OxyContin Addiction and Pain Management: Is There an Answer?

Article contributed By: Lauren N. Hardy, MA, clinical team member of Acadiana Addiction Center

Bio: Lauren N. Hardy, MA, clinical team member of Acadiana Addiction Center has several years of experience in the treatment field, two years as a research analyst at Vanderbilt University and a masters in counselling psychology.

Program Bio: Acadiana Addiction Center is a premier, leading treatment center for men and women struggling with chemical dependency to drugs or alcohol. We provide a compassionate, warm environment for those who need to successfully detox from drugs or alcohol and learn the skills needed to live a life free from the clutches of addiction.

In 1961, the worldwide convention of “The Single Convention on Narcotic Drugs” proclaimed that narcotic drugs were central to the alleviation of pain and suffering, and informed countries to make proper arrangements to ensure that narcotic pain relievers would be available for those struggling with moderate-to-severe pain [1].  Over fifty years later, this arrangement is still not properly implemented in many countries. In September of 2008, the World Health Organization stated that about 80 percent of the world population has insufficient or zero access to treatment for moderate to severe pain; including approximately four million cancer patients and 0.8 million HIV/AIDS patients who, at the end of life, suffer unbelievable pain without management [1].

In the United States, only recently has the treatment of pain become a part of treatment of chronic conditions. While medications such as Vicodin have been on the market a while, these medications have been reported as having limited efficacy in the treatment of chronic pain. On December 12, 1995, the FDA approved a new kind of painkiller intended for people struggling with chronic pain conditions in a non-hospital setting: OxyContin [2].

The release of OxyContin, the trade name for oxycodone hydrochloride, was a huge victory for chronic pain sufferers. OxyContin remains the only type of narcotic painkiller that provides time-released pain relief lasting up to twelve hours; other prescription pain relievers require frequent dosages, which, when missed, led to the return of agonizing pain [3].

Unfortunately, OxyContin has been making the news for unrelated reasons. People who abuse prescription narcotics found that by crushing the OxyContin, they were able to circumvent the time-release formula, and snorting, ingesting, or injecting the drug provided a high likened to heroin intoxication. The heightened media attention has caused a major backlash in the medical community. Physicians are afraid to prescribe the medications out of fear for prosecution. Insurance companies will not cover the drug – even in the presence of a well-documented pain-related medical condition. Chronic pain suffers deny prescriptions of OxyContin for fear that they will become addicted. It is clear that there is a major problem between those in chronic pain who require painkillers like OxyContin and those who abuse OxyContin for recreational purposes.

Chronic pain suffers must be more thoroughly educated about the difference between tolerance and addiction. It is expected that people who rely upon prescription painkillers such as OxyContin to reduce pain will develop a tolerance to OxyContin. This means that the dosage will be increased to ensure pain is managed. A tolerance to OxyContin is not to be confused with addiction. Addiction and abuse of OxyContin occurs when a person uses the narcotic not for legitimate pain relief, but to feel the euphoria and intoxication or for other reasons and this is when treatment might be necessary.

It is no secret that narcotic pain relievers such as OxyContin are increasingly abused. According to the CDC, the misuse and abuse of prescription narcotic painkillers was responsible for over 475,000 visits to the emergency room in 2009; a number that’s doubled over the past five years. In 2008, 14,800 people died from abuse of prescription painkillers. In 2010, over 12 million people in the United States reported using prescription narcotics in a non-medical manner; generally, to induce the feelings of pleasurable euphoria they cause [4].

Drug manufacturers are working tirelessly to create abuse-deterrent prescription painkillers to address the very real problem of chronic pain conditions while limiting the amount of abuse. Purdue Pharma, the manufacturers of OxyContin, created and released a reformulation of OxyContin that obtained FDA approval on April 13, 2013. Additionally, the FDA removed the previous generation of OxyContin extended-release tablets from sale and the FDA has made it clear that it will not approve any generics that rely upon the original OxyContin formulation. Purdue announced that the reformulated OxyContin would be more difficult to manipulate as each pill includes a protective coating as well as properties intended to prevent the medication from being easily crushed, broken, or dissolved in a manner consistent with drug abuse [5].

While some addicts will find a way to circumvent the new abuse-deterrent OxyContin, it is clear that there must be some balance.

OxyContin was the first prescription drug named a “drug of concern” by the DEA, which has put a large bulls-eye on its back. Unfortunately, the war on drugs has also become a war on prescription painkillers such as OxyContin; the doctors who prescribe them, and the people who need these medications to get through the day. OxyContin is both a life-saver for people living with cancer, arthritis, and other chronic pain conditions and a drug of choice for many prescription painkiller addicts. The answer to the OxyContin dilemma may be as simple as education for prescribers that encourages physicians to identify drug-seeking behaviors and assessment of addiction potential for chronic pain patients. Or it may include pain management outsourced to pain clinics, where chronic pain sufferers are able to be assessed and holistically treated for pain using a multidisciplinary approach. It is clear that as over 50 million people in the States are living with chronic pain, and these individuals should not pay the price for prescription drug abuse [6].


[1]: http://www.hrw.org/sites/default/files/reports/health0309web_1.pdf
[2]: http://www.fda.gov/downloads/AdvisoryCommittees/
[3]: http://www.webmd.com/pain-management/features/oxycontin-pain-relief-vs-abuse
[4]: http://www.cdc.gov/homeandrecreationalsafety/rxbrief
[5]: http://www.purduepharma.com/news-media/2013/04/fda-approves-new-label-for-reformulated-oxycontin-oxycodone-hcl-controlled-release-tablets-cii/
[6]: http://www.webmd.com/pain-management/guide/pain-clinics-overview


Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on March 11, 2014
Published on AddictionHope.com, Resources for Addiction & Substance Abuse