Oxycodone hydrochloride (C18 H21 NO4 – HCl MW 351.83) is the chemical
structural formula for OxyContin, manufactured by Purdue Pharma, L.P.
Tablets are an opioid analgesic, and a Schedule II controlled substance
with an abuse liability similar to morphine. OxyContin tablets are supplied
in 10mg, 20 mg, 40 mg, and 80 mg tablet strengths for oral administration.
The tablet strengths indicate the amount of oxycodone per tablet as
OxyContin is a trade name for the drug oxycodone hydrochloride, or
oxycodone HCL. Street names for Oxycodone include Oxy, O.C., Hillbilly
heroin, Oxycotton and Killer.
Oxycodone is a white, odorless crystalline powder derived from the
opium alkaloid, thebaine. Inactive ingredients include ammonio
methacrylate copolymer, hydroxypropyl methylcellulose, lactose,
magnesium stearate, povidone, red iron oxide (20 mg strength tablet
only), stearyl alcohol, talc, titanium dioxide, triacetin, yellow
iron oxide (40 mg strength tablet only) , yellow iron oxide with
FD&C blue No. 2 (80 mg strength tablet only).
It is believed that ancient civilizations in Egypt and Greece used
opium for its euphoric effects. During the 19th century, laudanum
(opium dissolved in alcohol) and other opium products were used in
Great Britain and America to treat various ailments, from teething
soreness in babies to fever and cough in children and adults.
The milky liquid from the opium poppy plant seed pods is extracted
and dried to form opium powder. Various alkaloids from this powder
can be isolated to form opioids such as morphine, codeine and
oxycodone. The alkaloid in oxycodone is thebaine.
OxyContin was introduced in the United States in December of 1995,
and Canada in July 1996, although oxycodone products have been
illicitly abused for the past 30 years.
OxyContin tablets are a controlled-release oral formulation of
oxycodone hydrochloride indicated for the management of chronic,
and moderate to severe pain when a continuous around-the-clock
analgesic is needed. When used properly, OxyContin can provide
pain relief for up to 12 hours. OxyContin is not intended as a
prn analgesic. (Not to be taken as needed.)
FDA: Food and Drug Administration
DEA: Drug Enforcement Administration
While OxyContin tablets are only to be administered by swallowing the
tablets whole, a number of other dangerous and potentially fatal
means of administration are often employed by those seeking to
increase the euphoria which can lead to a dangerous oxycontin addiction, by bypassing the time-release control mechanism.
According to many experts, this hazardous and abusive means of ingestion
creates a euphoric rush similar to heroin.
These potentially lethal ingestion practices include snorting,
crushing, chewing, or injecting the dissolved product. This results
in an uncontrolled delivery of the opioid and poses significant risks
to the abuser that could result in overdose and death.
Source: FDA: Food and Drug Administration
Oxycodone works by stimulating certain opioid receptors located
throughout the central nervous system, in the brain and along the
spinal cord. When the oxycodone binds to the opioid receptors, a
variety of physiologic responses can occur, including pain relief,
relaxation, slowed breathing, and euphoria.
Typical side effects of opioid therapy include constipation,
somnolence, nausea, vomiting, pruritus, (itching) headache, dry mouth,
sweating and asthenia (weakness).
Less common but potentially hazardous effects include respiratory
depression, altered mental state and postural hypotension. Elderly
patients are particularly susceptible to respiratory depression,
particularly when oxycodone is used in conjunction with other CNS
depressant medications. Oxycodone can cause severe hypotension and
is risky for individuals whose ability to maintain blood pressure has
All effects are typical opioid side effects. Such effects are dose
dependent, related to a patient’s level of opioid tolerance, and
specific to an individual’s host factors.
Oxycodone should only be used with extreme caution in the following
conditions: acute alcoholism; Addison’s Disease; CNS depression or
coma; delirium tremens; debiliated patients; kyphosocoliosis
associated with respiratory depression; myxedema or hypothyroidism;
prostatic hypertrophy or urethral stricture; severe impairment or
hepatic, pulmonary or renal function; and toxic psychosis.
Oxycodone usage may obscure the diagnosis or clinical course in
patients with acute abdominal conditions.
Oxycodone may aggravate convulsive disorders, and all opiods may
induce or aggravate seizures.
The use of oxycodone with alcohol, other opioids, or illicit drugs
will have an additive effect, causing central nervous system
Oxycodone addiction is much like other legal or illicit opioid agonists.
This medication has become widely sought by drug abusers and people
with a history of addiction.
Acute overdosage presents with respiratory depression, somnolence
leading to stupor or coma, skeletal muscle flaccidity, cold and
clammy skin, constricted pupils, bradycardia (unusually slow heart
action), hypotension and death. Oxycodone overdosage requires immediate medical attention.
For patients no longer requiring oxycodone, cessation of therapy
should include a gradual taper schedule to avoid acute withdrawal in
the physically dependent patient.
When taken as directed, oxycodone will produce physical dependence in
a few weeks time. However, the real danger is for users who take the
drug for a euphoric rush, or by ingesting by ANY other means than
swallowing the tablet whole.
According to the FDA, addiction is characterized by compulsive use,
use for non-medical purposes, and continued use despite harm or risk
Sudden cessation of OxyContin after even a few weeks can cause a
severe withdrawal syndrome.
OxyContin addiction is commensurate with whether an individual takes
the medication as directed. For those that do, physical and
emotional dependence is still a very real risk. For those ingesting
the drug without medical supervision, the dependency risks are
Tolerance to this class of drug builds quickly with again, increased
risk to those taking OxyContin by chewing, snorting, or injecting for
Hydrocodone withdrawal is often characterized by over-activity of the
physiologic functions that were suppressed by the drug and/or
depression of the functions that were stimulated by the drug.
Opioids often cause sleepiness, calmness, and constipation, so opioid
withdrawal often includes insomnia, anxiety, and diarrhea. Other
withdrawal symptoms include restlessness, sweating, chills, yawning,
muscle pain, teariness, and runny nose. Other symptoms include:
irritability, joint pain, backache, weakness, abdominal cramps,
insomnia, nausea, anorexia, vomiting, and increased blood pressure,
respiratory rate, or heart rate.
Any person using OxyContin for more than several weeks should consult
with a medical professional before stopping the drug. Generally
speaking, a gradual weaning off of the drug is optimal and less
traumatic to the user’s physical and emotional health. With a moderate
to severe addiction, an in patient detox in a hospital or medical
supervised setting is highly recommended for its multi- disciplinary
approach. While drug addiction is a treatable disease, relapse is
common and professional help is highly recommended.