The OxyContin Epidemic

In 1996 the American pharmaceutical market introduced a substance that would forever change the landscape of America. Pharma Purdue produced and launched the prescription painkiller OxyContin to market. Touted as a better choice than over-the-counter meds due to its incredible 12-hour pain relief, the prescription drug made a strong appeal to doctors and patients alike. Upon entering the medical scene patients were prescribed medicine which required interval doses that interrupted their day-to-day life. OxyContin was popularized by its image of convenience and peace of mind for those who struggled with chronic pain. This couldn’t be further from the truth.

An Innocent Beginning

OxyContin abuse often begins by innocently following doctor orders. Trusted medical professionals have been advising uninformed patients to take the subscription drug for over a decade. Unfortunately, the numbers of addicts continue to rise as doctors naively provide prescriptions of this seductive pain killer for back pain, cancer treatments, post-op recoveries and more. Unsuspecting men, women and even children are falling prey to OxyContin’s active ingredient oxycodone.

OxyContin stands for Oxycodone Continual Release. It is an opioid drug which means it comes from the synthetic form of opium. The drug is prescribed in doses between 10 – 80 mg. Doctors instruct patients to take pills every six hours. If this rule is not followed, the pills wear off and the patient can feel intense pain. The idea of Oxycontin pain management is to take the dose a little before the previous dose wears off. This will maintain a smooth and steady supply of pain depressants in your body.

The pain is suppressed because of the chemical dopamine. Nerves in our brains naturally produce dopamine. This chemical serves as a pathway for neurotransmitters and sends signals to other nerve cells in our body. Oxycodone is the main ingredient of OxyContin and works by blocking pain signals from the brain. As these signal pathways are blocked dopamine production – or “reward” receptors – increases in the brain and promotes feelings of relaxation and euphoria.

The result from all the chemical changes is pain not being felt at all in the body. Slow release pills have a special coating that controls the amount of oxycodone entering the bloodstream in a given time. Controlling the amount of oxycodone protects the body from experiencing the chemical all at once.

Since its original market launch, the drug’s production has expanded to modified chemical compositions of the dopamine-inducing ingredient oxycodone. Thus, the same chemical responsible for rewiring brains for OxyContin addiction is available in immediate release pills forms. Immediate release oxycodone pills usher the full potency of the drug into the user’s bloodstream immediately after it is taken. The effects of this pill are stronger pain relief and an even greater euphoria. When oxycodone is released all at once the good sensations occur at a magnitude far greater than that of the OxyContin time release.

The Forming of Addiction

Over time even medically advised prescription dosages can wire brains to become oxycodone dependent. Prescription drug abuse causes dopamine levels to increase and are sustained by the painkiller. The result is our bodies changing the way it functions to support the drug. As dosages are decreased or stopped altogether, the body will try to compensate the drug’s absence by slowing down. Once dopamine levels go down, the brain will recognize this as unnatural because it is so used to the drug enhancing the dopamine amounts – high dopamine levels become the brain’s new normal.

In turn, the user will feel sick or be in pain without the pain killer in their body. Therefore, even after the prescriptions are finished, patients will still feel like they need dopamine. On the other token, users who are prescribed the drug on a long-term basis can feel a need for more oxycodone as the body builds a tolerance towards the chemical. This is when the user will experience opiate withdrawals. During this time users are extremely vulnerable to accidental injury or death. They can become convulsive, anxious and can experience many health concerns including an irregular heartbeat, severe abdominal pain as well as a recurrence of the chronic pain which instated prescription use in the first place.

Prescription painkillers create a vicious cycle of use, withdrawal, and repeat that can last a lifetime while taking lives, and destroying families, relationships and economies in the process. No matter how the addictive habit is formed, whether by building a tolerance to present oxycodone levels in the body or withdrawing altogether, the reality is our bodies are no longer the same after taking OxyContin in any form or dosage.

The rampant onset of opioid prescriptions, especially Oxy, has set the stage for a major epidemic of OxyContin addiction. A recent (2015) approval from the Food and Drug Administration allows pediatricians to prescribe children ages 11 and older Oxy and other opioids. This has sparked concern over the medical community’s abilities to appropriately assess the need for opioid prescriptions while preventing adverse effects and addiction.

The National Institute of Drug Abusers conducted a survey of 45,473 students across the United States to monitor the prevalence of drug use in eighth, tenth and twelfth grade. The survey reported approximately 1% of eighth graders, 2% of tenth graders and 3.4% of twelfth graders using oxy without being advised by a doctor in 2016.

According to the Centers for Disease Control and Prevention (CDC), more than 6 out of 10 overdose deaths involve opioid drugs. In 2015, 50,000 deaths were recorded as being caused by overdoses.

How OxyContin is Becoming a Prevalent Street Drug

Oxycontin abuse is an illness that motivates behaviors such as lying, manipulating, violence and theft. Users will stop at nothing to fuel their pain pill addiction which also makes it a profitable business.

Pill mills are a growing problem in the United States as oxy addiction numbers steadily rise.  A pill mill is a medical practice that is often visited by drug addicts because they can walk in and receive prescriptions without a lengthy medical background check. Once addicts are rejected because of their multiple requests, they may recruit the homeless or poor and instruct them on what to say to obtain prescriptions from medical offices. Whether doctors knowingly or unknowingly prescribe to those who are predisposed to oxycodone dependence via family history, past substance abuse problems or depression/anxiety is an event that requires monitoring from states and medical boards.

