Oxycodone is an opioid analgesic, or ‘painkiller’ drug that is most often prescribed to control moderate to severe pain that cannot be treated with other medications. It is a semi-synthetic opiate that was first created in 1916 from thebaine, a chemical found in poppy plants and related to other narcotic drugs, such as morphine and heroin.
Oxycodone was first developed as part of an effort to find non-addictive alternatives to these drugs, which were commonly used in medicine before and during World War I.
Unfortunately, oxycodone also has significant potential for abuse and addiction. Like all opiates, it works by binding to opioid receptors in the brain and spinal cord, and these receptors are responsible for both:
Although the US only accounts for approximately 5% of the world’s population, the National Institute on Drug Abuse (NIDA) estimates that 81% of the world’s supply of oxycodone is now consumed here.
- The pain-relieving effects that patients need.
- At higher doses, the euphoric effects that abusers seek.
Individuals who take oxycodone without a prescription, or take more than prescribed by their doctor, are at high risk of developing dependence and addiction.
Oxycodone is most often prescribed in formulations combined with other pain-relieving drugs like acetaminophen (Percocet) or as extended release tablets (OxyContin). In the past, oxycodone and other opiate drugs were prescribed sparingly, and mainly for short-term pain. However, changes to government recommendations and aggressive marketing by pharmaceutical companies have led to a dramatic increase in the last 25 years in prescriptions of oxycodone for long-term use in patients with chronic pain.
This growth in legal prescriptions of oxycodone has increased its availability in the US, and a greater amount of the drug is now being diverted to street users. Major sources of oxycodone for sale on the black market include:
- Forged prescriptions.
- ‘Doctor-shopping’ to obtain prescriptions.
- Pharmacy break-ins and robberies.
- Diversion by unethical doctors and dentists (pill-mills).
The widespread availability both in prescriptions and on the black market lead to the significantly increased risk of medical complications and overdoses from the drug.
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Who’s Abusing Oxycodone?
Current statistics about oxycodone abuse present a mixed picture of the problem and suggest that although oxycodone abuse may no longer be increasing in the US, neither is it decreasing.
Consider the following statistics:
- The 2013 National Survey on Drug Use and Health showed that people aged 18-25 were the most likely to report ever having abused oxycodone (9.9%) compared to 6% of people 26 and older.
- The Monitoring the Future Survey, funded by NIDA, found that about 1 in 30 high school seniors has abused OxyContin at least once.
Overall, the number of people who reported abusing OxyContin in the previous 12 months declined from 2012 to 2013, but the number of people who have ever used this drug for non-medical purposes increased between 2012 and 2013.
This suggests that while there are fewer current abusers than in the past, more people are now trying the drug for the first time.
Likewise, NIDA reports that despite a modest decline in OxyContin abuse since 2010, the rate of oxycodone abuse overall has remained steady.
This suggests that changes to the formulation of OxyContin that make it harder to abuse have merely caused users to switch to other forms of the drug rather than quit altogether.
Oxycodone abuse is particularly frightening because it can easily lead to heroin abuse, as addicts may switch to heroin use when oxycodone pills become either too difficult to obtain or prohibitively expensive.
Oxycodone’s Addictive Power
Did you know that it is one of the 12 most addictive drugs? Read more here.
The Oxycodone Market
There were 53 million oxycodone prescriptions filled in 2013 by US pharmacies, according to NIDA. This translates to approximately one bottle of this addictive drug for every 6 people in the country.
When obtained legally through a pharmacy, the average cost for 30 tablets of 40mg of OxyContin is $240, or about $0.20 per milligram. However, because of the potency of oxycodone and the intense dependence that abusers develop, the black market value of this drug is much higher.
A 2013 study estimated the street value of oxycodone to be approximately $1 per milligram in all regions of the US (about $40 for a 40 mg tablet of OxyContin), a 5-fold increase over legal prices.
