What Is Opana?

Oxymorphone is an opioid analgesic. It’s marketed in the U.S. under the trade name “Opana.” 

Opana is a type of opioid pain medicine used to treat chronic pain. It’s available as a tablet and comes in two forms:^{1, 2, 3, 4} 

1. An immediate-release formulation for moderate to severe pain
2. An extended-release (ER), or long-acting, formulation for around-the-clock pain

Opana ER was removed from the U.S. market in 2017 after the Food and Drug Administration (FDA) requested its removal due to high abuse rates. However, generic versions of oxymorphone extended-release tablets may still be available by prescription.^{5, 6}

How Does Opana Work?

Opana works by binding to opioid receptors and increasing your pain threshold. It’s a potent and effective opioid analgesic, three times more potent than oral morphine.^{1, 3, 4}

However, it’s considered a Schedule II drug. This means it has a high risk of dependence and addiction. 

Like other prescription opioids, Opana may be intentionally misused or abused for its euphoric effect. Because of this, Opana is typically reserved for people who don’t tolerate or receive adequate pain control from alternative non-opioid analgesics or opioid combination products. 

How is Opana Used?

Opana pills must be taken on an empty stomach 1 hour before or 2 hours after a meal. They’re usually taken every 4 to 6 hours. 

Here are a few guidelines for using Opana safely:^{7, 8, 9}

• Take it as your doctor prescribes: Don’t increase the dosage or use it for extended periods
• Don’t stop taking it suddenly: This may cause withdrawal symptoms; ask your doctor about the safest way to stop
• Talk to your doctor about your reaction: If you begin to experience withdrawal symptoms or unusual cravings, it's important to reach out to your doctor
• Don’t crush, chew, or dissolve it: Swallow it whole to avoid potential overdose
• Don't share it: Avoid sharing your prescription with other people, especially those with a history of drug abuse or addiction
• Avoid drinking alcohol or other drugs: Opana can interact with alcohol and other medications, which can increase the risk of side effects or worsen existing ones
• Dispose of leftover Opana: This is done to prevent other people from ingesting or intentionally misusing it
• Do not double up on doses: If you miss a dose, skip the missed dose and wait for the next one instead of taking two doses to make up for the missed one

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Side Effects of Opana

People taking Opana may experience these common side effects:^{1, 3, 7, 8, 9}

• Nausea
• Vomiting
• Dry mouth
• Sedation
• Unusual sleepiness
• Insomnia
• Dizziness
• Headache
• Increased sweating
• Fatigue
• Decreased appetite
• Constipation
• Diarrhea
• Abdominal or chest pain

Uncommon Symptoms of Opana

Opana may also cause less common adverse reactions, including:^{1, 3, 7, 8, 9}

• Respiratory depression
• Allergic reactions
• Euphoria
• Dysphoria
• Agitation
• Hallucination
• Slow or fast heart rate
• Palpitations
• Low blood pressure
• Miosis (contraction of pupils)
• Central nervous system (CNS) depression
• Low oxygen in tissues
• Ileus (non-mechanical bowel obstruction)
• Hot flashes
• Urinary retention

Opana Abuse

Illicit Opana use occurs when it’s taken without a prescription to experience euphoria. Some examples of Opana abuse include:¹ 

• Chewing the pill to enhance drug release
• Crushing the tablet and snorting the powder
• Dissolving the drug in water and injecting the solution
• Taking the drug with alcohol or other substances

Improper use of Opana is dangerous, as it carries a high risk of overdose, dependence, and addiction. Once someone is dependent, dangerous withdrawal symptoms can develop if they stop taking the drug abruptly.

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Risks of Opana Abuse

Improper Opana use can lead to drug dependence and tolerance. If you develop a dependence on Opana, you may experience dangerous withdrawal symptoms when you stop using it.

You can also develop a tolerance for the drug. This means you'll need to take Opana at a higher dosage or frequency to experience the same level of pain relief.

Opana abuse can also lead to several risks, such as: 

• A potentially fatal overdose
• Clinically significant drug interactions
• An opioid use disorder (OUD)
• Adverse drug side effects 
• Pain and dangerous withdrawal symptoms

Signs of Opana Addiction 

Opana addiction is typically characterized by a loss of control or excessive cravings for the drug.^{12, 13} Those who become addicted to Opana will continue to use it despite the negative side effects.

Specific signs that may indicate Opana addiction include:

• Frequently “losing” prescriptions
• Returning to the doctor for early refills
• Seeing different doctors to get more medication
• Buying the drug from friends or strangers
• Lying or exaggerating an injury to get a prescription
• Stealing from family or friends to get drugs
• Crushing, chewing, or dissolving the drug
• Repeatedly requesting a dosage increase
• Dismissing non-opioid treatments
• An inability to stop taking the drug after multiple unsuccessful attempts
• Increased pain due to drug tolerance
• Prioritizing drug use above family, friends, work, or school
• Experiencing financial difficulties caused by drug use
• Displaying symptoms like breathing problems, drowsiness, and changes in sleeping habits

Someone who has a substance use disorder may not display these signs immediately. Only healthcare professionals can diagnose Opana addiction precisely. They'll use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for diagnosing a substance use disorder.

