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What Is Opana?

Opana, a brand name for Oxymorphone, is a powerful and highly potent opioid painkiller that is manufactured in instant-release tablet form to treat moderate-to-severe pain.

The generic Oxymorphone is produced in both instant-release and extended-release tablet form. Being an opioid medication, it is derived from the opium poppy plant and works similar to Codeine, Morphine, and heroin — though its closest relative is Oxycodone. Thus, Opana attaches to opioid receptors in the brain and depresses the central nervous system (CMS) to stop incoming pain signals.

Opioid dependence can happen after just five days.

The medication Opana is very powerful and has a high risk for:

  • Abuse
  • Addiction
  • Dependency
  • Overdose
  • Death

Therefore, physicians exercise a high level of caution and follow-up observation when deciding to prescribe the drug.

Side effects

Side effects are a normal, unintentional reaction that comes with the usage of Oxymorphone. Most people may experience one or more reactions to the drug. However, misuse or the use of Oxycodone in combination with other drugs or alcohol heightens the side effects up to the point of being dangerous. Common side effects include:

  • Euphoria
  • Tiredness
  • Drowsiness
  • Stomach pain and/or vomiting
  • Headache
  • Constipation
  • Red eyes
  • Itchiness and rash
  • Potential for seizure

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Opioid Crisis

The over-prescribing issue of opioids has reached epidemic levels. It is deemed as the "Opioid Epidemic." Many doctors are pressured or receive kickback payments from pharmaceutical companies, and such greed has led to opioid-related addiction and deaths at a staggering rate. The alarming numbers continue to rise year after year.

In October 2017, President Trump declared the opioid crisis a public health emergency. Ever since, the Trump Administration has applied an all-of-Government approach to the epidemic, taking an extraordinary range of actions that reflect the President’s commitment to stopping the crisis in its tracks.

In the wake of the ongoing crisis, much awareness has developed, and doctors are much more hesitant to prescribe the drug Opana and other opioid medications. They have also put significantly better practices into monitoring a patient on the medication.

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Risks

Risks of Opana use include the following:

Dependence

Dependence is a term used to describe a person’s physical and psychological loss of control. This occurs when a person abuses or misuses this drug, among others. Abuse or misuse of the drug will occur when:

  • A patient takes more of the drug than prescribed
  • A patient takes the drug without a prescription
  • When used in any way other than intended

People become at high risk for dependence and addiction, as well as other unintended consequences.

In 2012, the Opana manufacturer reformulated its higher-dosage Opana ER to combat widespread abuse of the drug. Still, the reformulation of the drug made it difficult for people to crush the tablets and snort or inject it, which causes its full immediate release directly into the bloodstream. However, people figured out they can avoid this measure by dissolving the tablet and injecting it.

In addition to the previous problems caused by abusing the drug, a new problem emerged from an increase in the spreading of HIV and hepatitis through needle use.This was due to the medication being in an injectable form.

Once dependent, a person will experience symptoms of withdrawal if they abruptly stop taking the drug. Oxymorphone is a highly potent drug. Hence, the dependence of the drug can be severe and can cause intense withdrawal symptoms. These may include:

  • A strong craving for the drug
  • Profuse sweating and clamminess
  • Runny nose
  • Chills and goosebumps
  • Muscle spasms
  • Stomach cramps
  • Nausea and vomiting
  • Depression
  • Psychosis
  • Agitation and irritability
  • Hallucinations
  • Homicidal or suicidal thoughts
  • Insomnia

Addiction

Due to being a highly potent opioid, addiction is a high risk for those that abuse oxymorphone.

Misuse of Oxymorphone can and will lead to addiction. At this stage, the brain’s motivation and reward system is chemically altered. Therefore, a person's motivation is uncontrollably re-directed towards the reward, whether it be getting high or to relieve pain.

