Critics wonder about the timing of the switch since they just offered the new version in April 2010, two years ago. According to a recent news article, it is extremely coincidental for a new product to be introduced to market just a few months before a patent expires and the generic version appears, said Dr. Dave Juurlink, medical toxicologist in Canada.

Juurlink has great concern over the growing abuse of the drug OxyContin. Purdue denies claims that it delayed the coming out of the new version, saying they have worked meticulously to introduce OxyNEO as quickly as they could.

Controversy has surrounded OxyContin since its introduction in 1996 in Canada. It has been called Purdue Pharma’s largest money maker. An official of a generic pharmaceutical firm in Canada calls Purdue’s latest move "brilliant" when it comes to marketing strategies.

York University’s School of Health Policy and Management, Dr. Joel Lexchin is blunt in his response. He believes you need to question if the new version is more about market share than concern for patient care.

Once proclaimed a "wonder" drug, its abuse soon became an epidemic that has led to overdoses, deaths and many ruined lives. In the United States, it quickly became popular in poor, rural areas and is known as "hillbilly heroine" because of this.

Purdue let government regulators know that they were creating their new version two years back but news didn’t hit the media until this year causing more hysteria over the dangers of OxyContin.

Now a new study from Canada has identified how nerve cells build up resistance to opiate painkillers, that might include morphine, codeine, oxycodone, hydrocodone, and so forth.

Opiates react with "receptors" that are found in every cell of the human body. These cells "receive" the chemical signals from the drugs and cause the cells to react in different ways. When a drug activates a receptor, a receptor moves from the surface of the cell to inside it. Once inside the cell, the receptor is destroyed or sent back to the cell surface to be used again. This is called "receptor recycling." What the Canadian research team found was that recycled receptors are less tolerant to painkillers.

"We now know that these drugs that activate the same receptor do not always produce the same kind of effect on the body, as receptors do not always recognize drugs in the same way," said Dr. Graciela Pineyro, lead author and a professor in the Department of Psychiatry and Pharmacology at the University of Montréal and the Sainte Justine Hospital Research Center. "Receptors will configure different drugs into specific signals that have different effects on the body. If we can understand the chemical mechanisms by which drugs produce therapeutic and undesired side effects, we will be able to design better drugs."

This study was funded by the Natural Sciences and Engineering Research Council of Canada and the Canadian Institutes of Health and published in the Journal of Neuroscience.

A second study of cell receptors and morphine, this time from the University of Colorado in Boulder, found that protein receptors in the central nervous system can cause unwanted neuroinflammation.

"The exciting thing about our research is that we’ve discovered that there is not just one receptor that detects morphine, there is a second one that no one knew about before," said Dr. Linda Watkins, a professor in the psychology department and lead author of the study. "We have shown this protein complex essentially cuts morphine off at the knees, preventing it from doing its job in controlling pain."

This research was funded by the National Institute of Health and published in the Proceedings of the National Academy of Science.

About 116 million Americans have chronic pain, and the bill for their treatment and lost productivity is as high as $635 billion every year, according to the Institute of Medicine of the National Academies. The United States has one of the highest use of morphine among all the other countries in the world. The population of the USA is only 4.6 percent of the world’s population, but consumes 80% of all opioids and 99% of the world’s hydrocodone, the main painkiller in Vicodin. The Centers for Disease Control says that about 12 million Americans used prescription painkillers for nonmedical reasons in 2010.

What is OxyContin?

Oxycodone, the active ingredient in Oxy, is a compound that acts on the central nervous system and in the gastrointestinal tract and is similar to morphine. Opiates like oxycodone come from the opium poppy. The latex that is extracted from the fruit of the flower contains a mix of opiate substances like morphine, codeine, and thebaine. Because of how these compounds act in the body, they are used as painkillers and to treat diarrhea. A side effect of feeling euphoric has led people to use them recreationally.

Oxycodone was first derived from thebaine in 1916 at Bayer in Germany. It was found to treat patients with less of a possibility of dependence than heroin or morphine. Oxycodone does not act as quickly, nor does its effect last as long as morphine and heroin. Besides OxyContin, other brand name drugs that contain oxycodone are Endocet, Percodan, Percocet, Roxicet, and Tylox, among others. Most of these contain oxycodone compounded with other painkillers like acetaminophen and paracetamol.

What makes OxyContin different from the other brand name oxycodone drugs is that it is a time-release formula. Each pill contains a high quantity of oxycodone and when taken correctly, releases a small amount over an extended period of time. OxyContin is also made with just oxycodone, as opposed to being diluted with other medications.

How is it used?

OxyContin is indicated for use as a prescription painkiller. Because of its time-release formula, it is designed to be taken by patients who require continuous, around the clock treatment for moderate or severe pain. It is not intended to be taken on an as needed basis. Oxy was originally targeted by drug users because when the pills are crushed, the oxycodone can be taken into the bloodstream all at once. The time-release nature of the pill is destroyed when it is crushed up to make a powder and those who abuse Oxy get the high they are after. Users typically snort the powder or inject it intravenously.

