What Is OxyContin Addiction

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What Is OxyContin Addiction

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KEY TAKEAWAYS

OxyContin Addiction is:

Crushing, snorting, or injecting the powder from 10 – 80mg OxyContin tablets at least 3 times weekly for 12+ months [1]
Spending large amounts of money (e.g. £1,300 in 14 days) on OxyContin to achieve euphoria [1]

Physical Signs Of OxyContin Addiction

Nasal Damage

Nasoseptal and palatal necrosis is a physical sign of OxyContin addiction because repeatedly inhaling crushed 10-80mg tablets to bypass the 12-hour sustained release mechanism restricts blood flow to the nasal tissues and causes chronic inflammation [2][3].

Greene (2005) studied a 37-year-old man with complaints of congestion, postnasal drip, sinusitis symptoms (e.g. green mucus), and reflux of liquid into the back of the nose after abusing OxyContin intranasally:

Physical/Oral examinations and a CT scan revealed a saddle nose deformity secondary to a collapse of the dorsum, and complete absence of the cartilaginous septum, a cavity within the nose, and extensive erosion of the turbinates
The patient declined surgical treatment, although otolaryngologic care is usually required for the reconstruction of damaged nasal structures (e.g. septum) after intranasal OxyContin abuse [2]

OxyContin abuse leads to nosebleeds, a diminished sense of smell, and a hoarseness of the voice due to the drug's rapid delivery into the circulating blood (within 5 minutes of use) and high intranasal bioavailability (54 - 101%) when sniffing the powder from pills [4].

Dental Erosion Patterns

Dental erosion patterns are a physical sign of OxyContin addiction because:

Oxycodone is an acidic substance (pKa = 8.5) that is transferred into oral fluid through the salivary gland membranes after 38% chew up to 400mg of extended-release (12-hour) pills during a single session [5][6]
The risk of needing 6 or more permanent teeth (e.g. premolars) removed increases by 26% after using OxyContin ≥ once per month due to tooth decay, gum disease, or infection caused by xerostomia (dry mouth) and salivary hypofunction [7]

Fraser et al. (2017) studied a 26-year-old who developed cervical, occlusal, and interproximal lesions with gingival inflammation after chewing oxycodone pills daily for 3 years, resulting in frothy saliva and a loss of dorsum tongue papillae due to hyposalivation [8].

Injection Site Infections

Injection site infections are a physical sign of OxyContin addiction because microorganisms (e.g. bacteria, fungi) present in the injecting environment cause redness, swelling, cellulitis, and abscesses in up to 35% of daily OxyContin users [9].

Up to 20% develop phlebitis and embolism due to obstructions in the veins after dissolving the crushed powder from 80mg OxyContin tablets in water and injecting insoluble excipients (e.g. talc, titanium dioxide, magnesium stearate) [9].

33% of users do not use a filtering method (e.g. cigarette/cotton wool or wheel filter) when preparing oxycodone pills for intravenous use, although 3 – 10% of those who do still develop serious infections (e.g. osteomyelitis or septicemia) [9].

Psychological Signs Of OxyContin Addiction

Fixation On Doses

Fixation on dosages is a psychological sign of OxyContin addiction that leads to a 2-fold increase in writing fake prescriptions, stealing from pharmacies, hospitals, or relatives without asking to obtain enough pills to provide up to 20 uses of Oxycodone daily [8][10].

Carise et al. (2007) found that some daily OxyContin users spend over £1000 on the drug every 2 weeks to get "high" or a "buzz", despite initially taking OxyContin for legitimate medical reasons (e.g. pain relief for arthritis) [1].

Kats & Hays (2004) studied three individuals who became psychologically addicted to OxyContin within 1 - 6 months of regular use and began stealing needles from doctors offices and selling personal belongings to facilitate taking 150 – 200 mg of OxyContin daily [11].

