morb Mortal Wkly Rep64.16 (2015): 443-4.
- Calcaterra, S., Glanz, J., & Binswanger, I. A. (2013). National trends in pharmaceutical opioid related overdose deaths compared to other substance related overdose deaths: 1999–2009. Drug and alcohol dependence, 131(3), 263-270.
- Kraft, W. K., Gibson, E., Dysart, K., Damle, V. S., LaRusso, J. L., Greenspan, J. S., ... & Ehrlich, M. E. (2008). Sublingual buprenorphine for treatment of neonatal abstinence syndrome: a randomized trial. Pediatrics, 122(3), e601-e607.