Skip to main content

Advertisement

Log in

A Multifaceted Analysis of Oxycodone Addiction

  • Original Article
  • Published:
International Journal of Mental Health and Addiction Aims and scope Submit manuscript

Abstract

Oxycodone is an important therapeutic agent in the treatment of pain. However, its excessive use in medical practice, as well as escalating rates of illegal sharing and high potential for abuse, has generated a public health crisis in North America. The objective of this review is to discuss the prevalence, clinical utility, pharmacology, pharmacokinetics/pharmacodynamics, and addictive properties of oxycodone. Oxycodone has an abuse liability that is similar to other opioids, and in some cases, even greater. The introduction to oxycodone use can come from peers at school, during the treatment of pain, or from the black market. Implementing approaches that increase training of doctors in conjunction with more information for patients, as well as employing harm reduction strategies, diversion resistant products, and drug monitoring programs, may help to reduce the risk of oxycodone misuse and abuse.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American Psychiatric Association. (2013). Opioid use disorder. In Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.

  • Babalonis, S., Lofwall, M. R., Nuzzo, P. A., Siegel, A. J., & Walsh, S. L. (2013). Abuse liability and reinforcing efficacy of oral tramadol in humans. Drug and Alcohol Dependence, 129, 116–124.

    Article  PubMed  CAS  Google Scholar 

  • Basbaum, A.I., & Jessell, T.M. (2013). Pain. In E.R. Kandel, et al. (Eds.), Principles of neural science (5th ed.). New York: McGraw Hill.

  • Beardsley, P. M., Aceto, M. D., Cook, C. D., Bowman, E. R., Newman, J. L., & Harris, L. S. (2004). Discriminative stimulus, reinforcing, physical dependence, and antinociceptive effects of oxycodone in mice, rats, and rhesus monkeys. Experimental and Clinical Psychopharmacology, 12(3), 163–172.

    Article  PubMed  CAS  Google Scholar 

  • Bell, J. (2010). The global diversion of pharmaceutical drugs. Addiction, 105(9), 1531–1537.

    Article  PubMed  Google Scholar 

  • Berridge, K. C., & Robinson, T. E. (1998). What is the role of dopamine in reward: hedonic impact, reward learning, or incentive salience? Brain Research. Brain Research Reviews, 28(3), 309–369.

    Article  PubMed  CAS  Google Scholar 

  • Betourne, A., Familiades, J., Lacassagne, L., Halley, H., Cazales, M., Ducommun, B., Lassalle, J. M., Zajac, J. M., & Frances, B. (2008). Decreased motivational properties of morphine in mouse models of cancerous- or inflammatory-chronic pain: implication of supraspinal neuropeptide FF(2) receptors. Neuroscience, 157, 12–21.

    Article  PubMed  CAS  Google Scholar 

  • Butler, S. F., Cassidy, T. A., Chilcoat, H., Black, R. A., Landau, C., Budman, S. H., & Coplan, P. M. (2013). Abuse rates and routes of administration of reformulated extended-release oxycodone: initial findings from a sentinel surveillance sample of individuals assessed for substance abuse treatment. The Journal of Pain, 14(4), 351–358.

    Article  PubMed  CAS  Google Scholar 

  • Campbell, A. T., Kwiatkowski, D., Boughner, E., & Leri, F. (2012). Effect of yohimbine stress on reacquisition of oxycodone seeking in rats. Psychopharmacology, 222(2), 247–255.

    Article  PubMed  CAS  Google Scholar 

  • Canadian Centre on Substance Abuse (CCSA). (2015). Prescription opioids. Ottawa: Canadian Centre on Substance Abuse.  

  • Carmichael, J. P., & Lee, M. A. (2010). Symptoms of opioid withdrawal syndrome afterswitch from oxycodone to alfentanil. Journal of Pain and Symptom Management, 40(6), e4–e6.

  • Casey, B. J., Jones, R. M., & Hare, T. A. (2008). The adolescent brain. Annals of the New York Academy of Sciences, 1124, 111–126.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Centers for Disease Control and Prevention (CDC). (2014). Opioid painkiller prescribing. Retrieved from https://www.cdc.gov/vitalsigns/opioid-prescribing/.

  • Chakravarthy, B., Shah, S., & Lotfipour, S. (2011). Prescription drug monitoring programs and other interventions to combat prescription opioid abuse. Western Journal of Emergency Medicine, 13(5), 422–425.

    Article  Google Scholar 

  • Ciccarone, D. (2009). Heroin in brown, black and white: Structural factors and medical consequences in the US heroin market. International Journal of Drug Policy, 20(3), 277–282.