Rationalising OxyContin Addiction Due To It Being A Prescription Drug

Rationalising OxyContin addiction due to it being a prescription painkiller is a psychological sign of OxyContin dependence because:

Up to 86% initially take prescribed OxyContin to manage chronic pain and condone taking higher than the recommended amounts (e.g. 21 pills daily) to cope with “ongoing pain problems”, despite 10% experiencing an overdose [12][28]
Around 36% use the drug ≥ 3 times per week after initially receiving a prescription for “chronic medical problems”, although 33% simultaneously access OxyContin via illicit sources (e.g. a drug dealer) for the purpose of “getting high” [1]
Up to 92% abuse prescribed OxyContin by manipulating the formulation of extended-release oxycodone for intranasal use by grinding and sniffing the powder from pills, and may rationalise drug-taking to manage “intractable back pain" [2][13]

Firestone & Fischer (2008) interviewed a 49-year-old who claimed, “I was in a car accident and went through the windshield. So, they prescribed me 2 40's [OxyContin] a day, for 3 consecutive weeks. It didn't take long before I was like, I love these now, I can't cope.” [14].

Who Is More Likely To Develop An OxyContin Addiction?

Demographic	Why?
30 - 60 year old's	Extramedical OxyContin use is 41% higher in over 35s compared to 12 - 17 y/o [10] The average age of patients in treatment for OxyContin addiction is 36 y/o [1] 40 - 64 y/o are 43x more likely than 18 - 24 y/o to develop an Opioid Use Disorder (OUD) [15]
Chronic Pain	Chronic pain increases the risk of developing a prescription OUD by 41% within 3 years [16] 22% of heavy OxyContin abusers (≥ 3x weekly for 1 year) are initially prescribed the drug for pain relief [1]
Pre-existing Mental Health Disorders	Having anxiety, depression, or psychosis increases the risk of developing an OUD by 3-fold [15] OxyContin abusers are 2x more likely to have anxiety or depression compared to other opioid analgesic users (e.g. morphine) [10]
Polydrug Abuse	Co-occurring alcohol, marijuana, or cocaine abuse increases the odds of developing an OUD by 6-fold [15] 46 - 77% of OxyContin abusers have a history of abusing amphetamines, cocaine, or heroin [1]

Long-Term Health Complications Of OxyContin Addiction

Bowel Damage

Haemorrhoids are a long-term health complication of OxyContin addiction because 23% experience constipation due to delayed gastric emptying, spasms of the sphincter of Oddi, and the suppression of intestinal motility after regularly taking 10 – 160mg pills [17].

Daily OxyContin users experience chronic constipation due to a 25% reduction in complete spontaneous bowel movements within 5 weeks of taking 100 – 160mg prolonged-release formulations of Oxycodone, increasing the risk of haemorrhoids by 4-fold [18][19].

Symptoms of bowel dysfunction (e.g. constipation, feelings of incomplete bowel evacuation) increase by 45% within 1 week of taking 20mg of OxyContin daily, and in some cases, long-term abuse (e.g. ≥ 3x weekly for 9 years) leads to bowel perforation [1][20].

Hormonal Dysfunction

Reduced fecundability (fecundability odds ratio = 0.71) is a long-term health complication of OxyContin dependence because [21]:

Testosterone and oestrogen levels are reduced by up to 52% after taking between 60 – 400mg of sustained-action Oxycodone for an average of 2 years [22]
Long-term use (≥ 90 days) of long-acting opioids (e.g 12 hours) increases the risk of amenorrhoea (absent menstruation) and oligomenorrhoea (< 9 menstrual periods per year or at least 35 days in between menstrual periods) by 13% [23]

18 - 55-year-old women who take OxyContin for 3 months or longer have a 16% increased risk of experiencing menopausal symptoms (e.g. hot flashes, vaginal dryness, low libido) within a 5-year period [23]

Kidney And Liver Strain

Cholestatic hepatitis is a long-term health complication of OxyContin addiction because 45% of the drug's total quantity is metabolised through the CYP3A4/5 pathway, and the pill’s hydrophobic ingredients (e.g. magnesium stearate) accumulate in the liver, resulting in [24]:

Jaundice and Biliary calculi (Gallstones) caused by increased bilirubin levels (140 μmol/L vs normal levels = <20 μmol/L) after consuming 80mg of OxyContin daily
Drug-induced hepatotoxicity marked by elevated liver enzymes, including alanine aminotransferase (ALT) at 295 u/L (normal levels < 45 u/L) and aspartate aminotransferase (AST) at 149 u/L (normal levels < 40 u/L) [25]

Robson et al. (2017) studied a 35-year-old with deteriorating renal function (creatinine = 242 umol/L) and recurrent anaemia (haemoglobin = 85 g/L), although renal function normalised after 6 months of abstaining from intravenous OxyContin use [26].

