The New England Journal of Medicine carries an article today, reviewing strategies that have been put in place to reduce the abuse of OxyContin. OxyContin (oxycodone) is the brand name of a pain killer medicine manufactured from thebaine extracted from the opium poppy.

Although oxcodone was originally synthesized in the early 20th Century, it’s only recently become widely used. OxyContin is manufactured by Purdue Pharama, and was first FDA approved in 1995. It’s popularity has increased rapidly in the last decade or so, with 11.5 tons produced in 1998, shooting to 51.6 tons in 2007. It’s ranked amongst the top three pain killers after morphine.

The drug is taken orally, as a time release pill, so it’s considered safer and less addictive than morphine injections. Patients can also administer it themselves. It has become popular for treatment for a wide range of conditions, from back pain to cancer patients.

Unfortunately oxycodone has also become a focus for recreational and addicted drug users. Prescription drugs are now more widely abused than the standard street drugs, such as heroin and cocaine. Supply is easier to come by locally, and quality and purity are more assured. The pills are commonly crushed so that they can be snorted or injected to give a faster more intense high.

Theodore J. Cicero, Ph.D. and Matthew S. Ellis, M.P.E. from Washington University in St. Louis, St. Louis, MO. conducted the study using data collected quarterly from July 1, 2009, through March 31, 2012. They gave the 2,566 opioid addicts, self-administered surveys that were completed anonymously following guidelines of the Diagnostic and Statistical Manual of Mental Disorders. More than 100 patients also agreed to telephone interviews

The results showed that abuse of OxyContin fell from 35% to just 12.8% twenty-one months after the formula was introduced to prevent tampering with the product. While some users indicated that they found ways to circumvent the tamper-proof pills, many switched to other opiates, with heroin being the most popular.

A common response ran along the lines of:

“Most people that I know don’t use OxyContin to get high anymore. They have moved on to heroin [because] it is easier to use, much cheaper, and easily available.”

Sadly though, the abusers didn’t appear to reduce or curtail their addictions just because supply of OxyContin became unusable; they simply switched to other substances, while around a quarter of users simply found a way to defeat the anti-tamper formulation.

Use of other opioids have increased in line with the decrease in OxyContin use, with high-potency fentanyl and hydromorphone rising significantly from 20.1% to 32.3%.

When asked what substances they used to get high on during the last 30 days, usage of OxyContin fell from close to 50% down to only 30%, according to the participants’ responses.

The researchers concluded that the overall outcome was not quite what might have been hoped for, when the manufacturer of OxyContin began producing tamper proof formulas. Although one specific drug was abused much less, addicts simply switched to other, potentially more harmful substances, including street heroin, which put the public at large in far more danger.

As Theodore Cicero of Washington University in St. Louis, first author of a letter in the New England Journal of Medicine put it:

“They didn’t stop (abusing drugs). They turned to something else … We should have asked the question … If they stop using the most popular drug out there, what are they going to turn to now?”

We only have to look back to the 1920s prohibition era to see the disaster of illegal bars, moonshine alcohol and gangster feuds to understand that people will always want to get high and will always take risks to create supply, even in the face of massive government opposition. Despite building a vast government complex that is now the FBI, prohibition of alcohol as a recreational drug was an abject failure. Whilst far fewer numbers of people feel the need to take opiates on a daily basis, the sector of the population that does, will find a way to do so.

Many junkies claim it’s easier to give up heroin than tobacco. Tobacco addiction is certainly more harmful and damaging to the health than a clean supply of opiate, and with a day’s supply of heroin costing about the same price as a loaf of bread, when considered from a simple production point of view, the whole concept of banning opiates and driving them into the black market must seem to many as being about as relevant today as alcohol prohibition in the 1920s.

Even police and law enforcement agree, with the Police Chief Constable Richard Brunstrom of the North Wales Police, UK, stating as far back as 2004 that heroin should be made legal.

“Heroin is very addictive but it’s not very, very dangerous,… It’s perfectly possible to lead a normal life for a full life span and hold down a job while being addicted to the drug.

The same statement cannot be made for those using large quantities of marijuana or alcohol on a daily basis.

Written by Rupert Shepherd