    Article  PubMed  Google Scholar 

  • Ciccarone, D., Unick, G. J., & Kraus, A. (2009). Impact of South American heroin on the US heroin market 1993–2004. International Journal of Drug Policy, 20(5), 392–401.

    Article  PubMed  Google Scholar 

  • Cicero, T. J., & Ellis, M. S. (2015). Abuse-deterrent formulations and the prescription opioid abuse epidemic in the United States. JAMA Psychiatry, 72(5), 424.

    Article  PubMed  Google Scholar 

  • Cicero, T. J., Kurtz, S. P., Surratt, H. L., Ibanez, G. E., Ellis, M. S., Levi-Minzi, M. A., & Inciardi, J. A. (2011). Multiple determinants of specific modes of prescription opioid diversion. Journal of Drug Issues, 41(2), 283–304.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cicero, T. J., Ellis, M. S., & Surratt, H. L. (2012). Effect of abuse-deterrent formulation of OxyContin. The New England Journal of Medicine, 367, 187–189.

    Article  PubMed  CAS  Google Scholar 

  • Cicero, T. J., Ellis, M. S., Surratt, H. L., & Kurtz, S. P. (2014). The changing face of heroin use in the United States. JAMA Psychiatry, 71(7), 821.

    Article  PubMed  Google Scholar 

  • Colucci, S. V., Perrino, P. J., Shram, M., Bartlett, C., Wang, Y., & Harris, S. C. (2014). Abuse potential of intravenous oxycodone/naloxone solution in nondependent recreational drug users. Clinical Drug Investigation, 34(6), 421–429.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Comer, S. D., Sullivan, M. A., Whittington, R. A., Vosburg, S. K., & Kowalczyk, W. J. (2008). Abuse liability of prescription opioids compared to heroin in morphine-maintained heroin abusers. Neuropsychopharmacology, 33(5), 1179–1191.

    Article  PubMed  CAS  Google Scholar 

  • Comer, S. D., Sullivan, M. A., Vosburg, S. K., Kowalczyk, W. J., & Houser, J. (2010). Oxycodone: Laboratory study of the relationship between pain and abuse liability. Drug and AlocoholDependence, 109, 130–138.

    CAS  Google Scholar 

  • Comer, S. D., Metz, V. E., Cooper, Z. D., Kowalczyk, W. J., Jones, J. D., Sullivan, M. A., et al. (2013). Comparison of a drug versus money and drug versus drug self-administration choice procedure with oxycodone and morphine in opioid addicts. Behavioural Pharmacology, 24, 504–516.

    Article  PubMed  PubMed Central  Google Scholar 

  • Coplan, P. M., Kale, H., Sandstrom, L., Landau, C., & Chilcoat, H. D. (2013). Changes in oxycodone and heroin exposures in the National Poison Data System after introduction of extended-release oxycodone with abuse-deterrent characteristics. Pharmacoepidemiology and Drug Safety, 22(12), 1274–1282.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Dart, R. C., Surratt, H. L., Cicero, T. J., Parrino, M. W., Severtson, S. G., Bartelson, B. B., & Green, J. L. (2015). Trends in opioid analgesic abuse and mortality in the United States. New England Journal of Medicine, 372(16), 1572–1574.

    Article  Google Scholar 

  • Dasgupta, N., Freifeld, C., Brownstein, J. S., Menone, C. M., Surratt, H. L., Poppish, L., et al. (2013). Crowdsourcing black market prices for prescription opioids. Journal of Medical Internet Research, 15(8), e178.

    Article  PubMed  PubMed Central  Google Scholar 

  • Davis, W. R., & Johnson, B. D. (2008). Prescription opioid use, misuse, and diversion among street drug users in New York City. Drug and Alcohol Dependence, 92(1–3), 267–276.

    Article  PubMed  Google Scholar 

  • Davis, C. P., Franklin, L. M., Johnson, G. S., & Schrott, L. M. (2010). Prenatal oxycodone exposure impairs spatial learning and/or memory in rats. Behavioural Brain Research, 212(1), 27–34.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Dhalla, I. A., Mamdani, M. M., Sivilotti, M. L., Kopp, A., Qureshi, O., & Juurlink, D. N. (2009). Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone. CMAJ, 181(12), 891–896.

    Article  PubMed  PubMed Central  Google Scholar 

  • Drug Enforcement Administration. (2014). Oxycodone. Sprinfield, Virginia: Drug Enforcement Administration.

    Google Scholar 

  • Edlund, M. J., Steffick, D., Hudson, T., Harris, K. M., & Sullivan, M. (2007). Risk factors for clinically recognized opioid abuse and dependence among veterans using opioids for chronic non-cancer pain. Pain, 129, 355–362.