This high markup creates a strong incentive for patients with legal oxycodone prescriptions, and even doctors and pharmacists with access to such medications, to sell their pills on the black market, which increases the supply available to recreational users.
Interest in Oxycodone on the Internet
Is Oxycodone Illegal?
Legal Penalties of Using Oxycodone
Doctors and pharmacists must follow strict record-keeping requirements when dispensing Schedule II drugs such as oxycodone, and there are stiff criminal penalties for illegally possessing and distributing such drugs.
Under federal drug laws, sentences of up to 20 years in prison and $1 million fines can be levied for trafficking oxycodone. Moreover, if a death results from the sale of the drug (overdose or otherwise), a life sentence can be imposed.
When used on a legitimate prescription basis, it is not illegal. However, it’s worth nothing that it was classified as a Schedule II drug by the Drug Enforcement Agency (DEA) in the early 1960s, which means it has both:
- Recognized medical uses.
- A high potential for abuse.
Other drugs that are also classified as Schedule II include:
- Hydromorphone (Dilaudid).
Although it has been in clinical use for nearly a century, the current epidemic of abuse did not begin until the 1990s. In 1995, the Food and Drug Administration (FDA) approved OxyContin, the extended-release form of the drug, subject to the same restrictions as other forms of oxycodone; however, high levels of OxyContin abuse were reported in the eastern US almost immediately after its introduction and soon spread throughout the entire country.
Because of their extended-release formulation, tablets of OxyContin can contain a very high amount of oxycodone, up to 80mg per pill, allowing patients with severe pain to take fewer pills per day. This high potency is attractive to drug seekers and dealers for 2 main reasons:
- Fewer tablets must be obtained.
- By crushing and injecting or snorting the tablets, abusers with high tolerance levels can more easily achieve a high.
Efforts have been made to reduce the appeal of OxyContin to abusers including:
- Discontinuation of the most potent 160mg tablets.
- The introduction of a new formulation in 2010 that made it more difficult to crush or dissolve the tablet in order to release the full dose all at once.
These changes may be responsible for the recent decrease in OxyContin abuse that has been observed. However, since oxycodone abuse overall has not changed, many users may not have stopped taking oxycodone, but simply switched to other forms of the drug.
How Dangerous Is Oxycodone?
Oxycodone, like all other narcotic painkillers, can cause addiction and dangerous, life-threatening effects when abused.
Furthermore, methods frequently employed by users to increase the euphoric high of this drug—including taking large quantities at once and crushing pills to inject or snort—increase the chances of developing a dependence or a experiencing an adverse reaction or overdose.
Effects of Oxycodone Use
Individuals who develop dependence on oxycodone and suddenly stop taking it may experience withdrawal symptoms including:
- Panic attacks.
- Gastrointestinal distress.
- Muscle weakness.
- Flu-like symptoms.
Withdrawal is extremely unpleasant and can cause users to persist in taking the drug despite negative effects on their life and finances. This addictive spiral can cause users to become depressed and, in extreme cases, even attempt suicide.
Another danger of oxycodone abuse lies in the fact that many formulations, such as Percocet, also contain other types of analgesic drugs like acetaminophen (Tylenol). Ingesting large amounts of these combinations can cause irreversible liver damage, and possibly death.
Overdose is the most serious danger of oxycodone abuse because large doses are needed to achieve a euphoric high, and the development of tolerance means the amount of drug required to achieve the same effect increases over time.
As the abuse of opiates has increased in recent years, so have emergency room visits due to overdose.
An individual who overdoses on oxycodone may experience:
- Extreme sleepiness.
- Constricted pupils.
- Uncontrolled vomiting.
- Slowed or shallow breathing.
- Cessation of breathing.
An oxycodone overdose can be fatal unless the user receives medical attention immediately. It should only be taken as prescribed and should be monitored with caution to avoid the development of dependence. If you notice the signs of overdose, do something immediately. Learn how in our blog, Taking Action: How to Intervene During an Overdose.