Joel Spendlove

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Health 1050-MWF 8am

Ibarra
11/29/2015
Oxycodone and the Negative Effects of Opioids
One hundred people die from drug overdoses every day in the United States. The misuse
and abuse of prescription painkillers was responsible for more than 475,000 emergency
department visits in 2009, a number that nearly doubled in just five years. More than 12 million
people reported using prescription painkillers non-medically in 2010, that is using them without
a prescription or for the feeling they cause. Taken as prescribed, opioids can be used to manage
pain safely and effectively. However, when abused, even a single large dose can cause severe
health problems, and death (Policy Impact: Prescription Painkiller Overdoses).
Opioids are medications that relieve pain. They reduce the intensity of pain signals
reaching the brain and affect those brain areas controlling emotion, which diminishes the effects
of a painful stimulus. Medications that fall within this class include hydrocodone, oxycodone,
morphine codeine, and related drugs. Hydrocodone is the most commonly prescribed for a
variety of painful conditions, including dental and injury-related pain. Morphine is often used
before and after surgical procedures to alleviate severe pain. Codeine, on the other hand, is often
prescribed for mild pain. In addition to their pain relieving properties, some of these drugs
(codeine and diphemoxylate for example) can be used to relieve coughs and severe diarrhea
(Prescription Drug Abuse. What are opioids?).
Opioids act by attaching to opioid receptors, which are found in the brain, spinal cord,
gastrointestinal tract, and other organs in the body. When these drugs attach to their receptors,
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they reduce the perception of pain. Opioids can also produce drowsiness, mental confusion,
nausea, constipation, and depending upon the amount of drugs taken, can depress respiration.

Some people experience a euphoric response to opioid medications, since these drugs also affect
the brain regions involved in reward. Those who abuse opioids may seek to intensify their
experience by taking the drug in ways other than those prescribed. OxyContin is an oral
medication used to treat moderate to severe pain through a slow, steady release of the opioid.
People who abuse OxyContin may snort or inject it, thereby increasing their risk for serious
medical complications, including overdose.
Physical dependence occurs because of normal adaptations to chronic exposure to a drug
and is not the same as addiction. Addiction, which can include physical dependence, is
distinguished by compulsive drug seeking and use despite sometimes devastating consequences.
Someone who is physically dependent on a medication will experience withdrawal symptoms
when use of the drug is abruptly reduced or stopped. These symptoms can be mild or severe
(depending on the drug) and can usually be managed medically avoided by using a slow drug
taper. Dependence is often accompanied by tolerance or the need to take higher doses of a
medication to get the same effect. When tolerance occurs, it can be difficult for a physician to
evaluate whether a patient is developing a drug problem, or has a real medical need for higher
doses to control their symptoms. For this reason, physicians to need to be vigilant and attentive
to their patients symptoms and level of functioning to treat them appropriately.
Some medications have psychoactive properties and, because of that, are sometimes
abused. Prescription and over-the-counter (OTC) drugs, after marijuana and alcohol, the most
commonly abused substances by Americans. The class of prescription drugs most commonly
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abuse are: opioid pain relievers, stimulants for treating ADHD, and central nervous system
depressants for relieving anxiety. The most commonly abused OTC drugs are cough and cold
medicines containing dextromethorphan. People often think that prescription and OTC drugs are

safer than illicit drugs, but thats only true when they are taken exactly as prescribed and for the
purpose intended. Prescription drugs may be abused in one or more of the following ways: taking
a medication that has been prescribed for someone else, taking a drug in a high quantity or in
another manner than prescribed, taking a drug for another purpose than prescribed. Prescription
and OTC drugs can also have a big impact on the brain. Opioid pain relievers such as OxyContin
attach to the same cell receptors targeted by illegal opioids like heroin. Prescription opioid abuse
could be the first step to heroin abuse. The terrible consequences of this epidemic include
overdose deaths, which have more than quadrupled in the past decade and a half.
Unaware of the dangers of sharing medications, people often unknowingly contribute to
this form of abuse by sharing their unused pain relievers with their family members. Most
prescription drugs are dispensed orally in tablets, but abusers sometimes crush the tablets and
snort or inject the powder. This hastens the entry of the drug into the bloodstream and the brain
and amplifies the effects. Taken as intended, prescription and OTC drugs safely treat specific
mental or physical symptoms. But when taken in different quantities or when such symptoms
arent present, they may affect the brain in ways very similar to illicit drugs. Opioid pain
relievers such as OxyContin attach to the same cell receptors targeted by illegal opioids like
heroin (Prescription Drug Abuse. What are the possible consequences of opioid use and
abuse?).
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Healthcare providers dilemma of treating patients who suffer from chronic pain stem
from the potential risks involved with long term treatment, such as the development of drug
tolerance, hyperalgesia (increased pain sensitivity), and addiction. Patients themselves may even
be reluctant to take an opioid medication to take an opioid medication prescribed to them for fear