    Article  PubMed  Google Scholar 

  • Emery, M. A., Bates, M. L. S., Wellman, P. J., & Eitan, S. (2015). Differential effects of oxycodone, hydrocodone, and morphine on the responses of D2/D3 dopamine receptors. Behavioural Brain Research, 284, 37–41.

    Article  PubMed  CAS  Google Scholar 

  • Emery, M. A., Bates, S., Wellman, P. J., & Eitan, S. (2016). Differential effects of oxycodone, hydrocodone, and morphine on activation levels of signaling molecules. Pain Medicine, 17(5), 908–914.

    PubMed  Google Scholar 

  • Enga, R. M., Jackson, A., Damaj, M. I., & Beardsley, P. M. (2016). Oxycodone physical dependence and its oral self-administration in C57BL/6J mice. European Journal of Pharmacology, 789, 75–80.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Everitt, B. J., & Robbins, T. W. (2005). Neural systems of reinforcement for drug addiction: from actions to habits to compulsion. Nature Neuroscience, 8(11), 1481–1489.

    Article  PubMed  CAS  Google Scholar 

  • Frank, D., Mateu-Gelabert, P., Guarino, H., Bennett, A., Wendel, T., Jessell, L., & Teper, A. (2015). High risk and little knowledge: overdose experiences and knowledge among young adult nonmedical prescription opioid users. International Journal of Drug Policy, 26(1), 84–91.

    Article  PubMed  Google Scholar 

  • Gerak, L. R., Galici, R., & France, C. P. (2009). Self-administration of heroin and cocaine in morphine-dependent and morphine-withdrawn rhesus monkeys. Psychopharmacology, 204, 403–411.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Gibson, A. E., & Degenhardt, L. J. (2007). Mortality related to pharmacotherapies for opioid dependence: a comparative analysis of coronial records. Drug and Alcohol Review, 26(4), 405–410.

    Article  PubMed  Google Scholar 

  • Gomes, T., & Juurlink, D. (2016). Opioid use and overdose: what we’ve learned in Ontario. Healthcare Quarterly, 18(4), 8–11.

    Article  PubMed  Google Scholar 

  • Goodman & Gilman’s. (2001). The Pharmacological Basis of Therapeutics. In J. G. Hardman, L. E. Limbird, & A. G. Gilman (Eds.), (10th ed.). New York: McGraw-Hill.

    Google Scholar 

  • Goodman & Gilman’s. (2011). The Pharmacological Basis of Therapeutics. In L. L. Brunton, J. S. Lazo, & K. L. Parker (Eds.), (11th ed.). New York: McGraw-Hill.

    Google Scholar 

  • Gossop, M., Green, L., Phillips, G., & Bradley, B. (1989). Lapse, relapse and survival among opiate addicts after treatment. A prospective follow-up study. The British Journal of Psychiatry, 154, 348–353.

    Article  PubMed  CAS  Google Scholar 

  • Gossop, M., Stewart, D., Browne, N., & Marsden, J. (2002). Factors associated with abstinence, lapse or relapse to heroin use after residential treatment: protective effect of coping responses. Addiction, 97(10), 1259–1267.

    Article  PubMed  Google Scholar 

  • Gould, T. J. (2010). Addiction and cognition. Addict SciClinPract, 5(2), 4–14.

    Google Scholar 

  • Grau, L. E., Dasgupta, N., Harvey, A. P., Irwin, K., Givens, A., Kinzly, M. L., & Heimer, R. (2007). Illicit use of opioids: Is OxyContin® a “gateway drug”? The American Journal on Addictions, 16(3), 166–173.

    Article  PubMed  Google Scholar 

  • Grella, S. L., Levy, A., Campbell, A., Djazayeri, S., Allen, C. P., Goddard, B., & Leri, F. (2011). Oxycodone dose-dependently imparts conditioned reinforcing properties to discrete sensory stimuli in rats. Pharmacological Research, 64(4), 364–370.

    Article  PubMed  CAS  Google Scholar 

  • Gwira, J. A., Wiedeman, C., Dunn, J. R., et al. (2014). High-risk use by patients prescribed opioids for pain and its role in overdose deaths. JAMA Internal Medicine, 174(5), 796–801.

    Article  CAS  Google Scholar 

  • Hagemeier, N. E., Gray, J. A., & Pack, R. P. (2013). Prescription drug abuse: a comparison of prescriber and pharmacist perspective. Substance Use & Misuse, 48(9), 761–768.

