What’s the Difference Between Taking OxyContin Whole and Crushed?
The drug label for OxyContin (oxycodone hydrochloride) has a black box warning that states that using OxyContin exposes users to the risk of addiction, abuse and misuse.1 Misusing/abusing prescription opioids like oxycodone means:2
- Taking someone else’s medication.
- Taking a medication with the intent to get high.
- Taking a medication in a way other than prescribed.
Unfortunately, it’s very common for people who are abusing and/or addicted to opioids such as OxyContin to crush up the drug and take it in ways other than intended. Such misuse of OxyContin increases the risk of overdose and death, as well as the likelihood of other serious health issues.1
OxyContin was reformulated in 2010 to deter misuse that involved crushing or dissolving the tablets;3 however, misuse of oxycodone and all other prescription opioids by both traditional and alternate routes of administration remains a national concern.4,5
Why Do People Crush Oxycodone?
Those who are attempting to quickly experience a powerful high will sometimes crush up oxycodone and then snort the powder or dissolve it in liquid and inject it.2,6 Some people also smoke oxycodone by crushing pills and heating them up on tin foil and inhaling the smoke through a straw, though snorting and injecting seem to more common.7-9
Often, people will switch their methods of use over time as their problem with opioids grows. For example, they may begin by abusing prescription opioids orally and then later begin to snort or inject them.4
Changing the route of administration of a drug like oxycodone can produce a quicker onset of effects and a greater high.10 However, it can also increase the risk of overdose. This risk is especially high when a user tampers with an extended-release formulation of oxycodone, such as OxyContin.1
Dangers of Crushing OxyContin
Oxycodone is prescribed in both immediate-release (IR) and extended-release (ER) formulations: IR formulations begin to release the opioid into the body shortly after it is taken orally, while the ER formulations are designed to release the full dose of the drug into the body slowly over the course of many hours.11 OxyContin is an extended-release formulation, and it only works as expected when the drug is taken as prescribed (by mouth as a whole tablet).1
Tampering with extended-release OxyContin by crushing it up is very dangerous because it allows for the immediate release of a large dose of medication that is meant to be released in the body over an extended period. The drug label for OxyContin specifically states that the drug should be taken whole and never cut, broken, chewed, crushed or dissolved and indicates that doing so could result in a fatal overdose.1
Risks of Snorting, Smoking or Injecting Oxycodone
Changing a drug’s route of administration in a manner that magnifies or concentrates its pharmacologic effects may not only increase the drug’s reinforcing high but can increase a person’s risk of opioid tolerance, addiction, and overdose.1,4,12 In addition to these serious risks, each method of abuse comes with its own unique dangers.
Dangers of Snorting Oxycodone
Snorting oxycodone and other opioids can cause health problems that include:6,13-16
- Nasal irritation and pain.
- Excessive production of mucous.
- Tissue death in the soft palate or other areas of the nasopharynx.
- Damage to or complete destruction of the nasal septum (the piece of cartilage that divides the nostrils).
- Fungal infections.
- Increased risk of transmitting bloodborne diseases (e.g., HCV and HIV) through shared tools used for snorting such as straws.
Dangers of Injecting Oxycodone
Injecting OxyContin and other opioid drugs can cause many health problems that include:6,17,18
- Increased risk of HIV, HCV and other infectious disease transmission.
- Bacterial infections, including infection of the heart lining (i.e., endocarditis), cellulitis (a fast-spreading skin infection), bone infections and sepsis.
- Fungal infections.
- Localized pockets of infection (i.e., skin abscesses).
- Track marks and scarring of the skin.
- Deep vein thrombosis (injection-related blood clots).
Dangers of Smoking Oxycodone
Smoking oxycodone can result in respiratory complications that include:19
- Shortness of breath.
- Chronic cough.
- Chronic bronchitis.
Though it may be relatively uncommon in the context of all other methods of misuse, the smoking of various types of prescription drugs (including opioids like oxycodone) has been observed in socially active youth, some of whom may have escalated to smoking from another route of administration such as oral consumption. This escalation to smoking has been linked to an increased risk of severe opioid dependence and drug-related problems.8
Is it Safe to Take Oxycodone Orally?
It is safe to oxycodone only exactly as prescribed (which, in addition to its intended oral use, includes parameters for the dose and how often it should be taken). Taking too much oxycodone by any means can result in an overdose, and any abuse of the medication by any method of administration—even oral—can increase your risk of becoming addicted to the drug.1,2
Oxycodone abuse/misuse means taking it in any way other than prescribed. Chewing the extended release tablets, or dissolving them into liquid prior to drinking constitutes an oral route of administration, but is still clearly misuse. Conversely, even if you’re not crushing it or tampering with the tablets prior to swallowing them, you are still misusing them if you’re taking more than directed or you’re taking them without a legitimate medical need.1,2
Even if you take an opioid drug like OxyContin orally in the prescribed dose, you can still overdose if you misuse the medication by taking it with other substances that slow the breathing, such as benzodiazepines or alcohol.1
Oxycodone Addiction Treatment
People who change their drug delivery methods, such as moving from oral ingestion to smoking or snorting opioids, may put themselves at a greater risk of overdose, dependence, addiction, and death.1,4 If you’re unable to stop abusing oxycodone via any means, it’s time to seek help.