Oxycodone is a powerful narcotic analgesic. It is the active ingredient in a number of commonly prescribed pain relief medications such as Percocet, Percodan, and Tylox, which are oxycodone plus some sort of non-steroidal anti-inflammatory drug (NSAID) like aspirin or acetaminophen. Oxycodone is also the active ingredient in OxyContin, a time release, long-acting form of the drug, and Roxicodone, a short acting form of the drug.
Oxycodone, like all drugs in the opiate class, is derived the opium plant. Many similar compounds were sold over the counter in the 19th century. In 1898, Bayer pharmaceuticals released an extremely potent compound known as heroin.
Oxycodone was synthesized from thebaine, which is derived from the opium plant. It was developed in Germany in 1916 as an alternative to heroin, which had been outlawed a couple years prior. It was hoped that oxycodone would have the analgesic (pain-killing) power of heroin without the dependence issues. It was first introduced to American consumers in 1939, but did not become widely used until the release of Percodan (oxycodone plus aspirin) in 1950.
As more people were prescribed oxycodone, its potential for addiction became more widely known. In 1963, the attorney general of California publicly denounced Percodan abuse as the source of one-third of all drug addictions within the state. As a result, regulation of oxycodone in the United States was increased. In 1970, oxycodone, along with all other opiates, was made a Schedule II drug under the Federal Controlled Substances Act.
In 1974, the FDA approved Percocet (oxycodone plus acetaminophen). It was prescribed in very small quantities. Over the next decade, however, the attitudes towards management of chronic pain began to change. Instead of using painkillers for acute or malignant pain, doctors began to prescribe it for chronic pain. Many of the states adopted new policies that supported the wider use of painkillers by doctors.
In 1995, Purdue pharmaceuticals released OxyContin. Shortly thereafter, Purdue implemented an aggressive marketing campaign. It promoted the use of OxyContin by primary care providers, use in non-cancer pain, and its use as first line therapy for chronic pain. Its marketing was physician directed, and certain promotional claims were even cited in medical journals. Within in two years, OxyContin came to account for 80 percent of all Perdue profits.
As the use of OxyContin became more wide spread, reports of abuse began to increase exponentially. Before the release of OxyContin, all formulations of oxycodone contained an NSAID, which limited its potential for abuse. The NSAID component of the drugs also restricted the routes of administration to oral ingestion. When OxyContin was released, abusers realized that they could crush the pill to release pure oxycodone (up to 80mg in one pill), which allowed larger doses and by additional routes of administrations such as intravenous and intranasal. Due to the widespread abuse, particularly in rural areas, OxyContin came to be known as “Hillbilly Heroin.”
Soon, the lawsuits began. Purdue was accused of disseminating misleading information about OxyContin. In 2001, both the FDA and Purdue issued warnings against the recreational use of the drug. Despite the warnings, OxyContin continued to be one of the most widely abused drugs in the United States.
In 2011, to try to curb abuse of the drug, manufacturers added additional binders to the formulation to prevent the grinding of tablets for insufflation or injection, and to maintain OxyContin’s extended release characteristics. The added binders greatly reduced the recreational value of OxyContin, because they were not easily broken down.