    Article  Google Scholar 

  • Harris, S. C., Perrino, P. J., Smith, I., Shram, M. J., Colucci, S. V., Bartlett, C., & Sellers, E. M. (2013). Abuse potential, pharmacokinetics, pharmacodynamics, and safety of intranasallyadministered crushed oxycodone HCl abuse-deterrent controlled-release tablets in recreational opioid users. The Journal of Clinical Pharmacology, 54(4), 468–477.

    Article  PubMed  CAS  Google Scholar 

  • Health Canada. (2017). New measures to inform Canadians of the risks of prescription opioids out for consultation. Retrieved from https://www.canada.ca/en/health-canada/news/2017/06/new_measures_to_informcanadiansoftherisksofprescriptionopioidsou.html.

  • Henriksen, G., & Willoch, F. (2008). Imaging of opioid receptors in the central nervous system. Brain, 131(5), 1171–1196.

    Article  PubMed  Google Scholar 

  • Horvitz, J. C. (2000). Mesolimbocortical and nigrostriatal dopamine responses to salient non- reward events. Neuroscience, 96(4), 651–656.

    Article  PubMed  CAS  Google Scholar 

  • Hughes, A., Williams, M. R., Lipari, R. N., Bose, J., Copello, E. A., &Kroutil, L. A. (2015). Prescription Drug Use and Misuse in the United States: Results from the 2015 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR2-2015/NSDUH-FFR2-2015.htm.

  • Hutchinson, M. R., Lewis, S. S., Coats, B. D., Skyba, D. A., Crysdale, N. Y., Berkelhammer, D. L., Brzeski, A., Northcutt, A., Vietz, C. M., Judd, C. M., et al. (2009). Reduction of opioid withdrawal and potentiation of acute opioid analgesia by systemic AV411. Brain BehavImmun, 23, 240–250.

    CAS  Google Scholar 

  • Ikemoto, A., & Panksepp, J. (1999). The role of nucleus accumbens dopamine in motivated behavior: a unifying interpretation with special reference to reward-seeking. Brain Research Reviews, 31, 6–41.

    Article  PubMed  CAS  Google Scholar 

  • Inciardi, J. A., Surratt, H. L., Cicero, T. J., Rosenblum, A., Ahwah, C., Bailey, J. E., et al. (2010). Prescription drugs purchased through the internet: who are the end users? Drug and Alcohol Dependence, 110(1–2), 21–29.

    Article  PubMed  PubMed Central  Google Scholar 

  • Johnson, S. W., & North, R. A. (1992). Opioids excite dopamine neurons by hyperpolarization of local interneurons. The Journal of Neuroscience, 12(2), 483–488.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2017). Monitoring the Future national survey results on drug use, 1975-2016: overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan.

  • Jones, C.M. (2013). Trends in the distribution of selected opioids by state, US, 1999–2011. Paper presented at: National Meeting Safe State Alliance, Baltimore, MD.

  • Jones, J. D., Vosburg, S. K., Manubay, J. M., & Comer, S. D. (2011). Oxycodone abuse in New York City: characteristics of intravenous and intranasal users. The American Journal on Addictions, 20(3), 190–195.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jones, C. M., Paulozzi, L. J., & Mack, K. A. (2014). Sources of prescription opioid pain relievers by frequency of past-year nonmedical use. JAMA Internal Medicine, 174(5), 802.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kahan, M., Srivastava, A., Wilson, L., Mailis-Gagnon, A., & Midmer, D. (2006). Opioids for managing chronic non-malignant pain. Canadian Family Physician, 52(9), 1091–1096.

    PubMed  PubMed Central  Google Scholar 

  • Katz, N., & Fanciullo, G. J. (2002). Role of urine toxicology testing in the management of chronic opioid therapy. The Clinical Journal of Pain, 18, 76–82.

    Article  Google Scholar 

  • Katz, D. A., & Hays, L. R. (2004). Adolescent oxycontin abuse. Journal of the American Academy of Child & Adolescent Psychiatry, 43(2), 231–234.

    Article  Google Scholar 

  • Keller, C. E., Ashrafioun, L., Neumann, A. M., Klein, J. V., Fox, C. H., & Blondell, R. D. (2012). Practices, perceptions, and concerns of primary care physicians about opioid dependence associated with the treatment of chronic pain. Substance Abuse, 33(2), 103–113.

    Article  PubMed  Google Scholar 

  • Kirkpatrick, S. L., & Bryant, C. D. (2015). Behavioral architecture of opioid reward and aversion in C57BL/6 substrains. Front BehavNeurosci, 8, 450.

