Oxy. That's the street nickname for what is now the most addictive drug in America, "oxycodone". Marketed under brand names such as Oxycontin, oxycodone is a legal painkiller medication. Used properly, oxycodine can spare needless human suffering. The problem is, oxycodone is also highly addictive. So addictive, in fact, that according to the Centers for Disease Control, oxycodone caused over 11,000 deaths in 2004, the last year for which statistics are available, and caused over 1.2 million emergency room visits in 2009. That's more than the total deaths caused by heroin, cocaine, and methamphetamine combined.
Anxious to get oxy, addicts are lining up outside so-called "pain clinics" in parking lots of strip malls across America. Oxy addiction has invaded almost every corner and crevace of American life, snagging the rich and famous like radio host Rush Limbaugh as well as the middle class and poor.
Oxycodone is prescribed to relieve moderate to severe pain, and is in a class of medications called opiate analgesics (also called narcotic analgesics), which are man-made versions of the natural compounds that are found in opium. In 2007 death from opioids analgesics poisonings made up 36% of all deaths from any sort of poisoning in that year. Why are opioids analgesics so dangerous? What are the particular risks with oxycodone overdose?
Oxycodone relieves pain with the same potency as morphine by changing the way that the brain and nervous system responds to hurt. Oxycodone overdose may occur because of addiction, increased tolerance, or for intentional reasons.
When someone is brought to the emergency room because of oxycodone overdose they will be given oxygen to help their breathing, which is usually followed by an antidote to reverse overdose symptoms (see "naloxone," below). The emergency department team may also use activated charcoal with a laxative to soak up any of the drug that remains in the stomach or intestines.
Say you are thinking about taking oxy as a painkiller. What are the risks? How much should you take? What are the symptoms of overuse? What remedies exist to help you if you have overdosed on oxycondone?
We have pulled together the current research on the risks involved with using oxycodone, as well as recent treatments for oxycodone overdose or addiction:
1. Use Naloxone to Treat Oxycodone Overdose - But Use Naloxone and Oxycodone to Treat Pain From Cancer?
Naloxone is a substance that is commonly used to treat oxycodone overdose in the emergency department; recent research finds that using oxycodone and naloxone together, with a strong twist of irony, may be the best combination of drugs for treating pain from cancer.
When naloxone is used as an antidote for oxycodone overdose, there may be withdrawal symptoms that are acute, but last less than one hour, and naloxone may have to be administered in multiple doses . When naloxone is not cleaning up oxycodone's overdose mess, so to speak, it might be working with oxycodone to help ease some of the more uncomfortable pains associated with cancer pain treatment.
In 2009 a team from the Clinic of Anesthesiology and Intensive Care at the Friedrich-Schiller University in Jena, Germany, including Winfried Meissner, focused on one of the less pleasant parts of living with cancer: constipation.
While opioids such as oxycodone are often used as pain-reducing treatments for patients with cancer, opioids also induce constipation which can have a "major negative impact on patients' quality of life."
The German team paired prolonged-release oral oxycodone with oral naloxone in prescriptions for 202 patients with chronic pain. Data showed that there was "no loss of analgesic efficacy with naloxone": that is, adding naloxone to the oxycodone prescription did not decrease oxycodone's ability to alleviate pain.
And even better news was that bowel function improved as the naloxone doses increased in the prescription. "Overall," the report concludes, "the combination was well tolerated, with no unexpected adverse events.
In the treatment of chronic pain, including that of cancer, current treatment lies in the details: though a seemingly unlikely pair, it is good to know that oxycodone and its sometimes nemesis-antidote naloxone, can join forces to clear constipation off of the lengthy list of woes resulting from chronic pain.
2. Oxycodone Addiction From Prescription: Not As Prescribed.
As paradoxical as it sounds, many oxycodone addictions start with oxycodone prescriptions. A study published by the National Institutes of Health in 2006 found that 47% of a group of persons "presenting for treatment of oxycodone addiction" were first exposed to the drug through a prescription for pain.
In 2006, Steven Passik and colleagues at the Memorial Sloan Kettering Cancer Center and Cornell University in New York, conducted a survey that gathered data on prescription drug use amongst 109 drug abusers entering a particular treatment facility.
The majority of these patients (84%) stated that they "had legitimately been given a prescription for opioids for pain at some point from a physician." Oxycodone -containing products were one of the most commonly abused drugs (abused by 69% of the patients).
Additionally, 91% of respondents had also purchased prescription opioids from a street dealer "at least once," and 80% of them had "altered the delivery system" of the drug, such as chewing, snorting, or intravenous administration. The team urges the "need for clinicians treating chronic pain to more thoroughly assess patients for their risk of abuse and addiction before starting an opioids regimen."
If you or someone you know has been prescribed an opioid such as oxycodone, discuss whether or not there are other options - especially if you find that person to be particularly vulnerable to opioids addiction.
3. A Modern Use for Chinese Herbs: Treatment for Oxycodone Overdose. The Chinese herbs corydalis and stephania can be purified in a way that forms a many-lettered substance called levo-tetrahydropalmatine (I-THP for short, thankfully).
In 2009, researchers from various institutions in China, including Liu Yan-Li with the College of Pharmacy at Soochow University in Suzhou, studied how I-THP could help out oxycodone-addicted rats (hey, rats have addictive personalities too). They found that I-THP that was "co-administered" with oxycodone "partly abolished the development of oxycodone-induced" addictions in the rats.
The team believes that their results "suggest that I-THP can inhibit oxycodone-induced psychological dependence" so that I-THP is a "potential" treatment for oxycodone addition.
This treatment is hopefully coming soon to humans!
4. No Cocktails Allowed When Oxycodone is Involved.