Facebook flagged me as a degenerate pornographer for my display in the previous post: a nekkid woman in an opium den, circa 1928. Shame on me. I’ve learned my lesson. Say hello to ‘Sailor Moon!’ As wholesome as it gets.
Repeating myself: OxyContin is Oxycodone. The difference in nomenclature steams from it being nothing but Oxycodone, just in a different “presentation’” if you will. The name is just a portmanteau of “Oxycodone” and “continuous.” No acetaminophen or aspirin mixed in. OxyContin, in the prescribed amount, also contains more Oxycodone that the dose found in Percodan or Percoset. Why? Because it’s buffered, it’s time-release, and in the process of making it so, the oh-so-attractive secondary effect had been negated. It’ll cure what ails ya, but only physically—when taken as prescribed. The promise of euphoria has been removed, and thus its temptations.
That’s the key, folks. Take these pills as directed and once the pain has been resolved, you won’t want to take any more of them. Do as your told, and you won’t get into trouble. Life wouldn’t be so difficult for us human beings had we heeded that statement the first time we heard it, and adhered to it for the rest of our time on this planet. If that line of thinking was all that was needed, we wouldn’t have this problem in the first place. This is right where doctors, Big Pharma, the press, and yes, the Government (note the big “G”) prove themselves as helpless and befuddled as those they care for, serve and ostensibly protect. This where they fail, and fail miserably.
Firstly, directing a junky to obey a prescription order is a conversation just as effectively held with the cat. Addicts aren’t heedful. If that approach had the slightest shred of merit, there wouldn’t be a problem. Secondly, telling an addict—or anyone else, for that matter—that what you most greatly desire in life has been put in a package that you can no longer open is a challenge, not a deterrent. How did the afflicted meet this challenge? It didn’t take long. Turns out that if you wanted open the package oxycodone now came in, all you had to do was crush it up and snort it. Or crush it up and inject it. Or crush it up and smoke it.
Curses, foiled again.
When OxyContin was released for public consumption and could be scribbled on a prescription pad, we at the office saw the effect almost immediately. We collected a shitload of dead people who were in possession of little blue-green pills. It blew past the “traditionals” on the first turn and entered the backstretch, going away. One could wonder why this spike in drug specific ODs would make such a leap. It was essentially the same drug that was snuffing people at a lower rate just weeks before, so why should this stuff—believed to be overdose-proof to the overly optimistic—pile up to what became at that time record numbers. Part of it was that it was suddenly the “new toy”. “You ain’t hip ‘til you take this trip.” Sad but true. What was ignored was that, while the same chemical, the dose was being served up three times stronger. Your previous therapeutic dose was intended to be effective for about four hours. OxyContin was meant to do three times the job, i.e. twelve hours. Therapeutic levels don’t fit the parameters of abuse. Opioid addicts I’d encountered typically abused their Percosets, Percodans and Vicodins orally. Crushing, then snorting or injecting it was the exception rather than the rule. Oxycodone is an “immediate effect” opioid. You gulp ‘em down and the narcotic effect initiates in minutes. Taking it this way was factored into the overall intended effect the medication. A reasonable example of abuse would be taking three pills when one was recommended. Snorting or shooting it up bypassed the digestive system, a natural buffer, and provided a straight shot into the bloodstream and hence the brain. People I’ve known with opioid addiction told me they didn’t like to snort or mainline because the initial rush was too intense. This massive hit usually resulted in a sudden and overwhelming physical reaction. They either vomited – “an instant punch-in-the-gut, projectile puke”– or passed out. “You’re out before you can even exhale,” I was told. “And when you come to, you can’t even fuckin’ move, like you’re nailed to the floor. Your whole day is pretty much done.” While you didn’t need as much if snorting or injecting, it was still seen as a “last resort”. “You only go that route if you’re running out and you don’t know when you’ll get a chance to resupply,” or if “You’re hooked so bad and in so deep it’s the only way you can get high any more. If you’re in that bad, about the only way you’ll get out is when you OD.”
Because it was so much stronger, and the only way you could access its narcotic effect was by snorting or injection, it wasn’t uncommon that the first time OxyContin was used to get wasted it was also the last.
I won’t believe for an instant those geniuses at Big Pharma (in this case, Purdue) didn’t have a clue their latest safety barrier could be breached by any fifteen-year-old in the habit of stealing Grandma’s hip medicine. Oh, well… The great thing for Big Pharma—and physicians and the Gumma-mint— is they have a ready-made scapegoat in such cases. The junky himself. Can’t blame them for the reckless and wanton behavior of the weak-willed and self-destructive. The Press did their bit to raise public awareness while at the same time assuring us ‘Merica’s Best and Brightest weren’t being thinned out. Due to its popularity among white males and the first widespread OD’s showing up in Appalachia, OxyContin was dubbed “Hillbilly Heroin.” Fuckin’ hilarious.
Big Pharma as well as the other powers-that-be didn’t take this shit lying down—nobody wants to take the blame for knocking off scads of rednecks. After a few months, those little aquamarine pills stopped showing up on my desk. OxyContin wasn’t banned—as other pharmaceuticals of the same era, like Fen-Phen (weight loss) and Seldane (allergies) and a whole lot more—but it lost its place as the newest and improved-est painkiller on the general market. Prescriptions were limited to those with a terminal illness or elderly folk with chronic pain issues primarily associated with other significant medical conditions. This clientele wasn’t in the habit of tinkering with their medications. Besides, their time on Earth was finite in anyone’s book. If they suddenly kacked, there were plenty of other places to point a finger before anyone got around to snooping in the medicine cabinet.
So… we could all take a deep breath and find assurance that this big bullet had been effectively dodged, yes? Uh . . . no. Funny thing; while the main culprit had been effectively caged up, the OD rate didn’t decline. Percoset, Percodan and Vicodin reclaimed their spot on the list, and stronger than ever. Disclaimer here: My theory follows, and I’ve not seen any “academic” support for it. Here goes: Those folk who abused OxyContin and managed to avoid the undertaker had been effectively hooked. They had to find another way to catch that dragon, and find it fast. They had to resort to what was available, and during this brief but intense crisis, they old stand-by’s hadn’t gone anywhere. Just sittin’ back and bidin’ their time…
This was hardly newsworthy. But, take heart folks. Big Pharma wasn’t about to take a break from coming up with the latest answer to pain, and addicts weren’t about to give up in gettingwhat they needed. Changes were acomin’. And those involved in freelance pharmaceutical supply weren’t about to stand by and watch the “legitimate” pushers rake in all that cash.
Stay tuned!