    Google Scholar 

  • Kokki, H., Rasanen, I., Reinikainen, M., Suhonen, P., Vanamo, K., & Ojanperä, I. (2004). Pharmacokinetics of oxycodone after intravenous, Buccal, intramuscular and gastric administration in children. Clinical Pharmacokinetics, 43(9), 613–622.

    Article  PubMed  CAS  Google Scholar 

  • Kokki, H., Kokki, M., & Sjövall, S. (2012). Oxycodone for the treatment of postoperative pain. Expert OpinPharmacother, 13(7), 1045–1058.

    Article  CAS  Google Scholar 

  • Kuehn, B. M. (2013). SAMHSA: pain medication abuse a common path to heroin. JAMA, 310(14), 1433.

    Article  PubMed  CAS  Google Scholar 

  • Lalovic, B., Kharasch, E., Hoffer, C., Risler, L., Liu-Chen, L.-Y., & Shen, D. D. (2006). Pharmacokinetics and pharmacodynamics of oral oxycodone in healthy human subjects: role of circulating active metabolites. ClinPharmacol Ther, 79, 461–479.

    CAS  Google Scholar 

  • Lankenau, S. E., Teti, M., Silva, K., Bloom, J. J., Harocopos, A., & Treese, M. (2012). Patterns of prescription drug misuse among young injection drug users. Journal of Urban Health, 89(6), 1004–1016.

    Article  PubMed  PubMed Central  Google Scholar 

  • Le Merrer, J., Becker, J. A., Befort, K., & Kieffer, B. L. (2009). Reward processing by the opioid system in the brain. Physiological Reviews, 89(4), 1379–1412.

    Article  PubMed  Google Scholar 

  • Leow, K. P., Wright, A. W., Cramond, T., & Smith, M. T. (1993). Determination of the serum protein binding of oxycodone and morphine using ultrafiltration. Therapeutic Drug Monitoring, 15(5), 440–447.

    Article  PubMed  CAS  Google Scholar 

  • Leri, F., & Burns, B. H. (2005). Ultra-low-dose naltrexone reduces the rewarding potency of oxycodone and relapse vulnerability in rats. Pharmacology, Biochemistry, and Behavior, 82, 252–262.

    Article  PubMed  CAS  Google Scholar 

  • Liu, Y. L., Liang, J. H., Yan, L. D., Su, R. B., Wu, C. F., & Gong, Z. H. (2005). Effects of l-tetrahydropalmatineon locomotor sensitization to oxycodone in mice. Acta Pharmacologica Sinica, 26, 533–538.

    Article  PubMed  CAS  Google Scholar 

  • Mars, S. G., Bourgois, P., Karandinos, G., Montero, F., & Ciccarone, D. (2014). “Every ‘never’ I ever said came true”: transitions from opioid pills to heroin injecting. International Journal of Drug Policy, 25(2), 257–266.

    Article  PubMed  Google Scholar 

  • Mccabe, S. E., Cranford, J. A., Boyd, C. J., & Teter, C. J. (2007). Motives, diversion and routes of administration associated with nonmedical use of prescription opioids. Addictive Behaviors, 32(3), 562–575.

    Article  PubMed  Google Scholar 

  • Moradi, M., Esmaeili, S., Shoar, S., & Safari, S. (2012). Use of oxycodone in pain management. Anesthesiology and Pain Medicine, 1(4), 262–264.

    Article  PubMed  PubMed Central  Google Scholar 

  • Narita, M., Nakamura, A., Ozaki, M., Imai, S., Miyoshi, K., Suzuki, M., & Suzuki, T. (2007). Comparative pharmacological profiles of morphine and oxycodone under a neuropathic pain-like state in mice: evidence for less sensitivity morphine. Neuropsychopharmacology, 33(5), 1097–1112.

    Article  PubMed  CAS  Google Scholar 

  • National Institute on Drug Abuse. (2016). Monitoring the future. Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/monitoring-future

  • Nielsen, C. K., Ross, F. B., & Smith, M. T. (2000). Incomplete, asymmetric, and route-dependent cross-tolerance between oxycodone and morphine in the dark agouti rat. The Journal of Pharmacology and Experimental Therapeutics, 295, 91–99.

    PubMed  CAS  Google Scholar 

  • Niikura, K., Ho, A., Kreek, M. J., & Zhang, Y. (2013). Oxycodone-induced conditioned place preference and sensitization of locomotor activity in adolescent and adult mice. PharmacolBiochemBehav, 110, 112–116.

    CAS  Google Scholar 

  • Olkkola, K. T., Kontinen, V. K., Saari, T. I., & Kalso, E. A. (2013). Does the pharmacology of oxycodone justify its increasing use as an analgesic? Trends in Pharmacological Sciences, 34(4), 206–214.

