Prescription drugs include a number of opiates, including morphine, codeine, hydrocodone (Vicodin), and oxycodone (OxyContin). OxyContin and Vicodin— Schedule II and III painkillers, respectively— represent the most widely abused prescription narcotics in the United States. Both have significant abuse potential. Recreational users take them orally in pill form, crushed and snorted, or dissolved in water and injected. Effects of Vicodin include feelings of well-being by reducing tension, anxiety, and aggression (“high”). Effects of OxyContin are stronger than those of Vicodin and similar to the effects of heroin.
Hydrocodone and oxycodone were first manufactured and marketed in the United States in the 1920s, as an answer to the number of Americans who were addicted to opium-derivative cough medicines such as heroin and morphine. The addictive potential of hydrocodone and oxycodone has been a major concern since the early 1960s. However, the introduction of the Vicodin and OxyContin preparations in the mid-1990s radically boosted illicit use and abuse due to a major marketing push by numerous pharmaceutical companies. The problem of Vicodin and OxyContin abuse became widely recognized by the media in 2003 when conservative radio host Rush Limbaugh admitted abusing these drugs. Hydrocodone products are the most frequently prescribed pharmaceutical opiates in the United States.
Despite their medical utility, they are also the most popular pharmaceuticals associated with trafficking, abuse, and addiction. In every geographical area in the country, the U.S. government lists Vicodin among the most commonly diverted. OxyContin has been popular among the narcotic-abusing population since its introduction in 1995. Medical misuse of both Vicodin and OxyContin is most common among the elderly, whereas illicit use is most common among youth. However, recent concern has grown among federal, state, and local officials about the increase in illicit availability and abuse of both Vicodin and OxyContin, particularly in the eastern United States.
Millions of dosage units of Vicodin and other hydrocodone products get diverted by theft, doctor shopping, fraudulent prescriptions, and Internet fraud. Chronic long-term use of Vicodin can cause severe liver damage, and hydrocodone-related deaths are widespread and increasing. Emergency room admissions for hydrocodone-related problems have increased by 170 percent since 1994. Consequently, the U.S. government has recently moved to enact regulations reclassifying Vicodin and other hydrocodone products as Schedule II controlled substances.
OxyContin abuse has also led to increased instances of pharmacy robberies, thefts, shoplifting incidents, and health care fraud incidents. Most OxyContin-related deaths result from ingestion of high quantities of the drug in combination with depressants such as alcohol. In the eastern United States, OxyContin is the drug of greatest concern to law enforcement, although reliable data on actual abuse incidence are difficult to establish. More recently, a number of states have enacted or proposed more stringent regulatory guidelines and increased penalties for its illegal sale.
- Ball, Judy and Dana Lehder Roberts. 2004. The DAWN Report: Oxycodone, Hydrocodone, and Polydrug Use, 2002. Washington, DC: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.
- National Drug Intelligence Center. 2004. “Intelligence Bulletin: OxyContin Diversion, Availability and Abuse.” Johnstown, PA: National Drug Intelligence Center. Retrieved March 29, 2017 (https://www.justice.gov/archive/ndic/pubs10/10550/index.htm).
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