OxyContin Abuse In Patients Entering Addiction Treatment

Prescription OxyContin Abuse Among Patients Entering Addiction Treatment – Am J Psychiatry. 2007 Nov – free full-text /PMC2785002/

This study shows how people who abused OxyContin also abuse other drugs, either multiple opioids like heroin and counterfeit pain pills, or cocaine, methamphetamine, and/or alcohol.

Objective

OxyContin and other pharmaceutical opioids have been given special attention in the media, who frequently describe problematic users of the drug as previously drug-naive individuals who become addicted following legitimate prescriptions for medical reasons.

The purpose of this study was to characterize the nature and origins of pharmaceutical opioid addiction among patients presenting at substance abuse treatment programs.  

Method

The authors evaluated the prevalence and correlates of OxyContin use and abuse among a population of 27,816 subjects admitted to 157 addiction treatment programs in the United States from 2001–2004.

Results

• Was OxyContin used to “get high”?

86% percent(N=1,208) of individuals who used OxyContin reported using it to “get high or get a buzz.”

• Was OxyContin prescribed for diagnosed pain or medical reasons?

78% percent (N=1,095) reported that OxyContin had not been prescribed for any medical reason.

One-third (N=100) of the 300 patients who did report receiving a prescription also reported receiving OxyContin through illicit means, and 56% (N=171) reported using the medication to “get high.”

• Was OxyContin used in combination with other opioids (includes heroin, methadone, hydromorphone, hydrocodone, and oxycodone)?

92% (N=1,242) of individuals categorized as “users” of OxyContin reported using the medication with one or more other opioid.

8% (N=102) of patients categorized as “users” of OxyContin reported no other opioid use, but

• 66% (N=67) reported the use of cocaine,
• 69% (N=70) reported heavy alcohol use, and
• 75% (N=76) reported using pot.

Only eight of the 1,425 (0.5%) individuals categorized as “users” of OxyContin reported no use of any additional drugs other than alcohol.

Yet alcohol is one of the deadliest drugs to mix with opioids because it also depresses respiration, which makes an overdose more likely.

Discussion

Media reports have often portrayed people who receive OxyContin and develop substance abuse problems as “drug naive” individuals or as individuals with “accidental” addiction, and in turn they have brought about the speculation that this opioid has unique properties that make it more likely to induce or prompt abuse and dependence among the general population.

Although some reporters have rescinded their reports or noted that OxyContin abuse may have been overstated (Fischman J. OxyContin abuse overstated. US News and World Report. 2003 March 1), this is the only prescription medication, to our knowledge, that has been compared with “a plague” or “nuclear bomb” by the media.

In fact, prior research studies of OxyContin use or abuse among the general population and among those receiving the medication for pain management in specialty clinics have not supported such media claims.

In fact, opioids have been proven to be effective for chronic pain in a review of 15 studies: No reason to abandon opioids for chronic pain.

These studies have reported that while the rates of OxyContin use have increased since 2000, the proportion of those individuals who are prescribed OxyContin and have shown signs of abuse or dependence are quite low (less than 2%).

Only 22% of these individuals who used OxyContin reported receiving the medication through prescription for any medical reason, and

86% of individuals who used OxyContin (whether prescribed or not) acknowledged using the medication primarily to “get high.”

Only eight (0.5%) of the 1,425 individuals who used OxyContin in our sample reported no other drug use.

Patients who reported any OxyContin use were also likely to have reported the use of hydromorphone, oxycodone, and hydrocodone (25%, 62%, and 70%, respectively).

Although these medications were not the focus of our study, it is clear that within this sample of patients entering addiction treatment programs, those who received OxyContin also used other drugs, especially other pharmaceutical opioids.