Just How Dangerous Is OxyContin, Anyway?

 by: Albert Frantz

OxyContin belongs to a family of drugs called opioids, which are derived from the opium poppy and are among the most common drugs used to address both chronic and acute pain. Due their abuse and addictive potential, they are nearly always prescribed with caution.

Opioids suppress the body's response to pain by acting on what is called the mu receptor, which is a molecule that bonds with the body's natural pain killers. The mu receptor is thus the body's most significant pain gateway. It also bonds with opiate drugs such as heroin and morphine. This receptor affects not only the experience of pain but also of euphoria, which contributes to the addictive potential of these drugs.

Unfortunately, medical textbooks inform us that all opioids have been abused, and there is no way around their high abuse potential.

To control distribution of addictive drugs, the U.S. Drug Enforcement Agency classifies drugs for regulatory purpose into schedules, of which there are five. Schedule 1 drugs, like raw opium and LSD, are as close to completely prohibited as is possible (they're permitted, for instance, in special laboratory research circumstances), while schedule 5 drugs are common over-the-counter medications that pose extremely little risk of addiction or abuse.

Where do opioids fit into the picture? Oh, they're in with their schedule 2 neighbors heroin, cocaine, morphine, amphetamine and the like. All except oxycodone (the active ingredient in OxyContin), which despite an addictive potential comparable to heroin is in the more "harmless" schedule 3!

OxyContin has been popping up in the news quite a lot lately. It's become the drug of choice among new addicts. In fact, according to the Drug Enforcement Agency, between 50 and 90 percent of new patients admitted to drug rehabilitation programs in the states most severely affected by OxyContin abuse (West Virginia, Pennsylvania, Kentucky and Virginia) list OxyContin as their drug of choice.

To be fair, chronic pain sufferers are seeking relief from their pain, rather than a dangerous high, and medication certainly plays a useful role in pain management in many circumstances. Further, OxyContin becomes most addictive when its long-acting time-release safeguard is circumvented, usually by chewing the pill, thus releasing the active drug oxycodone all at once. Patients using the drug legally, for its intended purpose and under their doctor's supervision are clearly at less risk.

Still, the risk is definite and grows over time, as all opioids are known to diminish in effectiveness over time, mandating either higher doses or opioid rotation (temporarily switching to a new opioid) or both. Further, withdrawal symptoms can be experienced when patients stop taking opioids, making them crave more drugs. In fact, many patients report that their sensation of pain is worse after ceasing treatment than it was before they started! (In some cases, such as cancer, this effect could be attributed to the progression of the disease.) Surely it's best never to get started along this vicious cycle.

Let us understand that even dangerously addictive drugs have their legitimate medical uses, one of which may indeed be to relieve chronic pain sufferers of their plight. Still, regardless of whether or not you and your doctor choose drugs as one means of treatment, never forget that pain is a message that you're doing the wrong thing or you're doing things wrong. Listen to your body. Don't shoot the messenger.