Oxycodone abuse has been an ongoing problem in the United States since the early 1960’s. The Controlled Substance Act of 1970 placed oxycodone products in a Schedule 2 category. The abuse of a release formulation of oxycodone, known as Oxycontin, has rocketed over the last year. Drug abuse treatment programs have reported a dramatic increase in the abuse. Sometimes seen as a “white-collar” addiction, oxycodone abuse spans among all groups. The number of hospital related oxycodone incidences doubled from 1996 to 1999 and DAWN has reported recently a 400% increase in oxycodone related deaths.
Oxycodone is a semi-synthetic opiate derived by chemical modification of codeine. Oxycodone is an effective analgesic for chronic pain and for the treatment of terminal cancer pain. Oxycodone is considered to be morphine-like and in this respect has similar abuse potential. The drug is available in tablet, capsule and liquid forms and a typical adult dose is 2.5 to 5 mg every 6 hours.
Oxycodone is legally prescribed under the trade names Percodan, Percocet, Roxicet, Oxycontin and Tylox. Oxycontin is the time release form of Oxycodone.
Oxycodone is abused for its opiate-like effects. The relative ease of oxycodone availability and its perceived safety makes this drug very dangerous. For illicit use, the tablets are crushed and the contents can be snorted or dissolved in water for injection. Common street names are “Oxy”, “OC” and “Hillbilly Heroin”. The major source of oxycodone on the street has been through forged prescriptions, professional diversion through unscrupulous medical professionals and through theft. Oxycodone sells for approximately $ 1.00 per milligram. A 40 mg tablet is sold for $ 25 to $ 40, and an 80 mg tablet is sold for $ 65 to $ 80.
Withdrawal symptoms may begin hours after the last dose and reach a peak at 2 to 3 days. Psychological effects include sedation, euphoria and mental clouding. Toxic side effects include increased risk of respiratory failure and risk of infection associated with illicit intravenous abuse.
LABORATORY FACTS:
Oxycodone is excreted in the urine principally as the parent drug, along with its metabolite oxymorphone. Following use of oxycodone, a laboratory may detect in urine, oxycodone only, or oxycodone and oxymorphone, or possibly oxymorphone only.
Most laboratories use commercially available immunoassays to screen for opiates in urine. These immunoassays are designed to detect use of the opiates-heroin, codeine and morphine but only to a lesser degree other opiates such as hydromorphone, hydrocodone and oxycodone. Users of laboratory services are often unaware that usual opiate immunoassay screening does not effectively detect oxycodone use and abuse.
To resolve these concerns, Friends Medical Laboratory has designed specific testing for oxycodone, utilizing innovative immunoassay and chromatographic techniques. These robust techniques are available as a special test and as such will obtain a more accurate indication of oxycodone use.
In areas where oxycodone abuse is known or suspected, Friends will continue to alert programs about limitations of traditional immunoassay testing. The emergence of oxycodone as a popular drug of abuse highlights the importance of ongoing communication between Friends and the programs it serves.