of becoming addicted. Estimates of addiction among chronic pain patients vary widely from

about 3 percent to 40 percent. Addictions between chronic pain patients vary widely. The
variability is the result of differences in treatment duration, insufficient research long-term
outcomes, and dispersed study populations and measures used to assess abuse or addiction. To
mitigate addiction risk, doctors should screen patients for potential risk factors, including
personal or family history of drug abuse or mental illness. Early or frequent requests for
prescription pain medication refills, for example, could represent illness progression, the
development of drug tolerance, or the first signs of a drug problem. Researchers are exploring
alternative medications that can get rid of pain but have less abuse occur (Drug Facts:
Prescription and Over-the-Counter Medications).
Taken as prescribed, opiates can be used to manage pain safely without problems. When
abused, even a single dose incorrectly portioned dose can cause severe respiratory depression
and death. Properly managed, short-term medial use of opioid analgesics rarely causes addiction
characterized by compulsive drug seeking and use despite serious adverse consequences.
(Wikipedia) Regular or longer term use or abuse of opioids can lead to physical dependence and,
in some cases, addiction. Physical dependence is a normal adaptation to chronic exposure to a
drug and is not the same as addiction. In either case, withdrawal symptoms may occur if drug use
is suddenly reduced or stopped. These symptoms can include restlessness,
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muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps, and
involuntary leg movements. Opiates can depress breathing by changing neurochemical activity in
the brain stem, where automatic body functions are controlled. Opiates can change the limbic
system, which controls emotions, to increase feelings of pleasure. Opiates can also block pain
messages transmitted through the spinal cord from the body, which can be very dangerous
(Chronic Pain Treatment and Addiction).

Oxycodone is a semi-synthetic opioid synthesized from poppy-derived thebaine. It is a

narcotic analgesic generally indicated for relief of moderate to severe pain. It was developed in
1916 in Germany as one of several new semi-synthetic opioids in an attempt to improve on the
existing opioids.
Oxycodone is available as single-ingredient medication in immediate release and controlled
release. Parenteral formulations of 10 mg/mL and 50mg/mL are available in the U.K. for IV/IM
administration. Combination products formulated with non-narcotic ingredients such as NSAIDs
and paracetamol (acetaminophen) are also available as immediate release formulations; a
combination with naloxone is available in managed-release tablets, naloxone reduces opioidinduced euphoria, as well side-effects such as constipation (Wikipedia).
`

Common side effects include euphoria, constipation, fatigue, dizziness, nausea, and

vomiting, dry mouth, anxiety, itching, and sweating. Less common side effects (experienced by
less than 5% of patients) include loss of appetite, nervousness, abdominal pain, diarrhea, urine
retention, dyspnea, and hiccups. In high doses, overdoses, or in patients not tolerant to opiates,
oxycodone can cause shallow breathing, bradycardia, cold-clammy skin, apnea, hypotension,

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circulatory collapse, respiratory arrest, and death. Oxycodone in combination with naloxone in
managed-release tablets, has been formulated to reduce side effects (Wikipedia).

Sources Cited
"Policy Impact: Prescription Painkiller Overdoses." Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention, n.d. Web. 07 Nov. 2014.
Drug Facts: Prescription and Over-the-Counter Medications National Institute on Drug Abuse
(NIDA). USA.gov, Sept. 2014. Web. 18 Sept. 2014.
Prescription Drug Abuse. How do opioids affect the brain and body? USA.gov, Oct. 2011.
Web. 18 Sept 2014.
Prescription Drug Abuse. What are opioids? USA.gov, Oct. 2011. Web. 18 Sept. 2014.
Prescription Drug Abuse. What are the possible consequences of opioid use and abuse?
USA.gov, Oct 2011. Web. 18 Sept. 2014.
Prescription Drug Abuse. Chronic Pain Treatment and Addiction. USA.gov, Oct. 2011. Web.
18 Sept. 2014.
"Oxycodone." Wikipedia. Wikipedia, n.d. Web. 11 Nov. 2014. <http%3A%2F
%2Fen.wikipedia.org%2Fwiki%2FOxycodone>.