OxyContin Abuse and Addiction

OxyContin is the brand name of a time-release formula of oxycodone, an opioid pain-relief medication synthesized from the opium-derived compound thebaine.  OxyContin is one of several semi-synthetic opioids created to replace morphine and codeine in medical practice.  OxyContin is currently the best-selling non-generic narcotic pain reliever in the United States.

OxyContin is classified as a Schedule II drug as it has a high potential for abuse that can lead to severe psychological and physical dependence.

According to several studies, hazardous abuse of opiates is increasing in general, but abuse of OxyContin is mentioned most frequently in the studies.  Several factors have contributed to rising hazardous use and diversion of OxyContin in the U.S.  First, the large amount of OxyContin available  compared with other types of oxycodone pills makes them more likely to be stolen or diverted.  Second, the rising trend of crushing OxyContin pills to rapidly release oxycodone despite warning, and then injecting or snorting the drug.  Last but not least, the ability to purchase OxyContin legitimately by prescription for a few dollars and then easily sell it illegally for as much as $20 per pill.

People who abuse OxyContin are at higher risk of severe withdrawal symptoms as they tend to use more than the standard prescribed doses.

The most common effects of OxyContin include euphoria, constipation, fatigue, dizziness, nausea, lightheadedness, headache, dry mouth, anxiety, itchy skin, and profuse sweating.  High doses can cause shallow breathing, bradycardia, apnea, hypotension, pupil constriction, and in some cases circulatory collapse, respiratory arrest, and death.

Severe withdrawal symptoms are likely if OxyContin use is discontinued abruptly.  Symptoms of OxyContin withdrawal, similar to other opioids, are anxiety, nausea, insomnia, muscle pain, muscle weakness, and fever.  Psychological dependence will continue after the physical withdrawal, and psychosocial treatment is recommended.

Medically supervised OxyContin detoxification (detox) is recommended for cases of OxyContin abuse and OxyContin dependence.

Dual Diagnosis/Co-Occurring Disorders

Dual diagnosis and co-occurring disorders are psychiatric disorders that are occurring along with substance abuse or substance dependence disorders.

More than half of people experiencing alcohol and drug abuse or dependence disorders are also suffering from a co-occurring mental disorder.

Diagnosing a dual diagnosis/co-occurring disorder condition in substance abusers can be difficult, as drug abuse itself often induces psychiatric symptoms.  In determining the correct dual diagnosis/co-occurring disorder diagnosis it is necessary to differentiate between substance induced and pre-existing mental illness.

Self Medication and Drug or Alcohol Abuse and Dependence

Often people suffering from mental disorders attempt to deal with the problem themselves by "self medicating."  It is common for people experiencing mental disorders to feel relief when drinking alcohol or taking drugs, so it is natural that they should start using these substances to alleviate or control their symptoms.

The problem with self medicating a mental disorder is that prolonged use of alcohol and recreational drugs will likely create a condition of pathological dependence.  In addition, use of certain substances may actually increase the symptoms or create new symptoms.

Treatment for Dual Diagnosis/Co-Occurring Disorders

Summit Malibu's world-class therapists have decades of experience treating the many dual diagnosis/co-occurring disorders that often accompany substance dependence.

Click on the links below to learns more about treatment of dual diagnosis/co-occurring disorders, such as:

• Anxiety Disorder
• Attention Deficit Hyperactivity Disorder (ADHD)
• Bi-Polar Disorder
• Borderline Personality Disorder (BPD)
• Depression
• Obsessive Compulsive Disorder (OCD)
• Panic Disorder
• Post Traumatic Stress Disorder (PTSD)
• Social Anxiety Disorder

Post Traumatic Stress Disorder (PTSD)

Post traumatic stress disorder (PTSD) is a severe anxiety disorder that may develop after an event that results in psychological trauma, such as a threat of death, a threat to physical, sexual, or psychological integrity, a near-death experience, etc.

The trauma preceding PTSD overwhelms the person's ability to cope in a normal manner.

Diagnostic symptoms include re-experiencing the original trauma through flashbacks or nightmares; avoidance of stimuli associated with the trauma; difficulty falling or staying asleep; anger; and hypervigilance.  symptoms would last more than one month and would cause significant impairment in social, occupational, or other important areas of functioning.

PTSD is believed to be caused by either physical trauma or psychological trauma, and frequently a combination of both.  Possible sources of trauma include experiencing or witnessing childhood or adult physical, emotional or sexual abuse.

In addition, experiencing or witnessing an event perceived as life-threatening such as physical assault, adult experiences of sexual assault, accidents, drug addiction, illnesses, medical complications, or employment in occupations exposed to war (such as soldiers) or disaster (such as emergency service workers).

Treatment for PTSD

Treatment for PTSD usually involves psychotherapy, especially Cognitive Behavioral Therapy and Dialectical Behavioral Therapy.  Relaxation therapy is also helpful to reduce and cope with residual anxiety.

A variety of medications have been applied to the disorder, including mood stabilizers, anti-depressants, and anti-psychotics.

Many PTSD medications list possible dependence (addiction) as one of the side effects.

Many of the medications prescribed for PTSD have the potential for creating a secondary condition of substance abuse or substance dependence.  Some long-term users of PTSD medications report that they felt compelled to take other prescription drugs and even illegal drugs to enhance the waning effects of their medication over time.  Other users reported a transition to illegal drugs with similar effects when the PTSD was withdrawn.

