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Why OxyContin May Have Become The True Gateway Drug For Upper-Income Use

Initially, OxyContin was introduced as a revolutionary painkiller. While it may certainly have been considered one of the leading opioid medications for a long time, we have since found that this medication has a very high potential for abuse. While OxyContin is FDA approved and regulated on a federal level, this does not mean that it is not at risk for misuse or abuse. When browsing through the statistics from the Centers for Disease Control and Prevention, you may note that prescription drug abuse with opioid painkillers is causing more deaths throughout the nation than any other substance. Even though physicians prescribe them, they have a high potential for abuse.

More about OxyContin

Before we delve a little further into the problem, it is important to recognize why this is a problem in the first place. Because of its time-release mechanism, it became one of the most popular prescriptions for those struggling with chronic pain. This meant that those living with pain needed a single dose every 12 hours instead of having to take pills throughout the day. Not only did this serve as less of a distraction, but it also meant that those struggling with chronic pain were able to sleep throughout the night.


The active ingredient in the formula is oxycodone. This substance is very similar to morphine and can be found in Tylox and Percodan as well. However, when we compare the two, Tylox only has five milligrams of oxycodone. Meanwhile, OxyContin has 40 to 160 milligrams. The aforementioned time-released formula was the main selling point at first, having the large dosage did not matter because it would be released over time, it would allow people to stop reaching for a pill bottle six times every day. However, people struggling with opioid dependence found a way to circumvent the time-release mechanism. This means that they could gain access to the very high dose of oxycodone immediately. They found that crushing the pills and injecting or snorting the powder would render the time-release mechanism useless. Circumventing the time-release mechanism led to a powerful, morphine-like high.

Time for a New Formula

It took the manufacturer of the medication a long time to come up with a response, initially completely ignoring the fact that OxyContin created dependence (which later led to $634 million in fines). However, they ultimately accepted responsibility and came up with the “new formula”. This would allow the same type of pain relief, but had one major difference, the structure of the pill itself. If the user submerged the pill in water (hoping to dilute it in order to inject it) or tried to crush the pill in order to snort it, it would be unusable. Adding water meant that it became a gelatinous substance that users were unable to inject or snort. Because of the latest formula, OxyContin no longer served as a possible way to get high for many people struggling with dependence.

Making the Switch to Heroin

While that may be good news for the manufacturer, this did very little for those battling opioid addiction. A survey in the New England Journal of Medicine revealed that while the use of OxyContin is down dramatically, similar substances, many of them illicit substances, have taken its place. Heroin quickly became a viable alternative to those who did not have the means to seek out drug treatment or simply did not want to find help. Unlike its legal precursor, heroin was suddenly interesting because it was abundant, affordable and readily available.

Many people that are struggling with the withdrawal symptoms will switch to heroin or another alternative instead. They are not likely to get help, even if it were offered to them. In fact, chances are that the majority of those in the upper socio-economic class do not have to walk past drug dealers every day, they are not necessarily tempted with crack cocaine, but most people know someone who has prescription drugs for sale. This means that while prescription drugs may initiate them into drug use, once hooked, they suffer the same level of dependence as everyone else. After the user takes prescription painkillers, it lowers possible inhibitions for continued, alternative use. This is the definition of a gateway drug, possibly opening up the floodgates for alternative substance abuse issues. In that sense, OxyContin is one of the reasons that there is no socio-economic group that is impervious to the grasp of these substances.

The Dangers of the Switch between the Two

OxyContin is a pharmaceutical product, this means that its production happens in a lab. This lab meets strict medical and legal guidelines. Government agencies inspect this lab to ensure that there is little to no risk of contamination or other manufacturing errors. When someone snorts a single pill, he or she can tell how much oxycodone is included in that particular pill, mainly because it says so right on the label. However, the purity levels and potency of heroin is unpredictable. This not only means it may have been cut with dangerous additives, but the user also has no earthly idea about the manufacturing process. This could potentially mean that a user smokes or injects heroin for a year at the same strength and suddenly finds a purer, far more potent dose of the narcotic. This drastically increases the risk of a possible fatal overdose. Add in the fact that heroin users may share needles and are at risk of many other infections and you understand why substituting the legal (though misused) alternative for the black market substance is exceedingly dangerous.

Getting Help

It is important to find help for any type of drug addiction. However, when switching to heroin abuse, the dangers of an overdose, infection or drug violence increase dramatically. It is important to remember that withdrawal symptoms for either product are incredibly difficult to deal with. This is one of the reasons that many long-term users fail at recovery without professional addiction treatment. After the opioids course through the user’s veins, the best alternative is to find a recovery program that offers medical detoxification that helps them clear their system to remove the immediate physical temptation altogether. This is the only way to resolve the problem rather than forcing users into abusing other substances.