OxyContin: a prescription for addiction

Where only first names appear, names have been changed to protect the identity of the sources.

Joe, a junior, sits silently amongst a boisterous group of friends along Blair Boulevard during 5B lunch on Dec. 22. After shooting paranoid glances up and down the hall, he is confident that the coast is clear and opens his hand, revealing a 10-mg OxyContin prescription pill. His back turned against the passing crowds in the hallway, Joe works quickly, crushing the pill with his driver's license and pushing the powder into a thin line on the cover of his student planner. In a matter of seconds, he snorts the drug through a pen cap and up his nose, brushes any residue onto the floor and leans back into the wall.

As Joe starts to feel the relaxing effects of OxyContin, he unknowingly sets himself up for addiction as his brain slowly builds tolerance to the drug with every use.

While Joe is among only a few Blazers who have experimented with OxyContin, it is one of the most commonly abused prescription drugs in America, according to the Office of National Drug Control Policy. OxyContin abuse has even been associated with celebrities, including MTV reality series star Jack Osbourne and conservative radio show host Rush Limbaugh. Recently, OxyContin abuse has nearly doubled, up from 1.9 million people over age 12 in 2002 to 2.8 million in 2003, according to the 2003 National Survey on Drug Use and Health. While it is a legal prescription drug when taken properly, OxyContin is similar to heroin when abused, presenting great risks of addiction and overdose for its abusers. For the handful of OxyContin abusers at Blair, their recreational use can easily turn into an addiction, leading to dangerous and possibly lethal consequences.

A new sensation

With the effects of his earlier-morning dose of OxyContin barely lingering, Joe feels the need to indulge in a second fix of the drug while in school, despite disapproving looks from his friends and the risk of being caught. Any unpleasant thoughts such as these, however, are swiftly pushed out of his mind as the opiate effects of OxyContin rush through his system and a strong euphoric sensation fills his body. Joe's relaxed body slides down onto the floor. His shoes brush against his friend's jeans, and his hand reaches out to clutch another friend's arm. His head tilts up toward the ceiling, eyes glazed over.

"It's that muscle relaxation feeling you get," says Joe. "You're just so high." Abusers acquire such an intense high by removing the coating around the pill that normally enables its active ingredient, oxycodone, to be released over a 12-hour period. Breaking, crushing or chewing the tablets this way negates the timed effect of the drug and leads to the rapid release and absorption of oxycodone, thus the acute bliss associated with OxyContin highs.

Though Kelly, a junior, has used OxyContin only once, she loved the high and plans to use it again. "It was an elated, happy feel," she says. "I was really excited about everything and felt totally disconnected from reality."

When used properly, OxyContin is a powerful pain-reliever taken by patients suffering from injuries, fractures, arthritis and pain associated with cancer.

But when the drug is abused through inhalation or digestion, its pain-relieving effects are exaggerated: Its active ingredient, oxycodone, blocks the transmission of pain messages to the brain and disrupts how the brain perceives pleasure, according to the National Institute on Drug Abuse.

This change in brain chemistry is appealing to habitual drug abusers who have grown bored with the monotony of marijuana and alcohol. For first-time users, OxyContin's effects can be very sudden and surprising, unlike the slow onset of drunkenness or the giddy highs of marijuana. "The first time I used [OxyContin] this past summer I was feeling sober, and then all of a sudden it kicked in. It was like a smack right across the face; I had never felt like that before," says Joe.

A dangerous high

Even patients using OxyContin legitimately with a prescription can grow dependent on the drug, as it has a very high potential for abuse. Controversy continues to follow the drug, as pharmacies are robbed specifically for their supply of OxyContin, and patients deceive doctors for prescriptions. Most abusers obtain OxyContin by "doctor shopping," according to the Office of National Drug Control Policy, where individuals visit many doctors to acquire large amounts of the drug. Joe, however, buys OxyContin illegally from his drug dealer, where it usually sells for $1 per milligram. The drug is even available online without a prescription.

When abused, OxyContin can cause serious health problems like malnutrition and skin infections, disproving any misconceptions that the drug is harmless. Chronic use of the drug leads to physical addiction, causing withdrawal symptoms if use is stopped abruptly.

"People can get to the point where they have to use OxyContin to not get sick," says Steve Moreno, an adolescent substance abuse counselor at Suburban Hospital. "It can get very expensive to do that. People start stealing, prostituting themselves. They disregard any morals they once had. OxyContin becomes their main priority, while everything else takes a backseat."

Most OxyContin abusers, however, overlook the risks and possible repercussions of their use, continuing to abuse the drug as needed to reproduce the addictive high. Since OxyContin is a legal prescription drug, abusers use this rationale that it is "safe" to justify their use, according to Moreno. "They're just fooling themselves," he says.

Just as Joe felt the need for a second in-school fix of OxyContin, abusers can grow to feel the constant desire for more. "The main danger of OxyContin abuse is that people can overdose and die," says Brian Elezy, director of Elezy Consultants, a substance abuse treatment center at Potomac Ridge Behavioral Center in Rockville. "The body builds tolerance to it, and the brain starts to adjust, it's like 'Uh-uh, no, that's not enough,' and needs more [OxyContin] to feel high."

Accidentally overdosing is especially dangerous for adolescents, who tend to cross over from using OxyContin to "get buzzed" to using it "just to get wasted," according to Elezy. "Teens can get addicted [more quickly] because their body chemistry is not fully developed yet," he says.

Although Kelly believes she cannot get addicted to the drug, her friends are now wary of her judgment. "While I was high [on OxyContin] my one friend said, 'I've lost all possible respect for you.' But since I was high at the time I didn't really think about it," she says.

While Kelly has since moved on from such objections, her friends continue to dwell on her decision to abuse OxyContin. "I felt like she let other people influence her to do it," says Kelly's friend, a junior. "[Using it is] not necessary. It's just stupid."