Dual Diagnosis/Co-Occurring Disorder

PTSD often occurs together with substance abuse and substance dependence disorders.  Often the substance use is the result of an attempt to "self-medicate" but just as often substance dependence is the primary disorder with PTSD being secondary.  In either case, both disorders must be treated simultaneously to achieve an effective outcome.

Depression Disorder

Depression is a major psychiatric disorder that affects millions of Americans and their families, friends, and colleagues.  The National Institute of Mental Health reports that 18.8 million adults, or about 9.5 percent of the U.S. adult population, suffer from some form of depressive disorder.

The linkage between depression and physical illnesses makes it, in the words of the World Health Organization, "the world's second-most disabling disease after heart disease."

Symptoms of depression

• Ongoing sad, anxious or empty feelings
• Feelings of hopelessness
• Feelings of guilt, worthlessness, or helplessness
• Feeling irritable or restless
• Loss of interest in activities or hobbies that were once enjoyable, including sex
• Feeling tired all the time
• Difficulty concentrating, remembering details, or difficulty making decisions
• Not able to go to sleep or stay asleep (insomnia); may wake in the middle of the night, or sleep all the time
• Overeating or loss of appetite
• Thoughts of suicide or making suicide attempts
• Ongoing aches and pains, headaches, cramps or digestive problems that do not go away.

What is Depression?

The American Psychiatric Association's Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) lists nine symptoms for major depression, five or more which must be present over the same two-week period, including one of the first two:

• Feeling depressed most of the day, nearly every day.
• Markedly diminished pleasure.

The other seven symptoms include:

• Significant weight gain or loss.
• Insomnia or hypersomnia.
• Psychomotor agitation or retardation.
• Fatigue or loss of energy.
• Feelings of worthlessness or inappropriate guilt.
• Diminished ability to think or concentrate.
• Recurrent thoughts of death, suicidal thinking, and suicide attempts.

How is depression treated?

Medications and counseling are the cornerstones of depression therapy.  Reacting to depression as soon as it is noticed is important. With prompt treatment, a depressed person can return to a happier lifestyle and more balanced outlook on life.  There are effective treatments for depression, including antidepressants and talk therapy.  Most people do best by using both.

How long will the depression last?

This depends on how soon you get help. Left untreated, depression can last for weeks, months or even years. The main risk in not getting treatment is suicide. Treatment can help depression lift in 6 to 8 weeks, or less.

Reasons to get help for Depression

• Early treatment helps keep depression from getting worse or lasting a long time.
• Thoughts of suicide are common in people with depression.
• The risk of suicide is higher if you don't get treatment for your depression.
• When depression is successfully treated, the thoughts of suicide will go away.
• Treatment can help you return to your "normal" self, enjoying life.
• Treatment can help prevent depression from coming back.

Other Types of Depression

Dysthymia Depression

Dysthymia is chronic mild to moderate chronic depression, as opposed to major depression. The DSM-IV mandates the same symptoms as for major depression, except for suicidality, but requires only three symptoms in all, so long as they have persisted over two years. Mild to moderate is a misnomer, as dysthymia can make a person’s life as miserable as major depression.

Melancholic Depression

Melancholic depression is major depression with an emphasis on lack of pleasure or lack of reactivity to pleasure. Other characteristics include (three or more): Depressed mood, depression at worst in the morning, early morning awakening, psychomotor agitation or retardation, significant weight loss, and inappropriate guilt.

Atypical Depression

Atypical depression is a misnomer, as more outpatients suffer from atypical depression than from other forms of depression. Atypical depression is major depression that differs from melancholic depression in that patients react positively to external events, plus (two or more): Significant weight gain (as opposed to weight loss), hypersomnia (as opposed to insomnia), leaden paralysis, and sensitivity to personal rejection.

Bipolar Depression

Bipolar depression is a feature of bipolar disorder, also known as manic depression, an illness characterized by mood swings from depression to mania. The diagnostic criteria for bipolar depression are the same as for major depression, but bipolar patients tend to have atypical features. Bipolar patients who rapid cycle can be up and down in a matter of minutes, and in mixed states depression and mania are present at once.

Psychotic Depression

Psychotic depression is a rare form of depression characterized by delusions or hallucinations, such as believing you are someone you are not and hearing voices.

Catatonic Depression

Catatonic depression is a rare form of major depression characterized by (at least two): Stupor, excessive motor activity, extreme negativism, peculiarities in voluntary movement, and repetition of other people's words or actions.

Seasonal Affective Disorder (SAD)

Seasonal affective disorder is major depression that appears in the fall or winter and goes away in spring, thought to be caused by lack of sunlight.

Postpartum Depression

Postpartum depression occurs within four weeks of a women giving childbirth. Most new mothers suffer from some form of the “baby blues.” Postpartum depression, by contrast, is major depression, thought to be triggered by changes in hormonal flows associated with childbirth.

Dual Diagnosis/Co-Occurring Disorder

Depression disorders often occurs together with substance abuse and substance dependence disorders.  Often the substance use is the result of an attempt to "self-medicate" but just as often substance dependence is the primary disorder with depression being secondary.  In either case, both disorders must be treated simultaneously to achieve an effective outcome.

Disclaimer: This assessment is not intended to diagnose or treat any medical or emotional condition. It is advised that you consult your physician with any concerns regarding this condition.