    Article  PubMed  CAS  Google Scholar 

  • Osborne, R., Joel, S., Trew, D., & Slevin, M. (1990). Morphine and metabolite behavior after different routes of morphine administration: demonstration of the importance of the active metabolite morphine-6-glucuronide. ClinPharmacolTher, 47, 12–19.

    CAS  Google Scholar 

  • Osgood, E. D., Eaton, T. A., Trudeau, J. J., & Katz, N. P. (2012). A brief survey to characterize oxycodone abuse patterns in adolescents enrolled in two substance abuse recovery high schools. The American Journal of Drug and Alcohol Abuse, 38(2), 166–170.

    Article  PubMed  Google Scholar 

  • Ostlund, S. B., & Balleine, B. W. (2008). On habits and addiction: an associative analysis of compulsive drug seeking. Drug Discov Today Dis Models, 5(4), 235–245.

    Article  PubMed  PubMed Central  Google Scholar 

  • Patrick, S. W., Schumacher, R. E., Benneyworth, B. D., Krans, E. E., McAllister, J. M., & Davis, M. M. (2012). Neonatal abstinence syndrome and associated health care expenditures: United States, 2000–2009. JAMA, 307(18), 1934–1940.

    Article  PubMed  CAS  Google Scholar 

  • Peacock, A., Bruno, R., Cama, E., Kihas, I., Larance, B., Lintzeris, N., ... Degenhardt, L. (2015). Jurisdictional differences in opioid use, other licit and illicit drug use, and harms associated with substance use among people who tamper with pharmaceutical opioids. Drug and Alcohol Review, 34(6), 611–622.

  • Perrino, P. J., Colucci, S. V., Apseloff, G., & Harris, S. C. (2013). Pharmacokinetics, tolerability, and safety of intranasal administration of reformulated OxyContin® tablets compared with original OxyContin® tablets in healthy adults. Clinical Drug Investigation, 33(6), 441–449.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Pöyhiä, R., & Kalso, E. A. (1992). Antinociceptive effects and central nervous system depression caused by oxycodone and morphine in rats. PharmacolToxicol, 70(2), 125–130.

    Google Scholar 

  • Rigg, K. K., Kurtz, S. P., & Surratt, H. L. (2012). Patterns of prescription medication diversion among drug dealers. Drugs: Education, Prevention and Policy, 19(2), 145–155.

    Google Scholar 

  • Riley, J., Eisenberg, E., Müller-Schwefe, G., Drewes, A. M., & Arendt-Nielsen, L. (2008). Oxycodone: a review of its use in the management of pain. Current Medical Research and Opinion, 24(1), 175–192.

    Article  PubMed  CAS  Google Scholar 

  • Rosenblum, A., Parrino, M., Schnoll, S. H., Fong, C., Maxwell, C., Cleland, C. M., et al. (2007). Prescription opioid abuse among enrollees into methadone maintenance treatment. Drug and Alcohol Dependence, 90(1), 64–71.

    Article  PubMed  Google Scholar 

  • Ross, F. B., & Smith, M. T. (1997). The instrinsic antinociceptive effects of oxycodone appear to be kappa-opioid receptor mediated. Pain, 73, 151–157.

    Article  PubMed  CAS  Google Scholar 

  • Ross, F. B., Wallis, S. C., & Smith, M. T. (2000). Co-administration of sub-antinociceptive doses of oxycodone and morphine produces marked antinociceptive synergy with reduced CNS side-effects in rats. Pain, 84(2), 421–428.

    Article  PubMed  CAS  Google Scholar 

  • Rutten, K., De Vry, J., Robens, A., Tzschentke, T. M., & Van der Kam, E. L. (2011). Dissociation of rewarding, anti-aversive and anti-nociceptive effects of different classes of anti-nociceptives in the rat. European Journal of Pain, 15, 299–305.

    Article  PubMed  CAS  Google Scholar 

  • Ruttenl, K., Vry, J., Robens, A., Tzschentke, T. M., & Kam, E. L. (2011). Dissociation of rewarding, anti-aversive and anti-nociceptive effects of different classes of anti-nociceptives in the rat. European Journal of Pain, 15(3), 299–305.

    Article  CAS  Google Scholar 

  • Sanchez, V., Carpenter, M. D., Yohn, N. L., & Blendy, J. A. (2016). Long-lasting effects of adolescent oxycodone exposure on reward-related behavior and gene expression in mice. Psychopharmacology, 233(23–24), 3991–4002.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Schultz, W., & Dickinson, A. (2000). Neuronal coding of prediction errors. Annu Rev Neuroscience, 23, 473–500.

