Opana (oxymorphone) has become one of the most infamous opioids on the market today, most known to those outside of the addiction community for its role in an unprecedented HIV outbreak in rural Indiana.
And while this incident alone is a powerful indicator of some of the risks associated with oxymorphone abuse and addiction, there are a number of other side effects of misusing this prescription drug that make it even more dangerous than you might think.
Opana is a brand name for the opiate analgesic oxymorphone and is used to treat moderate to severe around-the-clock pain. Opana itself comes in both an immediate release as well as an extended release tablet.
Other brands, however, such as Numorphan are administered via injection and are often used to treat labor pains or may be given before surgery along with a general anesthetic.
Opana belongs to a class of drugs called opioids. These powerful substances can be especially dangerous when used long term as they carry a high probability of addiction when used incorrectly as well as a significant risk of abuse.
A few other drugs that are opioids are heroin, Fentanyl, OxyContin, and opium.
Given the addictive potential of oxymorphone, it’s categorized as a Schedule II substance by the Drug Enforcement Agency and can only be legally obtained through a licensed and practicing physician.
Like other opioids, Opana interacts directly with the mu-opioid receptors found in the brain. These specialized receptors help regulate certain bodily processes such as mood and pain relief.
The structure of these receptors aligns perfectly with the brain’s own opioids, enkephalins and endorphins, which are released naturally. Opioids like oxymorphone, however, mimic the physical and chemical structure of these chemicals but when they attach themselves to the opioid receptors, they stimulate them to a much greater degree.
When abused at especially high levels, these opioids can create intense feelings of euphoria and pain relief as well as tranquility and deep sedation. Part of the cause of this pleasure can be attributed to an intense rush of dopamine into the reward systems of the brain, according to the National Institute on Drug Abuse (NIDA).
What’s more, opioids have been proven to have an effect on another one of the brain’s primary neurotransmitters called serotonin. This chemical is instrumental in regulating mood, sleep, memory, and may play a significant role in addiction and withdrawal.
Opana has recently received a fair amount of media attention, particularly for its role in helping cause one of the largest HIV outbreaks in recent history.
In 2015, Scott County, Indiana saw an unprecedented outbreak of HIV cases. The New York Times reports that in a county which rarely saw a single case in an entire year, 2014 saw five positive cases in the last few months of the year.
By mid-January, eight more people tested positive for the immune disease. On March 24th, 2015, the number of new HIV cases had risen almost to 90. As of Dec. 9th, 2016, there had been 210 confirmed cases of HIV with 95% of those infected also testing positive for hepatitis C.
How did a problem like this develop so quickly? How does a single county’s rate of HIV infection jump to more than half a percent higher than the average of the rest of the country in just one year?
The culprit, it turns out, was Opana. While this drug used to be abused by crushing and snorting it, a new formulation of Opana replaced the old one in 2012 and made it harder to grind it into a powder.
Residents of the county soon learned, however, that this new formula could actually be dissolved and injected instead. Given the county’s rural nature, clean needles were hard to come by and, as a result, HIV began spreading like wildfire.
One of the more interesting aspects of the story is how the officials in charge actually put a stop to the spread of this life changing disease.
At-the-time governor and Vice President Mike Pence, a staunch republican with uncompromising ideals, was faced with a very serious question: how do we stop the spread of HIV in this community?
After reaching out to experts at agencies like the CDC, he was told that by far the best way to mitigate the damage of such an outbreak was to legalize a needle exchange program. At the time, such programs were outlawed entirely in the state.
However, Pence and a number of health officials with legislative sway were deeply opposed to the idea. After all, wasn’t a needle exchange just enabling further abuse?
After taking a look at the research though, Pence finally acquiesced and signed an executive order to begin a needle exchange program. This shift in legislation along with aggressive community outreach helped turn the tide of the outbreak permanently.
While the story is certainly a triumph for the harm-reduction approach to addiction, it’s also a great example of how being stuck in the past can and does ruin lives.
Pence waited a full two months before issuing the executive order to legalize needle exchanges – during which time a significant number of new cases had likely developed. Had there been no question that addiction was a disease rather than a moral failing, they could have put an end to the outbreak almost immediately.
And it’s a fair question. After all, a whopping 75% of heroin users report that their first opioid experience was with a prescription drug.
The simple answer to this question is: you can develop a dependency faster than you think. The hard data is sparse on this question as so many different individual factors go into developing an addiction but in general, many practitioners believe that dependency can develop within just two weeks.
It’s worth remembering, though, that the risk of dependency scales with the dosage and the level of abuse. An especially prolific Opana abuser may find themselves hooked on the drug after just a week while the more conservative patient may use it for months at a time without suffering withdrawals.
In the end, it depends upon the individual, their exposure to other substances, their habits, their history of abuse, and many other factors as well.
If you’re worried about becoming dependent on oxymorphone though, it’s important that you openly discuss your concerns with your doctor. You may help influence his or her treatment suggestion and could even open up non-opioid treatment options that you weren’t aware of.
While discussing your condition with your prescribing physician is often the best way to help you determine if you’ve actually developed an Opana addiction, you can also take matters into your own hands as well.
