The abuse of oxycodone products in general has increased in recent years. In April 2000, The Journal of the American Medical Association (JAMA) published a study, which examined two data collection sources. The DEA Automation of Reports and Consolidated Orders System (ARCOS) data tracks the distribution of oxycodone and other opioid analgesics and the Drug Abuse Warning Network (DAWN) Medical Examiner (ME) and Emergency Department (ED) data ascertained the health consequences associated with its abuse from 1990 to 1996. The JAMA study found a 23 percent increase in the medical use of oxycodone with no corresponding increase in the illicit abuse of the drug. However, 1998 DAWN ME data reported a 93 percent increase in oxycodone mentions between 1997 and 1998 and the number of oxycodone-related DAWN ED mentions increased 32.4 percent from 1997 (4,857) to 1999 (6,429).
OxyContin is designed to be swallowed whole; however, abusers ingest the drug in a variety of ways. OxyContin abusers often chew the tablets or crush the tablets and snort the powder. Because oxycodone is water soluble, crushed tablets can be dissolved in water and the solution injected. The latter two methods lead to the rapid release and absorption of oxycodone. The alcohol and drug treatment staff at the Mountain Comprehensive Care Center, Prestonsburg, Kentucky, reports individuals who have never injected drugs are using OxyContin intravenously and they have never seen a drug “proliferate like OxyContin has since May 2000.” The staff at this center has over 90 cumulative years’ experience conducting drug evaluations.
OxyContin and heroin have similar effects; therefore, both drugs are attractive to the same abuser population. OxyContin is sometimes referred to as “poor man’s heroin,” despite the high price it commands at the street level. A 40 mg tablet of OxyContin by prescription costs approximately $4 or $400 for a 100-tablet bottle in a retail pharmacy. Street prices vary depending on geographic location, but generally OxyContin sells for between 50 cents and $1 per milligram. Thus, the same 100-tablet bottle purchased for $400 at a retail pharmacy can sell for $2,000 to $4,000 illegally.
OxyContin is, however, relatively inexpensive for those covered by health insurance, since the insurance provider covers most costs associated with doctor visits and the prescription. Unfortunately, many OxyContin abusers whose health insurance will no longer pay for prescriptions and who cannot afford the high street-level prices are attracted to heroin.
Opioids, Pain, and Addiction
Addiction to opioids used for legitimate medical purposes under a qualified physician’s care is rare. According to the National Institute on Drug Abuse, however, many physicians limit prescribing powerful opioid pain medications because they believe patients may become addicted to the drugs. Recent evidence suggests that, unlike opioid abusers, most healthy, nondrug-abusing patients do not report euphoria after being administered opioids, possibly because their level of pain may reduce some of the opioid’s euphoric effects making patients less likely to become abusers.