The Rising Tide of Oxycodone Abuse
In recent years, the abuse of oxycodone products has become an increasingly significant concern. A study published in April 2000 by The Journal of the American Medical Association (JAMA) analyzed data from the DEA’s Automation of Reports and Consolidated Orders System (ARCOS), which tracks opioid analgesic distribution, and the Drug Abuse Warning Network (DAWN), focusing on Medical Examiner (ME) and Emergency Department (ED) data to assess the health repercussions of abuse from 1990 to 1996. This JAMA study highlighted a 23 percent increase in the medical use of oxycodone, without a parallel rise in illicit abuse during that period. However, more recent data from 1998 DAWN ME reports indicated a dramatic 93 percent surge in oxycodone mentions between 1997 and 1998. Similarly, oxycodone-related DAWN ED mentions climbed 32.4 percent from 4,857 in 1997 to 6,429 in 1999, suggesting a shift in abuse patterns as the decade closed.
Opioid Addiction, Pain Management, and Misconceptions
Addiction to opioids when used for legitimate medical purposes under proper medical supervision is considered rare. Despite this, the National Institute on Drug Abuse notes that many physicians are hesitant to prescribe potent opioid pain medications due to concerns about patient addiction. Emerging evidence suggests a distinction between individuals seeking pain relief and those who abuse opioids. Healthy patients without a history of drug abuse often do not experience euphoria when administered opioids for pain, potentially because their pain levels mitigate the euphoric effects, thus reducing the likelihood of addiction. This understanding is crucial in addressing the opioid crisis and ensuring appropriate pain management.
The Deadly Toll of OxyContin Abuse and the Street Price Factor
Tragically, the abuse of OxyContin has resulted in numerous deaths across states like Kentucky, Ohio, Virginia, and West Virginia. In Pike County, Kentucky, the Coroner reported 19 OxyContin-related fatalities in 2000 alone. December of the same year saw seven OxyContin overdose deaths in Southeastern Kentucky, as reported by Kentucky State Police. The Logan Daily News in Ohio reported four overdoses in Hocking County over just 18 days in October 2000, with half proving fatal. Pulaski, Virginia, has seen at least four OxyContin overdose deaths since 1998. Furthermore, The Williamson Daily reported five OxyContin-related overdose deaths in southwestern West Virginia between May and July 2000. These incidents underscore the severe dangers associated with OxyContin abuse and highlight the urgent need to understand its illicit distribution and Oxy Street Price.
OxyContin tablets are formulated for oral consumption as a whole, time-release medication. However, those who abuse the drug often circumvent this mechanism to achieve a rapid high. Common methods include chewing the tablets, crushing them to snort the powder, or dissolving the crushed tablets in water for intravenous injection. These methods bypass the extended-release formulation, leading to a surge of oxycodone entering the bloodstream. Staff at the Mountain Comprehensive Care Center in Prestonsburg, Kentucky, with over 90 years of combined experience in drug treatment, noted a disturbing trend: individuals with no prior history of injection drug use were beginning to inject OxyContin intravenously. They described OxyContin’s proliferation since May 2000 as unprecedented.
The effects of OxyContin are often compared to those of heroin, making it attractive to a similar demographic of drug abusers. OxyContin is sometimes referred to as “poor man’s heroin,” a misnomer given its substantial oxy street price. While a 40 mg OxyContin tablet obtained legally via prescription costs approximately $4, or $400 for a 100-tablet bottle at a pharmacy, the illicit market commands significantly higher prices. Oxy street prices typically range from 50 cents to $1 per milligram, varying by geographic location and availability. This means the same 100-tablet bottle, legally priced at $400, can fetch between $2,000 and $4,000 on the black market.
However, for individuals with health insurance, OxyContin can be relatively affordable as insurance often covers the majority of prescription costs. This accessibility through insurance can inadvertently contribute to diversion and abuse. Paradoxically, when insurance coverage ceases or abusers can no longer afford the inflated oxy street price, many turn to heroin as a cheaper alternative. West Virginia, for instance, has seen an influx of OxyContin abusers transitioning to heroin due to its lower cost, even among those who have never previously used heroin. This economic aspect of drug abuse underscores the complex interplay between prescription availability, oxy street price, and the shift towards cheaper, often more dangerous, alternatives like heroin.
| Strength | Licit Retail Price per tablet | Illicit Retail Price per tablet (Oxy Street Price) |
|---|---|---|
| 10 mg | $1.25 | $5 to $10 |
| 20 mg | $2.30 | $10 to $20 |
| 40 mg | $4.00 | $25 to $40 |
| 80 mg | $6.00 | $65 to $80 |
| 160 mg | $14.00 | unknown |
Source: Cincinnati Police Department Pharmaceutical Diversion Squad, November 2000
In conclusion, the escalating abuse of OxyContin is a multifaceted problem driven by factors ranging from evolving abuse patterns and misconceptions about opioid addiction to the significant financial incentives created by the illicit market and the oxy street price. Understanding these dynamics, particularly the economic factors influencing drug choices and the dangerous allure of the oxy street price, is crucial for developing effective strategies to combat opioid abuse and its devastating consequences.
