Abuse of Oxycontin and Prescription Drugs

Although most people take prescription medications responsibly, there has been an increase in the non-medical use or, as NIDA refers to it in this report, abuse of prescription drugs in the United States.

What are the concerns?
A number of published reports indicate that prescription drug abuse is on the rise in the United States. According to the 2003 National Survey on Drug Use and Health, 6.3 million Americans aged 12 and older have used prescription medications for non-medical purposes in the prior 30 days.

The number of new non-medical users of pain relievers increased drastically-from 573,000 in 1990 to 2.5 million in 2000. Overall, men and women have roughly similar rates of non-medical use of prescription drugs (an exception is found among 12-17-year-olds, with more females likely to abuse these drugs).

Of these users, it is estimated that:

• 4.7 million used pain relievers
• 1.8 million used tranquilizers
• 1.2 million used stimulants
• 0.3 million used sedatives

The Drug Abuse Warning Network (DAWN), which monitors drug mentions (medications and drugs of abuse) from emergency departments (EDs) across the Nation, recently reported that two of the most frequently mentioned prescription medications in drug abuse-related cases are benzodiazepines (e.g., Valium, Xanax, Klonopin, and Ativan) and opioid pain relievers (e.g., oxycodone (OxyContin), hydrocodone, morphine, methadone, and combinations that include these drugs). In 2002, benzodiazepines accounted for 100,784 ED visits categorized as drug abuse-related cases and opioid pain relievers accounted for more than 119,000. Between 1994 and 2002, ED reports of hydrocodone and oxycodone (OxyContin) overdoses increased by 170% and 450%, respectively. While ED visits attributed to drug addiction have been increasing, suicide-related visits have remained stable since 1995.

What types of prescription medications are commonly abused?
Several classes of medications that are commonly abused include opioids, central nervous system (CNS) depressants, and stimulants. Certain over-the-counter (OTC) medicines can also be abused when not taken as directed. It is important to note that many prescription drugs or OTC medications can produce dangerous health effects when taken concurrently or taken with alcohol.

• Opioids - Opioids are commonly prescribed to treat pain. Examples of prescription opioids include morphine (Kadian, Avinza), codeine, oxycodone (e.g., OxyContin, Percodan, Percocet), hydrocodone (Lortab, Lorcet, Vicodin), propoxyphene (Darvon), fentanyl (Duragesic), and hydromorphone (Dilaudid). Opioids work in the brain to diminish the perception of pain. Opioids also can produce a sense of euphoria by affecting pleasure centers in the brain. This is often intensified when opioids are taken by routes other than those prescribed.1 For example, OxyContin can be crushed and snorted, or injected intravenously-this can enhance the euphoric effects, while at the same time increasing the risk for serious medical consequences, such as overdose.
• CNS Depressants - CNS depressants commonly are prescribed to treat anxiety and sleep disorders because of their ability to slow normal brain function. These medications include barbiturates, such as mephobarbital (Mebaral), pentobarbital sodium (Nembutal), butalbital (Fioricet), and benzodiazepines such as diazepam (Valium), chlordiazepoxide HCl (Librium), alprazolam (Xanax), triazolam (Halcion), and others.
• Stimulants - Stimulants, including dextroamphetamine (Dexedrine and Adderall) and methylphenidate (Ritalin and Concerta), are used primarily to treat attention deficit hyperactivity disorder, attention deficit disorder, and narcolepsy. These stimulants increase the amount of certain chemicals in the brain and peripheral nervous system. This can lead to increased blood pressure and heart rate, and increased blood glucose.

Source: NIDA National Institute on Drug Abuse