For instance, there are a number of self-assessment tools available today that can help you look at your own behaviors objectively and figure out if you need to seek further help from a qualified professional.
Taking online addiction assessments such as a short quiz is one of the quickest ways of determining your level of addiction and dependency. It’s simple, helpful, and ultimately a pain-free first step you can take on your road towards sobriety.
For the more detail-oriented among you, you can also use the official substance use disorder guidelines developed by the Diagnostic and Statistical Manual of Mental Disorders as well. This comprehensive questionnaire includes 11 criteria that practicing physicians and psychiatrists use to diagnose substance addiction.
In the end though, no matter which assessment tool you go with, you’re still showing that you’re willing to take the first steps in actually confronting your addiction. And that is often the hardest step of all.
Like many other opioids, oxymorphone has a particularly long list of short-term side effects in addition to the ones that are the reason for taking the drug in the first place. And unlike the euphoria and pain relief that some users experience when taking this drug, the other side effects aren’t quite as enjoyable.
According to Drugs.com they include:
These short-term effects are just some of the more common ones too. Plus, the severity of the symptoms often depends on the degree of abuse as well. As such, the symptoms of a hardcore oxymorphone addict will likely be much worse than those of someone who only abuses this drug occasionally.
Beyond that, one of the most notable short-term abuse side effects is the risk of overdose which can lead to permanent damage as well as potentially fatal outcomes.
As with any other opioid, whether it be heroin or even methadone, overdosing on oxymorphone can end up being fatal. Opioids are notorious for depressing respiration as well as other bodily functions and when taken at high doses they can slow your breathing to an absolute stop.
The threat of overdose and ultimately the overall danger of overdosing is compounded even further when opioids like Opana are combined with other central nervous system (CNS) depressants like benzodiazepines and sleeping medications.
This is particularly true when it comes to mixing opioids with alcohol. Studies have shown that there is a significant increase in risk of dangerous levels of respiratory depression when the two substances are used in combination. What’s more, this risk is particularly pronounced in the elderly.
The main point here is that opioids are already deadly enough on their own. When you add other substances like alcohol or benzodiazepines into the picture too, you’ve got one dangerous cocktail that may end up taking your life.
No matter how severe the overdose may be, there is one very important rule of thumb – time is of the essence. For every second that oxygen isn’t flowing to the brain, that a toxic amount of a drug stays in the system, or even that a person stumbles along uncoordinated, the risk of permanent and potentially fatal damage increases.
What’s more, opioid overdose can also lead to symptoms like seizures and coma as well.
Similar to other opioids like it, oxymorphone also has a wide variety of long-term effects, some of which can be quite devastating both physically and psychologically.
Another recent study outlined some additional long-term effects of abusing oxymorphone on a regular basis. Researchers found that using opioids like Opana for more than just 30 days could result in new-onset depression, possibly caused by “changes in neuroanatomy and low testosterone,” according to the study.
According to the National Institute on Drug Abuse (NIDA), researchers are also looking into connections between protracted use of opioids like oxymorphone and permanent brain damage.
The depressed respiration that’s so common in opioid abuse may actually be lead to less oxygen getting to the brain than what it requires. This condition is also known as hypoxia and it can have serious psychological and neurological effects.
Long-term opioid addiction in general may also decrease the amount of white matter in the brain, possibly affecting “decision-making abilities, the ability to regulate behavior, and responses to stressful situations” according to NIDA.
Withdrawals from oxymorphone can be incredibly uncomfortable. In fact, many substance abusers claim that detoxing from opioids like Opana is worse than trying to get off any other drug on the market today with the exception of benzodiazepines.
And with this especially long list of symptoms provided by Mental Health Daily, it’s easy to see why:
To make matters even worse, the withdrawal timeline for oxymorphone and other opioids can end up being particularly long for the immediate and protracted phases, up to three weeks for some opioids. The combination of the especially uncomfortable side effects of Opana detoxification as well as the long timeline lead many opioid addicts to eventually relapse.
Some oxymorphone abusers also report feeling a number of especially long-lasting symptoms after detoxing from Opana.
While opioid withdrawals can be especially hard to bear and often end up lasting for at least several weeks, these other symptoms are different – they include mostly psychological effects including:
What’s more, this collection of symptoms has been reported in users for multiple years, not just weeks or even months at a time.
Those in the addiction community have coined a term for this especially protracted and mostly psychological withdrawals – post-acute withdrawal syndrome or PAWS. While its existence is still up for debate among physicians, there are thousands of recovering addicts that adamantly agree that PAWS is a very real disorder.
Some physicians have found that treating PAWS with medications like naltrexone has brought about at least minor successes but in general, time is often the only antidote for this frustrating and lengthy aspect of addiction.
Oxymorphone has become one of the most widely abused prescription medications available today. And given the especially damaging side effects (both short- and long-term) that this substance of abuse can bring along with it, this opioid pain reliever is ultimately one drug that simply isn’t worth the risk.
If you or someone you know is suffering from an Opana addiction, it’s absolutely essential that you get the help of an addiction professional today. The rest of your probably depends on it.