The earliest misuse of Oxy in the U.S. occurred in rural areas, especially in Appalachia, in the late 1990s. For that reason, it is also called hillbilly heroin. The formula of the Oxy pill has been changed recently to make it more difficult to crush, but abusers find other formats to feed their oxycodone addiction. Pills made by Roxane Laboratories are becoming more popular and are often called roxies, berries, blues, or 30s.

What are the signs Oxy addiction?

Fortunately, those who are prescribed and use oxycodone correctly, addiction is a rare occurrence. When taken according to directions, oxycodone is much less addictive than morphine or heroin. However, those who use it recreationally are likely to become addicted quickly. Here are some signs of Oxy addiction:

• Behavior changes. As with all addictions, people change when they are using. Signs include loss of interest in relationships, work, and hobbies, depression or anger, and sudden financial problems. In other words, anything out of the ordinary could be cause for concern.
• Insomnia. People misusing oxy often cannot sleep or sleep well for days at a time.
• Stomach upset. Someone who is in between Oxy doses may develop stomach issues like constipation, nausea, or vomiting.
• Skin changes. Oxy use causes cold flashes and goose bumps. These can occur even when it is warm or even hot.
• Bone and muscle pain. Weakness along with muscle or bone pains often accompanies Oxy abuse, especially between hits. A user may also twitch or complain of being to weak to do anything.
• Breathing difficulties. Large intakes of Oxy cause the user to experience shallow and slow breathing. They often struggle to perform tasks without getting short of breath.

What are the consequences of using OxyContin?

Those who misuse Oxy are likely to become addicted. Coming clean from it is not easy and often requires professional help. Withdrawal symptoms include overwhelming cravings, severe agitation, depression, chills, tremors, diarrhea and nausea, and serious aches and pains.

Besides addiction, there are other serious consequences of abusing Oxy, which may even lead to death. Taking Oxy is especially dangerous when taken with other central nervous system depressants like alcohol. Over time, use of Oxy can result in damaged nerve cells, irregular breathing, mood swings, confusion, drowsiness, loss of mental function, seizures, low blood pressure, slowed hearth rate, and heart failure.

When to help

You should make every attempt to intervene and help someone who shows signs of Oxy abuse. If they are not addicted yet, they could be soon and then recovery will be much more difficult.

Seek emergency help if you see signs of an overdose:

• Excessive sleepiness
• Fainting
• Difficulty breathing
• Cold and clammy skin
• A slowed or stopped heart beat
• Blue skin, lips, or fingernails

But some families have to deal with situations where things hardly ever seem to be going well. In these instances, relapse is not so much a risk as it is a way of life, as those with addictions continually go back to using, even after swearing over and over again that this time things will be different. The chances are that families facing this circumstance will have tried everything – threats, ultimatums, interventions, proclamations of support and unconditional love – but regardless of what strategies they use nothing ever seems to make a lasting impact.

It would be great if there were a simple answer for families in this situation, but the truth is that there are no magic spells to be cast, nor easy recipes to be followed. Beating substance addiction presents the challenge of a lifetime, and for some their struggle becomes so massive that it comes to feel as if they are climbing toward the summit of a mountain that rises to infinity. These are the addicts who relapse time after time, and they can drive their family members to the point of complete exasperation.

Living in the Moment

But family members of substance abusers who repeatedly relapse should not give in to feelings of helplessness. Those trying to help a loved one overcome addiction must remember that success in any endeavor can only be achieved one step at a time, or one day at a time. This is a powerful principle in any situation, and when the problem that must be solved involves substance abuse, those attempting to rescue their cherished friend or family member from the throes of addiction should first put this principle into practice by giving up on the idea of helping their loved one reach a state of permanent sobriety. This goal is simply too grand, too ambitious, which is why family members of a serial relapser must resolve to stay completely in the moment and learn to accept things as they are right now, without any illusions or thoughts of a far-off future. When things are framed in this way, it refocuses the mission so the aim becomes the development of strategies that can help make things better for the addict today, with no thoughts or concerns beyond that. Then, when tomorrow comes, the same process can start all over again, and again the following day after that, and on and on into the foreseeable future.

What does this mean in more specific terms? Basically, it means that those who are still in contact with their troubled family member should pay them daily visits, or call them on the phone frequently, to discover how things are going on that particular day and to find out what is on the addict’s mind and what specifically is going on in his or her life. Close engagement through meaningful conversation is what we are really talking about here – if the recovering addict is clean and sober, then it is important to talk about what he or she is thinking or feeling right at that moment. If the contact is taking place during a time of relapse, on the other hand, then it might be time to try and work together with your loved one, in an analytical, non-judgmental way, to see if you can assist them in figuring out what triggered the relapse, and what possibly could be done to get things back on course again.

