Newsgroups: sci.med.pharmacy
Subject: Re: Dumb Questions about OxyContin
From: dyer@spdcc.com (Steve Dyer)
Date: Sat, 10 Feb 2001 21:07:37 GMT

	> Is this a new drug?

It's more accurate to say that Oxycontin is a new single-entity timed-release
formulation of a rather old drug, oxycodone. Oxycodone should be familiar to
most people as the opiate found in Percodan and Percocet, which combine
5mg of oxycodone with either 325mg of aspirin or 500mg acetaminophen,
respectively.  Percodan and Percocet are most useful for people who are
suffering from acute pain (i.e., broken bones, extracted wisdom teeth, etc.);
people with severe chronic pain often had to expose themselves to excessively
high daily doses of aspirin or acetaminophen to obtain adequate pain relief
with either formulation, especially as their pain increased and/or they
became tolerant to the opiate's effects.  Oxycontin omits the aspirin
or acetaminophen, and just provides oxycodone.  Furthermore, chronic pain
is often better served by providing a steady level of the opiate in the body,
supplementing it as necessary with additional doses if the pain should
"break thru" that baseline of analgesia.  Oxycontin is a timed-release
formulation of oxycodone that comes in several different strengths
depending on the patient and his pain, but they all release the drug
slowly over a period of 8-12 hours.

	About once every two years or so I will have something happen
	that requires something stronger than OTC pain medications.
	We're talking pulled muscles mainly, but once had broken ribs,
	and recently a bad toothache. Usually Tylenol 3 works for me,
	if bad pain, then Vicodin is the strongest I have ever needed.

Vicodin is analogous to Percocet, but the opiate is hydrocodone
rather than oxycodone.  They're both semisynthetic derivatives of
codeine, but more potent and powerful (in fact, they're virtually
identical chemically, with oxycodone having an -OH where hydrocodone
has a -H.)  Hydrocodone has a probably undeserved reputation for being
somewhat less powerful and having a lower abuse potential than oxycodone
(Vicodin is a C-III drug, Percocet and Percodan are C-II), but I'm
sure the placebo effect contributes more to any efficacy Percodan/cet
has over Vicodin than anything in their pharmacologies.

	This OxyContin sounds scary, although I read somewhere that people
	were abusing it by grinding it up or whatever. Is it safe if taken as
	directed? Is this stronger than Vicodin? Would I be safer in the future if
	I stayed with what has worked for me in the past, or not to worry? Also in
	the past if I have a lot of pain, I will take more Tylenol 3's or
	Vicodins than directed. (I know, shame on me!) Anyway could this
	be dangerous with OxyContin?

No one otherwise healthy would (or should) be prescribed Oxycontin
for acute, self-limited pain such as pulled muscles, broken bones,
dental pain, etc.  In fact, Oxycontin would usually never be
prescribed to someone as their first oral opiate analgesic,
without first having taken immediate-release opiate pain relievers
chronically for a while.  This is for several reasons:

First, it's not all that great for acute pain, because the drug is
released slowly; these timed-release formulations of oxycodone
and morphine (MS-Contin) are designed to be given 2-3 times a day,
and accumulate to a more or less constant blood level over a period
of several days.  Second, the higher doses of such time-released
formulations are designed (and dosed) for people already stabilized
on a certain daily dose of immediate-release opiates,who are already
familiar with the drug and its actions, and who may be tolerant to
doses of the drug that could harm someone who was opiate naive.

If you gave even the smallest dosage strength of Oxycontin (20mg)
to someone who'd never taken the drug before, not only might it
be too high a dose, but if they experienced one or more of opiates'
unpleasant side-effects (e.g., nausea, dizziness, itching, low blood
pressure), it could last as long a day to get over because of the
steady release of the drug as it passes thru the gut.  Higher dosage
strengths of Oxycontin would definitely be an overdose in an opiate
naive individual, and could be quite dangerous.

The putative consumers of diverted or illegally prescribed Oxycontin
generally do not find an oral timed-release opiate formulation to
have much recreational value, so they try to increase the amount of
drug released immediately by cutting and/or crushing the tablets,
and either ingest that or <shudder> inject an infusion of the crushed
tablets IV.  The risk of overdose in that case is that much higher,
to say nothing about the effect of the fillers and excipients that
end up in an addict's veins. <shudder>



--
Steve Dyer
dyer@ursa-major.spdcc.com

Newsgroups: sci.med.pharmacy
Subject: Re: Dumb Questions about OxyContin
From: dyer@spdcc.com (Steve Dyer)
Date: Sun, 11 Feb 2001 20:52:05 GMT

In article <13734-3A86C1B6-8@storefull-104.iap.bryant.webtv.net>,
zorro <pygmypony@webtv.net> wrote:
>Bill, you are the exact ignorant segment of society they directed this
>piece of pseudo journalism towards. Totally one sided full of scare
>tactics with no mention of the positive life saving and life enhancing
>effects of this miracle drug whose positive use and effects make this
>small ammount of abuse insignificant by comparisson.

You don't have to praise Oxycontin to the skies to feel nauseated by
the cynical promotion and publicity surrounding this "bust", with the
DEA serving up this ersatz news to unquestioning so-called journalists,
which regurgitated it at face value over the front page of every
newspaper in the country.
--
Steve Dyer
dyer@ursa-major.spdcc.com

Newsgroups: sci.med.pharmacy
Subject: Re: Painkiller Becomes Drug of Abuse
From: dyer@spdcc.com (Steve Dyer)
Date: Sat, 10 Feb 2001 21:09:08 GMT

In article <t4ia8t8u8igun31ffisief2rqpctt2d979@4ax.com>,
Paul Burridge  <pb@osiris1.co.uk> wrote:
>Is this the same stuff as is marketed in the UK as "MST" (morphine
>sulphate in modified release tablet form)?

Same idea, different drug.  "MS-Contin" == "timed-release morphine sulfate",
"Oxycontin" == "timed-release oxycodone".
--
Steve Dyer
dyer@ursa-major.spdcc.com