    Article  CAS  Google Scholar 

  • Secci, M. E., Factor, J. A., Schindler, C. W., & Panlilio, L. V. (2016). Choice between delayed food and immediate oxycodone in rats. Psychopharmacology, 233(23–24), 3977–3989.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Seip-Cammack, K. M., & Shapiro, M. L. (2014). Behavioral flexibility and response selection are impaired after limited exposure to oxycodone. Learning & Memory, 21(12), 686–695.

    Article  CAS  Google Scholar 

  • Sellers, E. M., Schuller, R., Romach, M. K., & Horbay, G. L. (2006). Relative abuse potential of opioid formulations in Canada: a structured field study. Journal of Opioid Management, 2(4), 219–227.

    Article  PubMed  Google Scholar 

  • Silvasti, M., Rosenberg, P., Seppälä, T., Svartling, N., & Pitkänen, M. (1998). Comparison of analgesic efficacy of oxycodone and morphine in postoperative intravenous patient-controlled analgesia. ActaAnaesthesiolScand, 42(5), 576–580.

    CAS  Google Scholar 

  • Smith, H. S. (2009). Opioid metabolism. Mayo Clinic Proceedings, 87(7), 613–624.

    Article  Google Scholar 

  • Smith, M. Y., & Woody, G. (2005). Nonmedical use and abuse of scheduled medications prescribed for pain, pain-related symptoms, and psychiatric disorders: patterns, user characteristics, and management options. Curr.Psychiatry Rep., 7, 337–343.

    Article  PubMed  Google Scholar 

  • Sng, B., Kwok, S., Mathur, D., Ithnin, F., Newton-Dunn, C., Assam, P., et al. (2016). Comparison of epidural oxycodone and epidural morphine for post-caesarean section analgesia: a randomised controlled trial. Indian Journal of Anaesthesia, 60(3), 187.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Sproule, B., Brands, B., Li, S., & Catz-Biro, L. (2009). Changing patterns in opioid addiction: characterizing users of oxycodone and other opioids. Canadian Family Physician, 55(1), 68–69.

    PubMed  PubMed Central  Google Scholar 

  • Squeglia, L. M., Jacobus, J., & Tapert, S. F. (2009). The influence of substance use on adolescent brain development. Clinical EEG and Neuroscience, 40(1), 31–38.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Steketee, J. D., & Kalivas, P. W. (2011). FDrug wanting: Behavioral sensitization and relapse to drug-seeking behavior. Pharmacological Reviews, 63(2), 348–365.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Stoops, W. W., Hatton, K. W., Lofwall, M. R., Nuzzo, P. A., & Walsh, S. L. (2010). Intravenous oxycodone, hydrocodone, and morphine in recreational opioid users: abuse potential and relative potencies. Psychopharmacology, 212(2), 193–203.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Substance Abuse and Mental Health Services Administration (SAMHSA). (2013). National Survey on Drug use and Health 2011 and 2012. Rockville: Center for Behavioral Health Statistics and Quality.

  • Substance Abuse and Mental Health Services Administration (SAMHSA). (2017). Prescription Drug Misuse and Abuse. Retrieved from https://www.samhsa.gov/topics/prescription-drug-misuse-abuse

  • Thompson, C. M., Wojno, H., Greiner, E., May, E. L., Rice, K. C., & Selley, D. E. (2004). Activation of G-proteins by morphine and codeine congeners: insights to the relevance of O- and N-demethylated metabolites at mu- and delta-opioid receptors. The Journal of Pharmacology and Experimental Therapeutics, 308(2), 547–554.

    Article  PubMed  CAS  Google Scholar 

  • United Nations. (2016). World drug report on international narcotics control board for 2016. Vienna: United Nations.

    Book  Google Scholar 

  • Upadhyay, J., et al. (2010). Alterations in brain structure and functional connectivity in prescription opioid-dependent patients. Brain, 133, 2098–2114.

    Article  PubMed  PubMed Central  Google Scholar 

  • U.S. Cong., Senate Caucus on International Narcotics Control. (2014, May 14). National Institute on Drug Abuse. (ND. Volkow, Author) [Cong. Rept.]. Retrieved from https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse.

  • Vilà-Balló, A., Mas-Herrero, E., Ripollés, P., Simó, M., Miró, J., Cucurell, D., et al. (2017). Unraveling the role of the hippocampus in reversal learning. The Journal of Neuroscience, 37(28), 6686–6697.

    Article  PubMed  PubMed Central  Google Scholar 

  • Volkow, N. D., & Mclellan, A. T. (2016). Opioid abuse in chronic pain—misconceptions and mitigation strategies. New England Journal of Medicine, 374(13), 1253–1263.

