OxyContin® is a prescription painkiller used for moderate to high pain relief associated with injuries, bursitis, dislocations, fractures, neuralgia, arthritis, lower back pain, and pain associated with cancer.1 OxyContin® contains oxycodone, the medication’s active ingredient, in a timed-release tablet. Oxycodone products have been illicitly abused for the past 30 years.2
Oxycodone is a Schedule II narcotic analgesic and is widely used in clinical medicine. It is marketed either alone as controlled release (OxyContin®) and immediate release formulations (OxyIR®, OxyFast®), or in combination with other nonnarcotic analgesics such as aspirin (Percodan®) or acetaminophen (Percocet®). The introduction in 1996 of OxyContin®, commonly known on the street as OC, OX, Oxy, Oxycotton, Hillbilly heroin, and kicker, led to a marked escalation of its abuse as reported by drug abuse treatment centers, law enforcement personnel, and health care professionals. Although the diversion and abuse of OxyContin® appeared initially in the eastern US, it has now spread to the western US including Alaska and Hawaii. Oxycodone-related adverse health effects increased markedly in recent years. In 2004, Food and Drug Administration (FDA) approved for marketing generic forms of controlled release oxycodone products.3
Oxycodone products are in Schedule II of the federal Controlled Substances Act of 1970.4
Kicker, OC, Oxy, OX, Blue, Oxycotton, Hillbilly Heroin
Pharmacological effects include analgesia, sedation, euphoria, feelings of relaxation, respiratory depression, constipation, papillary constriction, and cough suppression. A 10 mg dose of orally-administered oxycodone is equivalent to a 10 mg dose of subcutaneously administered morphine as an analgesic in a normal population. Oxycodone’s behavioral effects can last up to 5 hours. The drug is most often administered orally. The controlled-release product, OxyContin®, has a longer duration of action (8-12 hours).5
The most serious risk associated with opioids, including OxyContin®, is respiratory depression. Common opioid side effects are constipation, nausea, sedation, dizziness, vomiting, headache, dry mouth, sweating, and weakness. Taking a large single dose of an opioid could cause severe respiratory depression that can lead to death.6
As with most opiates, oxycodone abuse may lead to dependence and tolerance. Acute overdose of oxycodone can produce severe respiratory depression, skeletal muscle flaccidity, cold and clammy skin, reduction in blood pressure and heart rate, coma, respiratory arrest, and death.7
Chronic use of opioids can result in tolerance for the drugs, which means that users must take higher doses to achieve the same initial effects. Long-term use also can lead to physical dependence and addiction — the body adapts to the presence of the drug, and withdrawal symptoms occur if use is reduced or stopped. Properly managed medical use of pain relievers is safe and rarely causes clinical addiction, defined as compulsive, often uncontrollable use of drugs. Taken exactly as prescribed, opioids can be used to manage pain effectively.8
Drug Abuse Recognition (DAR)
As a point of reference, the following objective symptoms: Horizontal Gaze Nystagmus, Vertical Gaze Nystagmus, Lack of Convergence, Pulse, Romberg Stand, Pupil Size, and Pupillary Reaction To Light are determined during a DAR evaluation to identify drug influence and impairment. The following objective symptoms of someone under the influence of oxycodone may be used as a reference only, and should not be used to replace certified Drug Abuse Recognition Training.
Please contact Express Diagnostics if you would like more information on DAR-OS or drug abuse recognition training.
Opiates: Buprenorphine, opiates, methadone, oxycodone, tramadol, fentanyl
|Horizontal Gaze Nystagmus||Not Present|
|Vertical Gaze Nystagmus||Not Present|
|Lack of Convergence||Not Present|
|Pupillary Reaction To Light||Slow|