How Does OxyContin Addiction Develop?

	Addiction through prescribed use	Addiction through Recreational Use	Addiction through Self-Medication
Previously opioid naïve, leading to addiction?	Yes	No, 92% have previously used ≥ 1 other opioid (e.g. heroin) [1]	In some cases, other prescription opioids (e.g. Percocet) may be used first [11]
Underlying trauma of illness/chronic pain leading to addiction?	Yes, 22% abuse prescribed OxyContin intended for pain relief [1]	No, 86% use ≥ 3x weekly just to create a “buzz” [1]	In some cases, also used by up to 28% to self-treat anxiety/depression [12]
Used as a substitute for heroin/ other illicit opioids?	No	Yes, referred to as “poor man’s heroin” [11]	Yes, up to 34% use when heroin is unavailable [12]
Patterns of denial?	Yes, some condone taking 20+ tablets daily due to “ongoing pain” [12]	No	Yes, excused due to mistrust in patients who believe pain is dismissed by physicians [12]

OxyContin Vs Oxycodone Addiction

	OxyContin Addiction	Oxycodone Addiction
Controlled release or immediate release?	Controlled, with a 12-hour duration of action (TΩ = 6.2 hrs) [3]	Immediate, typically prescribed in 5mg doses (TΩ = 3.5 hrs) [17]
Reason for prescription	To provide relief for moderate/severe persistent pain caused by injuries, arthritis, or cancer	Short-term management of severe acute pain (e.g. post-operative)
Method of abuse	69% crush and snort up to 400mg of extended-release tablets per session [6] Smoked or injected by 17 - 19% [1][6]	83% crush and snort around 60mg of immediate-release tablets per session [6]
Underlying Causes of Addiction	22% become addicted after receiving a prescription for chronic pain [1] Depression and suicidality in up to 51% [1]	Up to 86% use to cope with chronic pain or past trauma (e.g. sexual abuse) [12] Up to 28% use to self-treat anxiety/depression [12]
Withdrawal Symptoms	Deep muscle aches + Hot/cold flashes Rebound emotional sensitivity + Obsessive fear of pain returning Onset: 24 - 72 hours after last use	Diarrhoea + Abdominal pain Dilated pupils + Restlessness + Irritability Onset: 6 - 12 hours after last use
Risk of Overdose	10% overdose + intravenous use increases the risk by 10-fold compared to intranasal use [27][28]	0.4% overdose + daily abuse of 5mg tablets increases the risk of overdose by 65% [29]
Denial?	Yes, some condone daily use to manage chronic pain, despite having co-occurring alcohol addictions [1]	Yes, some claim, “Makes me normal. Without it, I can't get out of bed.” [14]

