Recently, you have probably heard about OxyContin, and you may be wondering what the issue is. To understand the matter better, let’s start by thinking a bit about the opioid class of drugs. The first historical mention of opioids is in Greek writing dating back to the third century BC, although the pain-relieving and psychological effects of these drugs may have been discovered even earlier. Indeed, these drugs have been around for a very long time!
The words opioid and opium are derived from the Greek word for juice, for a very simple reason. These drugs are obtained from the juice of the poppy plant. Opium itself contains more than 20 distinct compounds and the first, morphine, was isolated in 1806 and named after the Greek god of dreams, Morpheus. Other pure compounds such as codeine followed and thus the use of the pure compounds rather than opium itself started.
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Today, opioid drugs, including oxycodone, are synthetically manufactured.
Opioid drugs are effective pain relievers due to their ability to attach to various nervous system receptors called — what else? — opioid receptors. The receptors are referred to by the Greek letters μ, δ, ε, κ, and σ and there are various subtypes of each. Once the opioid is attached to the target receptors, pain messages are blocked, which means the sensation of pain is alleviated.
For patients, the differences between the opioid drugs depends upon which receptors — or which combinations of receptors — they block.
It is also important to know that while they are effective as pain relievers, opioid drugs do have side-effects, for example constipation, dizziness, drowsiness, respiratory depression, altered mental states, tolerance, and dependency.
In fact, it was this potential for dependency and addiction that prompted a change in the OxyContin formulation.
About 17 per cent of Canadians experience chronic pain, with women and the elderly being more often affected, and opioid drugs such as OxyContin are treatment options. Over time, tolerance and dependence can develop.
As well, all opioid drugs can be abused for their nervous system effects, specifically euphoria. The OxyContin tablet was a slow release formulation which could be crushed to obtain the total amount of the drug and either inhaled as powder or mixed with water for injection.
While there are no data regarding how many Canadians have an OxyContin addiction, there seems to be a prevalence in Atlantic Canada and rural areas including First Nation communities.
Rather than discontinue the product completely, the manufacturer replaced it with OxyNeo which contains the same amount of active ingredient, but in a tamper-proof formulation. This new tablet is much harder to crush and it forms a gel when added to water making it difficult to inject. Unfortunately for people addicted to OxyContin, they may need to change to another opioid drug or enter a drug withdrawal program.
If you take opioid drugs, including OxyContin, for a chronic pain condition, effective analgesics are still available. And, if you need pain relief for an acute problem, the opioid drugs will still be effective.
But remember to use any pain reliever wisely. That is, only use it for the shortest time possible and on a scheduled basis to keep your pain under control.
Of course, don’t forget the non-drug approaches to pain relief such as exercise, massage, physiotherapy, rest, braces, supports, heat, cold packs, relaxation techniques, and even solving the underlying problem that’s causing the pain.
Pain may be inevitable, but suffering is optional.