Once addiction has set in, the symptoms will range from subtle to highly obvious. Some of the key indicators include:

  • Self-isolation
  • Depression
  • Relationship problems with friends, family, or significant other
  • “Nodding off” or visible fatigue
  • Craving of the drug
  • Mood swings
  • Memory loss
  • Appetite loss
  • Weight loss
  • Irregular financial problems
  • Legal problems
  • Doctor shopping — where a person requests prescriptions from different doctors

Overdose

Overdosing on Opana can cause permanent damage or even death. It depresses the central nervous system (CNS) to dangerous levels when used to the point of toxicity. At the point of overdose, the following severe symptoms occur:

  • Slurred speech
  • Loss of basic functioning
  • Lowered blood pressure
  • Slowed pulse
  • Pupil size significantly reduced
  • Clammy skin
  • Lowered body temperature
  • Bluish fingertips and lips
  • Seizures

The most dangerous symptoms of overdose occur when the CNS is suppressed to the point where it significantly slows breathing. Oxygen is vital to the brain and other organs. Therefore, lack of oxygen can cause permanent brain damage or organ failure. In worst case scenarios, an overdose may leave a person without oxygen for too long and death occurs.

A person experiencing an overdose is usually given the drug Naloxone. Naloxone acts fast as it quickly breaks Oxymorphone’s attachment to the opioid receptors. This reverses the effects and gives the CNS an opportunity to recover, therefore restoring breathing and resupplying the brain and organs with oxygen.

Instant-release vs. extended-release Oxymorphone

Immediate-release provides fast-acting pain relief for people with short-term pain issues. Patients with long-term and chronic pain issues benefit from extended-release, which come in higher doses and releases gradually, providing long-lasting pain relief.

In June 2017, the Food and Drug Administration (FDA) requested that Endo Pharmaceuticals remove reformulated Opana ER from the market because the benefits no longer outweigh the risks. Following the FDA's request, Endo Pharmaceuticals announced in July 2017 that it would voluntarily remove reformulated Opana ER from the market.

Abuse of the higher-dosage Opana ER became widespread. Instances of abuse, overdose, and death skyrocketed from 2012 to 2017 and political pressure continued to mount upon its manufacturer as well as the FDA. However, Oxymorphone ER remains on the market.

Treatment Options

Comprehensive treatment is critical for Oxymorphone addiction. Treatment starts with ridding the body of dependency through detoxification (detox). In short, detox is when a person goes to a facility to safely taper off the drug. The taper process involves using progressively smaller doses of the drug, to prevent the harsh withdrawal symptoms that come with stopping “cold turkey.” There are medications available, such as Suboxone, to aid in the process.

In order to achieve a long-term substance-free life, the root of the problem must be identified and addressed. Since Oxymorphone has a euphoric effect, many people abuse it without the need or desire of using it for its intended effect, but rather to get high. They may have no pain problems whatsoever, but become addicted in pursuit of the high.

Unfortunately, many people who take Oxycodone with the purpose of relieving pain become addicted unintentionally — even when following directions as prescribed.

Treatment is not a “one size fits all” approach, as every individual has specific needs to stay on the right path.

Through cognitive-behavior treatment, a doctor or trained professional, as well as peers in the same situation, will help an individual identify triggers that lead to abuse. Healthy behavioral and emotional tactics can be firmly established to avoid drug abuse. Additionally, other psychological issues such as PTSD, depression, schizophrenia, and other mental or emotional issues may lead to drug abuse. However, these conditions are treatable.

Other effective programs include Medication Assisted Therapy (MAT), 12-Step-Program, faith-based programs (the reliance on a higher power), peer group sessions, hotlines, as well as support from friends and family.

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Resources

MORE
LESS

Berner, Todd. “A Comparison of Daily Average Consumption Of Oxycodone Controlled Release (OxyContin CR) And Oxymorphone Extended-Release (Opana ER) In Patients With Low Back Pain.” PubMed Central (PMC), 1 Mar. 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086105/

Academic, Oxford. “Observations on the Urine Metabolic Ratio of Oxymorphone to Oxycodone in Pain Patients.” OUP Academic, 1 May 2012, https://academic.oup.com/jat/article/36/4/232/806738

“Opana ER (Oxymorphone Hydrochloride Extended-Release) Side Effects, Images, Uses, Dosage, Overdose at RxList.” RxList, https://www.rxlist.com/opana-er-drug/patient-images-side-effects.htm

“Oxymorphone (Marketed as Opana ER) Information.” U.S. Food and Drug Administration, 9 Feb. 2019, http://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/oxymorphone-marketed-opana-er-information

Trump, President. “Ending America’s Opioid Crisis | The White House.” The White House, 1 Mar. 2018, https://www.whitehouse.gov/opioids/

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