OxyContin is a semi-synthetic opiate used to treat moderate to severe pain. It was first approved by the Food and Drug Administration in 1996 and since then has become one of the most widely used and misused painkillers on the market. According to the U.S. Department of Justice, in 2008 over 50 million prescriptions were dispensed for OxyContin and its generic equivalents. OxyContin has a high potential for addiction because it contains a much larger dose of the active ingredient oxycodone compared with other opiate pain medications. OxyContin also has a high addiction potential because users may want to avoid the severe withdrawal symptoms. There are several drugs used to treat OxyContin addiction.
Suboxone
Suboxone is one of the newest and most effective medications used to treat OxyContin addiction. Suboxone was approved by the FDA in 2002 for the treatment of narcotic addiction, and in 2008 about 3.5 million prescriptions were dispensed. Suboxone is a combination of buprenorphine and naloxone. Buprenorphine is a long-acting opiate with a ceiling effect, significantly reducing any potential for overdose. Naloxone is an opiate blocker that blocks other opiates such as heroin and morphine. Naloxone also prevents the misuse of buprenorphine if the user injects the Suboxone; if Suboxone is taken as directed, under the tongue, the naloxone has no effect. In the March 2008 issue of "The Cochrane Database of Systematic Reviews," Dr. Richard Mattick and associates found that medium and high doses of buprenorphine are significantly superior to placebo in suppressing illicit opiate use.
Methadone
Methadone has traditionally been the drug used to treat opiate addiction. It was first approved by the FDA in 1947 and has been used to treat opiate addiction since the 1960s. Methadone is a powerful opiate that lasts 24 to 36 hours. While on methadone, patients do not feel the typical highs and lows of shorter-acting opiates like OxyContin. Being in a methadone maintenance program also helps patients stay within the law by not acquiring OxyContin from illegal sources. While on methadone, patients can taper off slowly, by increments as little as 1mg at a time. According to the Substance Abuse and Mental Health Services Administration, OxyContin is the most frequently used prescription opiate by people entering methadone treatment. In the study by Mattick and associates, methadone was found to be more effective than buprenorphine in low and medium doses. Patients on methadone must typically come in for daily clinic dosing, whereas patients on buprenorphine can receive a month's supply from most pharmacies.
Tramadol and Other Medications
Some patients may not want to switch from one powerful opiate to another. Other effective medications with fewer potential for dependence include tramadol, clonidine and methocarbamol. Tramadol is a drug with weak opiate effects that also increases the neurotransmitters serotonin and norepinephrine, which can help to elevate mood during opiate withdrawal. Clonidine helps to lower blood pressure during withdrawal and methocarbamol acts as a muscle relaxer blocking nerve impulses that result in pain sensations. Patients may take these medications together or separately. In the winter 2003 issue of the "Journal of Addictive Diseases," Dr. Paul Sobey and associates found that tramadol was significantly more effective in managing withdrawal than clonidine.
References
- U.S. Department of Justice-Office of Diversion Control: Oxycodone
- "The Cochrane Database of Systematic Reviews"; Buprenorphine Maintenance Versus Placebo or Methadone Maintenance for Opioid Dependence; Dr. Richard Mattick et al.; March 2008
- Substance Abuse and Mental Health Services Administration: OxyContin-Prescription Drug Abuse---2008 Revision
- "Journal of Addictive Diseases"; The Use of Tramadol for Acute Heroin Withdrawal: A Comparison to Clonidine; Dr. Paul Sobey; Issue 4-Winter 2003
- U.S. Department of Justice-Office of Diversion Control: Buprenorphine