Currently, doctors are permitted to legally prescribe at their discretion and are financially rewarded to do so by pharmaceutical vendors. This incentive set by the pharmaceutical industry is a segway to a dangerous trait of corrupt medical practitioners – greed. Pill mills are not just run by addicts. They can be operated by corrupt dentists, psychiatrists, and doctors looking to get rich quickly at the expense of addiction or patients who are suffering from pain.  Doctors who are in on these operations advise employees and pharmacies to conceal prescription records from the government calling these prescriptions “off-label”. The incentivized system may play a major role in the success of pill mills around the country as doctors are not only rewarded but encouraged to prescribe opioids if driven by greed.

A 2016 crackdown in California resulted in a medical practitioner being sentenced 30 years to life after three of her patients died because of an opioid overdose which she prescribed while lacking medical justification. That same year a psychiatrist was also found guilty of murder for prescribing patients pain killers without medical necessity. The patients died because of overdose. While accountability is a step in the right direction towards making opioids less accessible, it is also a step that is leading towards black market opioids and increased heroin use.

As the government imposes regulations on doctor offices and pharmacies, opioids are rapidly evolving into another dangerous street drug labeled “oxycotton”, blue, 40, 80, or kicker. The price is far cheaper by private drug dealers and use can be untraced by doctors who may catch on to an addict’s pill mill activity.  In 2013, the patent for Purdue Pharma’s Oxycontin expired. The FDA has since banned all generic versions of Oxycontin from the market which further motivates addicts to turn to the streets to supply synthetic opioids. Street oxy is often laced with other deadly chemicals that put addicts at greater risk of death.

Florida declared a heroin epidemic in 2014 after cracking down on pill mills. Opioid users move from prescriptions to heroin after their tolerance increases to the point that pain killers no longer cut it. Heroin is cheaper and easier to get than prescription pills. According to a study by CDC, the death toll rate of opioid-related heroin use is steadily rising. The trend reveals heroin-related deaths increasing by 439% from 1999 – 2014.  In 2014, 28,647 deaths involved opioids and nearly half or 10,574 deaths were related to heroin. That study accounts 61% of America’s entire overdose death rate to opioids including Oxycontin and oxycodone. CDC’s study also highlights illegal and prescribed opioid OD deaths have increased over the long-term and seem to be continually rising.

The Impact on Families and Children

CDC Director, Dr. Tom Frieden, revealed in the March 2016 edition New England Journal of Medicine that opioid dependence may be as high as 26% for patients using opioids for chronic non-cancer pain and that one out of every 550 patients started on opioid therapy died of opioid-related causes a median of 2.6 years after their first opioid prescription. With statistics pointing to the evident death and deterioration of addicts, we must also recognize the impact the OxyContin epidemic has on families and society as a whole.

Congress attempted to address the negative effects of opioids on families when passing the Keeping Children and Families Safe Act in 2003. According to Reuters, 27,000 cases of drug-addicted babies were born in 2013 at the rate of opioid dependent newborns (Neonatal Abstinence or NAS) birthed every 19 minutes. Under this law, health providers are to notify social workers when babies are brought home under the care of an addict. This is to ensure that the parents will be monitored and guided as they care for their babies. The 2013 study by Reuters indicated that most states are neglecting this law with at least 36 of them omitting policies to notify social workers. Thus, infancy mortality rates are increasing not only due to NAS but by being raised by addicts without proper support from social services. A 2016 CDC report concludes, “The overall incidence of NAS in the states …  has increased almost 300% during 1999–2013, from 1.5 to 6.0 cases per 1,000 hospital births.”

As addicts continue giving birth to babies it is likely that either the parents will die from an overdose or babies will experience death by neglect. As children become parentless, a greater strain is put on our social services system making it more difficult to provide adequate help as an already inadequate system. Just as Reuter’s study suggests, painkiller addiction doesn’t not only impact single lives but multiple generations.

Making A Change

The OxyContin epidemic is a problem not only for addicts but for everyone who is in the life of those dependent on pain killers. Opioid users don’t always start as people looking for a high. The majority become addicted by doing what their doctors instruct to manage chronic pain. Although the government is beginning to step up regulations, challenges arise as opioid use becomes relevant to an increase in heroin addiction.

We each play a role in swinging the pendulum the opposite way for this epidemic. If you are a part of the epidemic, help make a change today by seeking out resources and people who can assist you. If you or a loved one you know is struggling with OxyContin or oxycodone dependence, there is no better time than now to experience a breakthrough.

Sources:

Hays. “A Profile of OxyContin Addiction.” NCBI. Mar. 2002. 14 Mar. 2019. https://www.ncbi.nlm.nih.gov/pubmed/15339710

Crane, Marisa. “OxyContin Abuse.” Drugabuse.com. 14 Mar. 2019. https://drugabuse.com/oxycontin/

“OxyContin.” Recovery Connection. 14 Mar. 2019. https://www.recoveryconnection.com/substance-abuse/drug-information/oxycontin/