References

[1] Carise, Deni, et al. “Prescription OxyContin Abuse among Patients Entering Addiction Treatment.” American Journal of Psychiatry, vol. 164, no. 11, Nov. 2007, pp. 1750–56. Accessed 11 June 2025." OxyContin, which is typically prescribed for chronic pain in doses ranging from 10 to 80 mg. If used as prescribed, the opioid in OxyContin is slowly released over 12 hours, ... They reported using only OxyContin and used the medication only to “get high.” They used OxyContin an average of 14 days prior to admission, spending an average of $1,737 on the drug during that period."
[2] Greene, David. “Total Necrosis of the Intranasal Structures and Soft Palate as a Result of Nasal Inhalation of Crushed OxyContin.” Ear, Nose & Throat Journal, vol. 84, no. 8, Aug. 2005, pp. 512–16. Accessed 11 June 2025.“A 37-year-old man presented with complaints of nasal deformity, congestion, postnasal drip, sinusitis symptoms, and reflux of liquid into the back of his nose, ... He admitted to extensive intranasal abuse of crushed OxyContin, ... presented with total necrosis of the septum, sinuses, and soft palate.”
[3] Therapeutic Goods Administration (TGA). PRODUCT INFORMATION OxyContin ® Tablets (5 Mg, 10 Mg, 15 Mg, 20 Mg, 30 Mg, 40 Mg and 80 Mg). 25 Nov. 2010. Accessed 11 June 2025.“The absorption of oxycodone from OxyContinÆ tablets is biphasic, with an initial absorption of approximately 40% of the active drug (TΩ = 0.6 hrs) providing onset of analgesia within 1 hour in most patients, followed by a more controlled absorption, which determines the 12 hour duration of action (TΩ = 6.2 hrs).”
[4] Lofwall, M. R., et al. “Pharmacokinetics of Intranasal Crushed OxyContin and Intravenous Oxycodone in Nondependent Prescription Opioid Abusers.” The Journal of Clinical Pharmacology, vol. 52, no. 4, Apr. 2012, pp. 600–6. Accessed 11 June 2025.“Compared with IV oxycodone, the mean IN bioavailability of crushed OxyContin was 78.2% ± 17.8% and 75.0% ± 15.5% in the 15 mg/70 kg and 30 mg/70 kg conditions, respectively; these 2 values did not differ significantly. The range across both IN doses was from 54% to 101%, ... Intranasal bioavailability of crushed OxyContin tablets in this study (~77%) exceeds its oral bioavailability estimated at approximately 60%.”
[5] Tarja Heiskanen, et al. “Opioid Concentrations in Oral Fluid and Plasma in Cancer Patients with Pain.” Journal of Pain and Symptom Management, vol. 50, no. 4, Elsevier BV, Oct. 2015, pp. 524–32. Accessed 11 June 2025.“All three opioids are weak bases (pKa 8.5, 8.1, and 8.4 for oxycodone, morphine, and fentanyl), ... Drugs are transferred into the OFL through the salivary gland membranes by passive diffusion.”
[6] Osgood, Eric D., et al. “A Brief Survey to Characterize Oxycodone Abuse Patterns in Adolescents Enrolled in Two Substance Abuse Recovery High Schools.” The American Journal of Drug and Alcohol Abuse, vol. 38, no. 2, Jan. 2012, pp. 166–70. Accessed 23 June 2025.“Table 2.”
[7] D’Amore, Meredith M., et al. “Oral Health of Substance-Dependent Individuals: Impact of Specific Substances.” Journal of Substance Abuse Treatment, vol. 41, no. 2, Sept. 2011, pp. 179–85. Accessed 11 June 2025.“Table 3.”
[8] Fraser, Andrew D., et al. “Prescription Opioid Abuse and Its Potential Role in Gross Dental Decay.” Current Drug Safety, vol. 12, no. 1, Feb. 2017, pp. 22–26. Accessed 11 June 2025.“The patient admits to consuming approximately twenty tablets per day (on average 6.5 g of acetaminophen and 100 mg of oxycodone a day), ... The patient presented clinically with signs synonymous with hyposalivation such as 1) sticking of the dental mirror to the buccal mucosa, 2) frothy saliva.”
[9] Peacock, A., et al. “Barriers to Harm Reduction: Heating and Filtration of Oxycodone Tablets prior to Intravenous Use by People Who Inject Drugs in Australia.” National Drug and Alcohol Research Centre. University of New South Wales, Jan. 2014. Accessed 11 June 2025.“Table 3.”
