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Oxycodone’s Unparalleled Addictive Potential: Is it Time for a Moratorium?

  • Other Pain (A. Kaye and N. Vadivelu, Section Editors)
  • Published:
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Abstract

Purpose of Review

This study and literature review were carried out to investigate whether oxycodone is the most addictive prescription opioid.

Recent Findings

This was a cross-sectional survey from a pain management practice in south-central Alaska and review of the literature involving 86 patients diagnosed with opioid dependence/opioid use disorder from 2013 to 2018. Patients were given a list of prescription opioids and asked to identify the one (1) most desirable to themselves, (2) most desirable among drug-using associates or community, and (3) they deemed most addictive. Patients with a history of heroin use were asked which, if any, served as their gateway drug to heroin. The literature was reviewed using a PubMed search for articles containing the words “oxycodone” and “abuse,” “addiction,” “dependence,” “disorder,” and “euphoria.” Oxycodone was ranked most highly in all four questions (n = 50, 60.2%; n = 46, 75.4%; n = 38, 60.2%; n = 14, 77.8%, respectively) by a wide margin.

Summary

Numerous observational studies performed over the past few decades have demonstrated the supreme “likability” and abuse and dependence liability/addictiveness of oxycodone, with more recent mechanistic studies illuminating biological underpinnings including markedly increased active transport across the blood-brain barrier, increased phasic dopaminergism in the ventral tegmental area, nucleus accumbens and related striatal reward centers, and possibly increased kappa opioid receptor-mediated withdrawal dysphoria. Oxycodone possesses pharmacologic qualities that render it disproportionately liable to abuse and addiction and the risks of any long-term prescription outweigh the benefits.

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  1. Northern Anesthesia and Pain Medicine, LLC, 10928 Eagle River Rd. #240, Eagle River, AK, 99577, USA

    Daniel Remillard & Heath McAnally

  2. Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Alan David Kaye

  3. Department of Anesthesia and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA

    Heath McAnally

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Heath McAnally and Daniel Remillard declare no conflict of interest. Alan Kaye is on the speaker bureau for Merck and Depomed, Inc.

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Remillard, D., Kaye, A.D. & McAnally, H. Oxycodone’s Unparalleled Addictive Potential: Is it Time for a Moratorium?. Curr Pain Headache Rep 23, 15 (2019). https://doi.org/10.1007/s11916-019-0751-7

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