Opana Addiction Risks

Aside from the aforementioned side effects of Opana abuse, addiction can lead to worse substance use disorders and other long-term health risks.

These include:^5,6,10

• Switching to more potent opioids: People who use prescription opioids may switch to heroin or fentanyl to get their fix
• Bloodborne disease: Those who inject Opana can lead to various infections and diseases such as HIV, hepatitis C, and a rare blood disorder that mimics thrombotic thrombocytopenic purpura

These side effects and the opioid epidemic eventually led to Opana ER's removal from the U.S. market. ^5,6

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Opana Overdose

Symptoms of Opana overdose are the same as any opioid overdose. They include:^{1, 7, 8}

• Respiratory depression
• Unusual sleepiness, leading to unconsciousness or coma
• Decreased responsiveness
• Muscle weakness
• Cold and clammy skin
• Pale or bluish lips, fingernails, or skin
• Miosis (contraction of pupils)
• Low blood pressure
• Irregular heartbeat
• Cardiac arrest
• Death

If you or someone you know is experiencing an Opana overdose, call 911 and seek medical help immediately. Certain overdose side effects like cardiac arrest and irregular heartbeat require advanced life support techniques.^{1, 7, 8}

Drug Interactions

Opana can interact with prescription or nonprescription medications. Co-ingestion can increase the risk of adverse reactions to Opana.

These substances include:^{7, 8, 9}

• Alcohol: Mixing alcohol and Opana may increase blood levels of Opana, which can lead to a fatal overdose
• Other types of prescription opioids: Medications like pentazocine, nalbuphine, and butorphanol may decrease Opana’s analgesic effect and/or cause withdrawal symptoms
• Central nervous system (CNS) depressant drugs: Co-ingestion may cause respiratory depression, low blood pressure, sedation, coma, or death
• Cimetidine: A drug for reducing stomach acid, which may cause respiratory depression when taken with Opana
• Anticholinergics: Drugs used to treat different conditions like asthma and Parkinson’s disease, which may lead to urinary retention and severe constipation when taken with Opana

Opana Withdrawal Symptoms

People may develop withdrawal symptoms if they abruptly stop or reduce their Opana intake. They may continue drug use to avoid uncomfortable symptoms, which include:^{1, 7, 8, 9}

• Severe drowsiness
• Restlessness
• Mood changes
• Teary eyes
• Runny nose
• Sweating
• Chills
• Hypertension
• Irregular heart rate
• Abdominal pain
• Muscle and bone pain
• Nausea
• Vomiting
• Diarrhea

Babies may experience neonatal opioid withdrawal syndrome if their mothers use Opana during pregnancy. These babies usually require medical treatment for several weeks.¹¹

Treatment for Opana Addiction 

In case of emergencies, medical professionals will typically administer a rescue medication like naloxone or nalmefene to reverse life-threatening respiratory depression. They may also supply oxygen and other supportive measures in case of circulatory shock or fluid build-up in the lungs.

Treatment approaches for Opana addiction are similar to those of other opioid treatments. They include:

Medication-Assisted Treatment (MAT)

Medications used for opioid treatment include:¹⁴

• Methadone: An opioid agonist that activates opioid receptors but doesn’t produce euphoria
• Buprenorphine: A partial opioid agonist that can reduce or remove withdrawal symptoms
• Naltrexone: A synthetic opioid antagonist that blocks the euphoric effect of any opioid 
• Lofexidine: A non-opioid prescription medicine that can reduce withdrawal symptoms

Detoxing in a medically assisted detox center is the safest treatment for Opana addiction. Home detox (without professional help) is dangerous and unlikely to be successful. It can also lead to death.

Behavioral Treatments

Behavioral treatments are designed to:

• Change people’s attitudes and behaviors concerning drug use
• Help people develop healthy life skills
• Help people stay the course in taking their medications or following other treatment plans

Behavioral treatments can occur in an outpatient or inpatient setting. 

Outpatient Treatment

In an outpatient setting, the person regularly visits a counselor. Counseling can be done individually, as a group, or both.

Outpatient programs typically offer:¹⁵

• Cognitive behavioral therapy (CBT): Helps people recognize, avoid, and cope with situations in which they are most likely to use drugs
• Multidimensional family therapy: Designed for teenagers with substance use disorders and their families
• Motivational interviewing: Maximizes people's readiness to change their behavior and enter treatment
• Contingency management (motivational incentives): People receive vouchers they can exchange for things that encourage healthy living, like a gym membership

Inpatient Treatment

Inpatient or residential treatment is better for people with more severe substance use disorders. Examples include:¹⁵

• Therapeutic communities: Highly structured programs where people stay in residence for 6 to 12 months
• Shorter-term residential treatment: Focuses on detoxification, initial counseling, and preparation for community-based treatment
• Recovery housing: Designed to help people transition to an independent life

Summary

Opana is the brand name of Oxymorphone. It's an opioid analgesic used to treat chronic pain.

However, Opana has been removed from the U.S. market because of the high abuse rate. It's considered a Schedule II controlled substance with a high potential for abuse and addiction.

Opana abuse and addiction can be dangerous, like most opioid addictions. Fortunately, there are treatment options available to recover from Opana addiction.

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