[10] Martins, Silvia S., et al. “Correlates of Extramedical Use of OxyContin® versus Other Analgesic Opioids among the US General Population.” Drug and Alcohol Dependence, vol. 99, no. 1-3, Jan. 2009, pp. 58–67. Accessed 12 June 2025.“Table 4.”
[11] KATZ, DEBRA A., and LON R. HAYS. “Adolescent OxyContin Abuse.” Journal of the American Academy of Child & Adolescent Psychiatry, vol. 43, no. 2, Feb. 2004, pp. 231–34.“Patient 1 became addicted to OxyContin 6 months after her introduction to the drug, ... which escalated to 150 and then 200 mg of OxyContin per day. Behavior to obtain OxyContin often escalates quickly and can involve serious high-risk behaviors such as using stolen needles, neglecting medical care (e.g., insulin treatment), and stealing from doctors and family members.”
[12] Brands, Bruna, et al. “Prescription Opioid Abuse in Patients Presenting for Methadone Maintenance Treatment.” Drug and Alcohol Dependence, vol. 73, no. 2, Feb. 2004, pp. 199–207. Accessed 12 June 2025.“Table 1 - 5.”
[13] Gasior, Maciej, et al. “Routes of Abuse of Prescription Opioid Analgesics: A Review and Assessment of the Potential Impact of Abuse-Deterrent Formulations.” Postgraduate Medicine, vol. 128, no. 1, Dec. 2015, pp. 85–96. Accessed 12 June 2025.“For extended-release oxycodone, 92% reported manipulating the formulation for intranasal administration.”
[14] Firestone, Michelle, and Benedikt Fischer. “A Qualitative Exploration of Prescription Opioid Injection among Street-Based Drug Users in Toronto: Behaviours, Preferences and Drug Availability.” Harm Reduction Journal, vol. 5, no. 1, Oct. 2008, p. 30. Accessed 12 June 2025.“‘I was in a car accident. I went through the windshield. So, they prescribed me 2 40’s [OxyContin] a day, for three consecutive weeks. It didn’t take long before I was like, I love these now, I can’t cope...’ (Female, age 49).”
[15] Oladunjoye, Adeolu O., et al. “Trends of Opioid Use Disorder and Associated Factors in Hospitalized Patients with Arthritis.” Cureus, Sept. 2020. Accessed 12 June 2025.“After adjusting for other variables, mental health (OR 2.50 (2.43-2.58)), and substance use (OR 6.39 (6.14-6.66)) disorders were associated with increased odds of OUD.”
[16] Blanco, Carlos, et al. “Pain as a Predictor of Opioid Use Disorder in a Nationally Representative Sample.” American Journal of Psychiatry, vol. 173, no. 12, Dec. 2016, pp. 1189–95. Accessed 12 June 2025. “The path for pain interference was associated with a 41% relative increase in the risk of developing a prescription opioid use disorder.”
[17] Purdue Pharma L.P. OxyContin Is an Opioid Agonist and a Schedule II Controlled Substance with an Abuse Liability Similar to Morphine. 5 Nov. 2007. Accessed 23 June 2025.“Table 3.”
[18] D. Dupoiron, et al. “A Phase III Randomized Controlled Study on the Efficacy and Improved Bowel Function of Prolonged‐Release (PR) Oxycodone‐Naloxone (up to 160/80 Mg Daily) vs Oxycodone PR.” European Journal of Pain, vol. 21, no. 9, Wiley-Blackwell, June 2017, pp. 1528–37. Accessed 12 June 2025.“The number of CSBM in the OXN PR group approximately doubled compared with a 25% decrease in the OxyPR group.”
[19] Kibret, Anteneh Ayelign, et al. “Prevalence and Associated Factors of Hemorrhoids among Adult Patients Visiting the Surgical Outpatient Department in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.” PLOS ONE, edited by Y Zhan, vol. 16, no. 4, Apr. 2021. Accessed 12 June 2025.“The odds of having hemorrhoid was 4.32 times higher among participants who had constipation as compared to their counterparts (AOR = 4.32, 95%CI; 2.20, 8.48).”
[20] Kokki, Merja, et al. “Opioid-Induced Bowel Dysfunction in Patients Undergoing Spine Surgery: Comparison of Oxycodone and Oxycodone-Naloxone Treatment.” Advances in Therapy, vol. 34, no. 1, Dec. 2016, pp. 236–51. Accessed 12 June 2025.“Table 3.”
