Oxycodone is a very powerful and addictive analgesic medication synthesized from thebaine. It is similar to codeine, but is more potent and has a higher dependence potential. It is effective orally and is marketed in combination with aspirin (Percodan®) or acetaminophen (Percocet®) for the relief of pain. It is also sold in a sustained-release form under the trade names Oxycontin and Tylex.

Medical use

Oxycodone is the most powerful medication for pain control that can be taken orally. Percocet tablets (oxycodone with acetaminophen) are routinely prescribed for post-operative pain control. When used at recommended doses for relatively short periods (several weeks), it provides effective pain control with managable side effects.

Constipation is the most frequently reported side effect, and occurs often enough that most physicians prescribe a laxative for use at the same time. Nausea is also common.

Oxycodone is also used in treatment of severe, chronic pain, particularly for cancer sufferers and individuals with severe back injury. Tolerance and physical dependence occurs after several months of treatment, with larger doses being required to achieve the same degree of analgesia.

According to the DEA and the companies that manufacture the drug, psychological addiction as a result of medical use is extremely rare. However, there are several lawsuits underway brought by plaintiffs who claim that they became addicted to the drug as a result of medical use.

While no studies are available, it seems likely that increased prescribing of oxycodone products has resulted from a greater emphasis on compassionate pain management within the medical community.

Recreational use

The introduction of Oxycontin in 2000 resulted in increasing patterns of abuse. Unlike Percocet, whose potential for abuse is limited by the presence of acetominophen, Oxycontin contains only oxycodone and inert filler. Abusers crush the tablets to defeat the time-release mechanism, and have been reported to snort or inject the resulting powder to achieve rapid absorption into the bloodstream.

Oxycodone has similar effects to morphine and heroin, and appeals to the same abuse community. Armed robberies of pharmacies where the robber demanded only Oxycontin, not cash, have occurred. In some areas, particularly the eastern U.S., Oxycontin has been the drug of greatest concern to enforcement authorities.

Like other opium derivatives, oxycodone is fatal at high doses or when combined with alcohol or other depressants. Several documented fatalities from Oxycontin abuse have been made public.

On October 10, 2003, talk radio personality Rush Limbaugh made a public admission of addiction to Oxycontin, and announced his intention to pursue inpatient treatment.