Recent reports indicate a rise in the abuse of oxymorphone (Opana® and Opana ER®) a semi-synthetic opiate drug related to Percodan, Percocet and Oxycontin. Like the other opiates, it is used as an analgesic for moderate to severe pain. However, because of some unusual characteristics of the drug, overdoses and deaths from oxymorphone abuse are on the rise, and likely to continue to increase.
Since January of 2008, oxymorphone deaths have been reported in California, Colorado, Connecticut, Florida, Michigan, New Mexico, North Carolina, Ohio, South Dakota, Washington, Tennessee and Kentucky. Between January and April of 2011, there were nine deaths in Louisville, KY alone. Newport, TN officials reported five fatalities within a three month period in March of 2009. Other deaths may have been oxymorphone-related as well, since toxicology results may not have been available for some victims at the time the reports were made. Like abuse of other prescription opiates, cases seem to be clustered in, but by no means limited to, areas with economic depression and high unemployment, and in areas such as Florida, where prescription drug mills proliferate.
Oxymorphone is known as: blues, biscuits, octagons, stop signs, pink, pink heaven, biscuits, Mrs O, Orgasna IR, OM, Pink O, The O Bomb and a variety of other names. Like other opiate drugs, it causes feelings of euphoria, well-being, increased sociability and similar effects that make it a desirable drug of abuse. The euphoria is usually less intense than with the other opioid drugs, and there is a tendency to take larger doses to obtain the desired level of intoxication. This, along with the fact that the effects of the drug vary widely among individuals due to physical condition, the presence of other drugs, food eaten and other factors, creates a situation where the “right” dose for one person may have little effect on another, while creating extreme intoxication or overdose in a third.
These circumstances are further complicated by the fact that when taken with alcohol, the availability and effects of the drug are nearly doubled — in addition to the added effects of the alcohol itself. These three factors, varying response, relatively low euphoric effect, and the synergistic effect with alcohol, combine to create a “perfect storm” for overdose. This is especially true in those who purposely attempt to enhance the effect of the drug by drinking. Oxymorphone overdose typically involves lethargy, relaxed muscles, respiratory depression and sometimes low blood pressure, progressing to coma, cardiac and respiratory collapse, and death if not treated quickly.
We will be hearing more about Opana® and oxymorphone abuse, addiction and overdose in the coming months. Parents, professionals and law enforcement, in particular, need to be aware of this “new” and deadly trend in illicit drug use. Even more, we need to be aware that these tragedies are, to a great extent, avoidable. Painkiller abuse and addiction are treatable conditions. Addiction is a recognized disease that responds well to proper treatment and aftercare. The ill-conceived “War on Drugs” has diverted billions of dollars into an unproductive endeavor that does nothing to address the root of the problem — the drug users who make dealing profitable. We need to develop a national policy of education, treatment and rehabilitation, and act as though we mean it. It would save a lot of money but, more importantly, it would save a lot of lives.