OxyContin

When it comes to drugs, I'm not exactly what you would call in the know. Even so, I was little surprised when I started watching Justified recently that a lot of the drama (and a lot of the crime) centered around the smuggling of something called Oxy, or what I thought was called Oxycotton. As may be obvious from reading this blog over time, it can take me awhile to get curious enough to find out more, and for the purposes of the show, it was enough to know that it was a profitable illicit substance that was finding its way into Harlan County, Kentucky.


Flash forward to a couple of nights ago when I happened to tune into a TV show on CNN in which Lisa Ling explores the drug culture of Salt Lake City. It's called "Unholy Addiction". I was pretty surprised to learn that non-smoking, non-drinking Mormon country has such a prescription drug problem, ironically in part because in such an idealistic society, addiction issues tend to remain in the shadows. Anyway, there was our old friend OxyContin again, one of the chief culprits. Although there is the usual pathway of kids taking their parents pills there is also the fact that OxyContin is incredibly and swiftly addictive and people who'd  never believe they could become junkies suddenly find themselves with a habit.


This morning I read a piece by Charles Ingraham at Wonkblog  which reports that despite the fact that heroin looms large in our consciousness thanks to high profile deaths like that of Philip Seymour Hoffman, and that its usage is said to be on the upswing, it's actually used by a very tiny percentage of people, a number so small statistically that its hard to track it reliably in traditional ways.


Just in case you were weighing up what your recreational drug of choice should be, Wonkblog goes on to say that in 2011, 4012 people overdosed in the U.S. on heroin, but 17, 241 people OD'd on prescription drugs, which is roughly the number of people who died by firearm homicide.


I was struck by the unintentional side effect that an idealistic society which values clean living had on drug use in Utah. But I was also struck by another possible unintended consequence. Ingraham goes on to say that as the Feds crack down on prescription drug abuse, they may actually be driving people to start into heroin, which is cheaper. This was also a point driven home on Ling's show.


So what is Oxycontin exactly? Well, it's a brand name, for one thing. The actual drug is oxycodone, with OxyContin being a time released version, "Contin" standing in for "continuous". Ironically, when people become addicted to these pills, they often chew, snort or ingest the drug as a means of overriding that time release mechanism.


According to How Stuff Works, oxycodone is an agonist opoid. The agonist bit means that it binds to a receptor in the body and causes a physiological response. Wikipedia tells us that oxycodone is a semi-synthetic opoid derived from a minor constituent of opium called Thebaine (and if you see Thebes in that word, you see correctly). It is similar to morphine and codeine, but instead has stimulatory effects rather than depressant effects. What separates oxycodone from say, aspirin, is that aspirin has a threshold to its effectiveness, while agonist opoids have no such threshold, so the more you take the better you feel.

Oxycodone

Unfortunately, frequent use habituates the user to the effect and as with so much else in life, more and more must be taken for the desired effect. Hence, addiction. In a word, don't go there, people.


Etymologically oxy is just short for hydroxyl, and codone comes from codeine. Codeine goes back to the Greek kodeia or "poppy head".


Obviously, a lot of people in tremendous pain have derived great benefit from the invention--and intervention--of oxycodone, which the Germans managed to do in 1916. For those of us more fortunate, though, there was a lesson embedded in The Wizard of Oz which many of us would have done well to have heeded.

"Poppies... Poppies. Poppies will put them to sleep. Sleeeeep."

In case you've forgotten, the Wicked Witch of the West wasn't wishing Dorothy well.