Wednesday, November 26, 2008

When OxyContin Use Becomes OxyContin Abuse

Opioid drugs, such as oxycodone, work primarily through their interaction with the mu opioid receptors, especially in the brain and spinal cord. When activated, these receptors mediate the drugs' analgesic effects. However, they also mediate the ability to produce the euphoric state. Moreover, opioids like oxycodone have similarities to virtually every other drug of abuse, including nicotine, alcohol, marijuana, cocaine, heroin, and methamphetamine, in that they elevate levels of the neurotransmitter dopamine in the brain pathways that control the experience of pleasure.
Prolonged use of these drugs eventually changes the brain in fundamental and long-lasting ways, explaining why people cannot just quit on their own, and why treatment is essential. In effect, drugs of abuse take over the brain's normal pleasure and motivational systems, moving drug use to the highest priority in the individual's motivational hierarchy, thereby overriding all other motivations and drives. These brain changes, then, are responsible for the compulsion to seek and use drugs that we have come to define as addiction. This is likely the state people are in when they are reportedly "doctor shopping," feigning illnesses, and stealing from pharmacies to obtain the drug.
Addiction to opioids used for legitimate medical purposes under a qualified physician's care is rare. According to the National Institute on Drug Abuse, however, many physicians limit prescribing powerful opioid pain medications because they believe patients may become addicted to the drugs. Recent evidence suggests that, unlike opioid abusers, most healthy, non drug-abusing patients do not report euphoria after being administered opioids, possibly because their level of pain may reduce some of the opioid's euphoric effects making patients less likely to become abusers.


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