    Article  PubMed  CAS  Google Scholar 

  • Vosburg, S. K., Eaton, T. A., Sokolowska, M., Osgood, E. D., Ashworth, J. B., Trudeau, J. J., et al. (2016). Prescription opioid abuse, prescription opioid addiction, and heroin abuse among adolescents in a recovery high school: a pilot study. Journal of Child & Adolescent Substance Abuse, 25(2), 105–112.

    Article  Google Scholar 

  • Wade, C. L., Vendruscolo, L. F., Scholosburg, J. E., Hernandez, D. O., & Koob, G. F. (2015). Compulsive-like responding for opioid analgesics in rats with extended access. Neuropsychopharmacology, 40(2), 421–428.

    Article  PubMed  CAS  Google Scholar 

  • Walsh, S. L., Nuzzo, P. A., Lofwall, M. R., & Holtman, J. R. (2008). The relative abuse liability of oral oxycodone, hydrocodone and hydromorphone assessed in prescription opioid abusers. Drug and Alcohol Dependence, 98(3), 191–202.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Webster, L. R., Bath, B., Medve, R. A., Marmon, T., & Stoddard, G. J. (2012). Randomized, double-blind, placebo-controlled study of the abuse potential of different formulations of oral oxycodone. Pain Medicine, 13(6), 790–801.

    Article  PubMed  Google Scholar 

  • Weele, C. M., Porter-Stransky, K. A., Mabrouk, O. S., Lovic, V., Singer, B. F., Kennedy, R. T., & Aragona, B. J. (2014). Rapid dopamine transmission within the nucleus accumbens: dramatic difference between morphine and oxycodone delivery. European Journal of Neuroscience, 40(7), 3041–3054.

    Article  Google Scholar 

  • Wiebelhaus, J. M., Walentiny, D. M., & Beardsley, P. M. (2016). Effects of acute and repeated administration of oxycodone and naloxone-precipitated withdrawal on intracranial self-stimulation in rats. Behavioral Pharmacology, 356(1), 43–52.

    CAS  Google Scholar 

  • Wise, R. A., & Koob, G. F. (2014). The development and maintenance of drug addiction. Neuropsychopharmacology, 39(2), 254–262.

    Article  PubMed  Google Scholar 

  • Wisniewski, A. M., Purdy, C. H., & Blondell, R. D. (2008). The epidemiologic association between opioid prescribing, non-medical use, and emergency department visits. Journal of Addictive Diseases, 27(1), 1–11.

    Article  PubMed  Google Scholar 

  • Wong, A., Macleod, D., Robinson, J., Koutsogiannis, Z., Graudins, A., & Greene, S. L. (2015). Oxycodone/naloxone preparation can cause acute withdrawal symptoms when misused parenterally or taken orally. ClinToxicol (Phila), 53(8), 815–818.

    Article  CAS  Google Scholar 

  • Wu, L., Pilowsky, D. J., & Patkar, A. A. (2008). Non-prescribed use of pain relievers among adolescents in the United States. Drug and Alcohol Dependence, 94, 1–11.

    Article  PubMed  Google Scholar 

  • Yanagidate, F. (2004). Epidural oxycodone or morphine following gynaecologicalsurgery. British Journal of Anaesthesia, 93(3), 362–367.

    Article  PubMed  CAS  Google Scholar 

  • Zacny, J. P., & Drum, M. (2010). Psychopharmacological effects of oxycodone in healthy volunteers: roles of alcohol-drinking status and sex. Drug and Alcohol Dependence, 107, 209–214.

    Article  PubMed  CAS  Google Scholar 

  • Zhang, Y., Picetti, R., Butelman, E. R., Schlussman, S. D., Ho, A., & Kreek, M. J. (2009). Behavioral and neurochemical changes induced by oxycodone differ between adolescent and adult mice. Neuropsychopharmacology, 34, 912–922.

    Article  PubMed  CAS  Google Scholar 

  • Zhang, Y., Brownstein, A., Buonora, M., Niikura, K., Ho, A., Rosa, J. C., et al. (2015). Self-administration of oxycodone alters synaptic plasticity gene expression in the hippocampus differentially in male adolescent and adult mice. Neuroscience, 285, 34–46.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francesco Leri.

Ethics declarations

Conflict of Interest

Meenu Minhas and Dr. Francesco Leri declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Minhas, M., Leri, F. A Multifaceted Analysis of Oxycodone Addiction. Int J Ment Health Addiction 16, 1016–1032 (2018). https://doi.org/10.1007/s11469-017-9827-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11469-017-9827-y

Keywords

Navigation