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In 1995, the FDA approved the powerful prescription pain killer OxyContin, and in 1996 Americans were first able to use the drug. OxyContin is in fact a chemical cousin of heroin, and its manufacturer claimed the sustained-release opioid could offer a smooth 12 hours of consistent pain relief for patients. Between 1997 and 2002, OxyContin appeared to be the drug of choice prescribed for pain relief and physician's prescriptions increased nearly tenfold during that time. While all of this was taking place, the FDA began approving higher dose versions of OxyContin, one at 80mg and then another at 160mg in 2000 for patients who were "opioid tolerant". By 2010, annual sales of the drug reached over $3 billion dollars and accounted for over 25% of total opioid analgesic sales that year.
With the availability of such a large dose of opioid drug so readily available to millions of Americans, it is no wonder that it became a street drug of choice for diversion and illicit use. It is also no wonder that even patients with legitimate prescriptions for pain also began abusing the powerful pain killer once they became opioid dependent, through no fault of their own. Between 1999 and 2010, while sales of prescription pain killers quadrupled, so did drug overdose deaths. And it all started with OxyContin, which has spawned a prescription pain killer epidemic that is far worse than any other drug problem facing Americans.
Most non-medical users who first became opiate addicted to OxyContin would crush and snort the tablets or intravenously inject the drug much like someone would do so with heroin. This earned OxyContin the name "Hillbilly Heroin". Recognizing the need for restrictions on availability of such potent prescription pain killers, the FDA forced manufacturers to come up with a solution so that illicit users couldn't use the drug in this way. Their solution was an OxyContin formulation that is "uncrushable" and turns into a stringy liquid if someone intended on dissolving it and injecting it. Needless to say it's still possible to get high from OxyContin pills, no matter the formulation. This also hasn't stopped opiate dependent and addicted Americans from finding other prescription pain killers to crush, inject, snort, etc. In an even worse turn of events it has spawned a new heroin epidemic as users turn to heroin for an easier and cheaper high.
Today, and primarily because of OxyContin's influence in creating a whole new generation and type of drug user 20 years ago, an estimated 7 million Americans are abusing prescription pain killers. In 2013, over 205 million prescriptions were written out to Americans for prescription pain killers, representing nearly 100% of the worldwide consumption of hydrocodone and over 80% of the oxycodone consumed globally. The fact is, Americans are dying because of it.
The dangers of abusing pain killers are the exact same dangers associated with heroin abuse. These dangers become more increased and common when someone abuses higher doses, i.e. doses that would get you high. Someone who can't get high on one pill, would take two instead. Likewise, the dangers become more increased and common when the administration method is one that increases the drugs euphoric effects, such as snorting, injecting or combing pain killers with alcohol or other illicit drugs or pharmaceutical drugs.
When becoming involved in abuse of prescription pain killers, you become involved in a deadly cycle of abuse. Users not only put themselves at risk of dependence and addiction, but they can literally stop breathing, go into a coma and die of overdose just as a heroin user would. This is particularly common among users who attempt to tamper with the newly formulated extended release version of pain killers, which are meant to be "tamper proof". Unless you have a tolerance for such a high dose of opioid medication in your system all at once, you will die. When you're using prescription pain killers non-medically and at your own discretion, you have no idea what dosage your body is tolerant of. Yet, you will chase your high at all costs, even if it costs you your life. Overdoses due to this type of misconception are particularly common among pain killer abusers who remain abstinent for even a short period of time and then proceed to take whatever they would consider to be their regular dose. It's just too much drug in their bodies at one time, and they experience a fatal overdose.
Taking benzodiazepines and/or alcohol while abusing prescription pain killers significantly increases the risk of fatal overdose. All of these substances act as depressants in the body. Take a pain killer and you slow breathing, heart rate and other important functions of the body crucial to sustaining life. Put alcohol or benzodiazepines on top of that, and you magnify those effects exponentially.
Withdrawal from pain killers can be just as punishing as withdrawal from heroin, and this is one of the problems abusers face when they want to put an end to their pain killer abuse. Medication assisted therapy was developed in response to the heroin and pain killer abuse epidemic, and the medications used work in the same areas of the brain to reduce withdrawal and cravings. Drugs like Methadone, Vivitrol and Suboxone are the most commonly used medications for opiate dependence today. These drugs however need to be continuously administered to help opiate addicts maintain their abstinence and to help them refrain from drug seeking behavior. Meaning, this may interfere with someone's desire to free themselves from opiate dependence entirely and is a daily expense and logistical obligation once started. Drug free treatment for pain killer abuse is available as an alternative, and programs showing the most promise for opiate addicts are those which provide long term treatment in a therapeutic inpatient or residential treatment setting.