Edition 30 August 2018, by Anastasiia Myronenko
One of the most powerful existing painkillers, Oxycodone (also known as OxyContin or Oxynorm), was introduced to the pharmaceutical market in the United States in the nineties. It was described at the time as a revolutionary discovery in pain management, with a low risk of addiction and few major side effects. Years later, the manufacturer of Oxycodone was fined hundreds of millions of dollars for misinformation and deception. America is now facing an “opioid epidemic”.
The chemical composition of the medication is similar to that of morphine and heroine. This medication is an opioid that originally was used for treating severe pains in cancer patients. Oxycodone is a very strong painkiller – it is considered to be twice as strong as morphine – and the side effects that it may cause are quite severe too; from drowsiness, headache and constipation as the most common, to confusion, depression and breathing problems. However, the most dangerous part to using the drug is its highly addictive nature. Taking it for more than a month might potentially result in a strong physical and mental dependence that is almost impossible to overcome without specialist help. In some cases addiction can develop even faster.
In 2016 about 42.000 people in the USA died from opioid overdoses, which indicates a true epidemic. Prescribing heavy painkillers is widely normalized nowadays. In some cases it is necessary, since it may be the only way to overcome excruciating pain. Oxycodone brings relief by intercepting pain signals in the brain and giving a feeling of euphoria. Gradually, the body needs more of the medication to minimize the pain, and if a patient tries to lower the dosage or stop the treatment, the symptoms can be similar to those of heroin withdrawal. Patients suffer shaking, sweating, nausea, severe stomach pain, anxiety and panic attacks.
What is more, Oxycodone is prescribed in cases where milder measures could have been taken, such as paracetamol or ice application. Opioids are used for all kinds of pain, from the more serious like bone fractures and to treat chronic pains and hernias, but also after minor surgeries like tonsillectomy. Patients get an extensive supply of the medication to avoid unnecessary painful symptoms and can easily renew their prescription. That is, in fact, how opioids end up being sold at the black market.
According to statistics, every year about 1,3 million people in the Netherlands use opioids. These include medication such as pethidine, morphine, tramadol, methadone, oxycodone, fentanyl and carfentanil – all very strong painkillers. And even though the addiction to Oxycodone hasn’t reached an epidemic scale here, there are still alarming signals that the situation should be assessed more thoroughly as soon as possible. What complicates the issue even more is that hospitals in the Netherlands are rated according the “pain rate” – the less pain is reported by patients, the better the rating of the institution. The insurance companies, in their turn, prefer to work with the “best rated” hospitals. Therefore, some doctors might prescribe a stronger medication to make sure that the patient feels as comfortable as possible. In some cases, patients are allowed to leave the hospital earlier, on the condition that they will take their medication – which is often Oxycodone.
It is not known for sure how many people in the Netherlands are currently addicted to Oxycodone. Usually, they don’t seek help at rehabilitation centers, unless the situation gets really out of control. Instead, they visit their general practitioners or specialists. Therefore, they are not registered as drug addicts. Despite this, the Dutch General Practitioners’ Association (NHG) is trying to raise awareness of the problem and is taking measures to fight it. For instance, the so-called “Pain Standard” was adjusted: now, the patient must be examined again, before the opioid prescription can be prolonged. In addition, strong medications are not advised for people who have a history of addiction to alcohol, nicotine or other substances. According to pharmacists, in 2017 almost 440.000 people in the Netherlands took Oxycodone. In 2011 there were 148.000. Thus, the number has tripled in just four years. Many of those who suffer from addiction say that if they had known what the outcomes would be, they would never have taken the drug. Thus, the problem still remains mostly unknown among the general public.