[21] Flannagan, Kerry S., et al. “Is Opioid Use Safe in Women Trying to Conceive?” Epidemiology, vol. 31, no. 6, Aug. 2020, pp. 844–51. Accessed 13 June 2025.“In our primary analysis, opioid use at baseline was associated with reduced fecundability (FOR: 0.71; 95% CI: 0.50, 1.0), ... . An FOR <1 indicates decreased fecundability or a longer time to pregnancy.”
[22] Daniell, Harry W. “Opioid Endocrinopathy in Women Consuming Prescribed Sustained-Action Opioids for Control of Nonmalignant Pain.” The Journal of Pain, vol. 9, no. 1, Jan. 2008, pp. 28–36. Accessed 13 June 2025.“Table 3.”
[23] Richardson, E., et al. “Increased Risk of Reproductive Dysfunction in Women Prescribed Long-Term Opioids for Musculoskeletal Pain: A Matched Cohort Study in the Clinical Practice Research Datalink.” European Journal of Pain, vol. 22, no. 9, June 2018, pp. 1701–8. Accessed 13 June 2025.“Long-term opioid use was associated with an increased risk of altered menstruation (Hazard Ratio 1.13 95% CI 1.05 – 1.21); and with an increased risk of menopause (Hazard Ratio 1.16 95% CI 1.10 – 1.23).”
[24] Huddart, Rachel, et al. “PharmGKB Summary: Oxycodone Pathway, Pharmacokinetics.” Pharmacogenetics and Genomics, vol. 28, no. 10, Sept. 2018, p. 1. Accessed 13 June 2025.“Oxycodone is primarily metabolized in the liver by CYP3A4/5, which mediates the N-demethylation of oxycodone to noroxycodone. Around 45% of a total dose of oxycodone is metabolized through this pathway.”
[25] Ho, Vincent, et al. “Cholestatic Hepatitis as a Possible New Side-Effect of Oxycodone: A Case Report.” Journal of Medical Case Reports, vol. 2, no. 1, May 2008. Accessed 13 June 2025. “He had been taking only controlled release oxycodone at the doses of 40 mg in the morning and 20 mg at night every day, ... His admission bilirubin level was recorded at 140 μmol/L (<20 μmol/L).”
[26] Robson, Kate J., et al. “Thrombotic Microangiopathy Associated with Intravenous Injection of Extended-Release Oxycodone.” BMJ Case Reports, July 2017. Accessed 23 June 2025.“The patient disclosed that he had been regularly injecting oral formulation tamper-resistant Oxycontin, informally obtained from another person to whom it was prescribed, ... was readmitted 6 weeks later to investigate recurrent anaemia and deteriorating renal function (creatinine 242 umol/L).”
[27] MEIER, BARRY. “Overdoses of Painkiller Are Linked to 282 Deaths.” Federal Study Details Misuse of OxyContin, Oct. 2001. Accessed 23 June 2025.“OxyContin is suspected of playing a role in the overdose deaths of 282 people in the last 19 months, ... the overdose deaths were previously believed to have been of people who injected or snorted crushed pills.”
[28] Yarborough, Bobbi Jo H., et al. “Understanding Opioid Overdose Characteristics Involving Prescription and Illicit Opioids: A Mixed Methods Analysis.” Drug and Alcohol Dependence, vol. 167, Oct. 2016, pp. 49–56. Accessed 23 June 2025.“Table 2.”
[29] Weiner, Scott G., et al. “Opioid-Related Overdose and Chronic Use Following an Initial Prescription of Hydrocodone versus Oxycodone.” PloS One, vol. 17, no. 4, Apr. 2022. Accessed 23 June 2025.“The risk of first-year chronic use after an initial opioid prescription was lower with oxycodone compared to hydrocodone (aOR 0.95, 95% CI 0.91–1.0) but the risk of opioid overdose was markedly higher following oxycodone (aHR 1.65, 95% CI 1.45–1.87).”

About the author

Mischa Ezekpo

Mischa Ezekpo has a Bachelors degree in Psychology from Northumbria
University, and a Masters degree in Childhood Development and
Wellbeing, from Manchester Metropolitan University. Since 2018, Mischa
has written and published work on Addiction, Mental Health, Depression, and Eating Disorders. Content reviewed by Laura Morris (Clinical Lead).

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Last Updated: October 31, 2025