Making Today a Good Day

Achieving sobriety is a big goal, and it is the kind of goal that can seem incredibly elusive for some people. When loved ones with addictions are overwhelmed by the immense challenge of trying to overcome them, they may ultimately end up in a cycle of repeated relapses interspersed with periods where they do manage to stop using for awhile. During this tumultuous time in their lives, they will need the help of highly-trained professional counselors, to be sure. But they will also need the help of their family members, who can help guide them calmly and rationally through the personal issues they must face.

Minute by minute, day by day, it is possible for those who care about someone dealing with addiction to make a positive impact. Patience, fortitude, and good listening skills may seem like small offerings, but for those who have gone through repeated relapses, these gifts given with love can be just the thing they need to help them reconnect with that sense of hope and optimism that is such an essential ally in the battle against the scourge of drug and alcohol addiction. Step by step starting from small beginnings, this is how big changes happen in the real world.

They studied and surveyed almost 10,000 adults in America in this first national sampling regarding the relationship between depression and sleep apnea. According to Psych Central, researchers did not find a correlation between snoring and depression.

Lead author for the study, Dr. Anne G. Wheaton, said gasping, snorting or stopped breathing while sleeping were linked with almost all depression symptoms, including feeling like a failure or feeling hopeless.

Wheaton says that although they expected the patients to report trouble with sleep issues or too much sleeping, feeling tired or having low energy they did not expect them to report other symptoms.

Earlier studies had focused on smaller groups of people in specific populations like those who suffered from depression, obstructive sleep apnea (OSA) and other health issues. Wheaton reported that the chance of having depression did increase with the incidence of snorting and/or times the person stopped breathing during the study.

If sleepiness was the main complaint, Wheaton suggested then screening for these sleep disorders to see if the other problems were present. In the future, this could help researchers address the increased prevalence and lack of diagnosis for depression and sleep apnea.

All the signs of OSA are gasping, pauses in breathing and snorting, according to experts. Of all the participants diagnosed by physicians in the study, three percent were women and six percent were men.

Obstructive sleep apnea happens when your muscles relax while you sleep and this causes the soft tissue in the rear of your throat to collapse and block your upper airway. Researchers reported their findings in this months’ journal of SLEEP.

Researchers studied almost 900 ER patients who had dangerous or harmful drinking problems. They discovered that those who received even brief counseling sessions were more likely to cut back on their binge drinking and also their overall consumption of alcohol.

When these patients visited with trained emergency practitioners they did have much lower rates of consumption, as well as drinking and driving, than those who did not receive the counseling. The study further found that such short interventions by emergency room practitioners continued to impact the lives of their patients even up to a year after they received the short counseling session.

Chair of emergency medicine at Yale School of Medicine, Dr. Gail DOnofrio said that many tragedies they see in the ER department are because of problem drinking. The study was important because it showed that even quite brief counseling sessions with patients can make a life-saving impact and improve a patients’ outcome.

The study was provided by funding from a grant through the National Institute on Alcohol Abuse and Alcoholism.

Detox is the phase of rehab during which your body is allowed to clear itself of alcohol. Obviously denying the body a substance upon which it feels dependent is bound to feel uncomfortable. For some people the symptoms of detox will be nothing more than uncomfortable. For persons with a longer history of abuse, symptoms may be more intense. However, patients in a residential alcohol detox program will have the benefit of medical care and supervision along with the assurance that everything possible will be done to make this phase as easy as possible.

Alcohol addiction greatly impacts a person’s physical well-being. Many alcoholics are malnourished and are suffering from a vitamin and mineral deficiency. Inpatient rehab is a great opportunity to begin replenishing these much-needed resources and to start a new habit of healthful eating. Alcohol also takes a toll on sensitive organs like the liver, kidneys and even the heart. Alcohol detox and rehab cannot undo the damage already done but the medical staff can take appropriate steps toward halting any further deterioration.

Alcohol addiction likely began due to an emotional struggle and the disease certainly continued to damage the person’s mental and emotional health. Inpatient care will provide therapy sessions (both individual and group) that provide needed skills to help the person learn how to cope with problem emotions in a more healthful and positive way.

Living sober after rehab will require a supportive circle of people who are committed to helping the person meet their goal of sobriety. Rehab treatment will also train the person to spot things in life that trigger a desire to drink and teach them to plan ahead to avoid those triggers when possible and when avoidance isn’t possible, how to think and act so that relapses don’t occur.

There is no doubt that alcoholism is an expensive habit. On top of the high cost of the alcohol itself, alcoholics often wind up in financial distress. The disease may have distracted from on-time bill payments or the person may have made unwise purchases while under the influence of alcohol but one way or another, breaking free of alcoholism will lead to improved finances.

Inpatient alcohol detox and rehab treatment is beneficial because it provides a totally separate environment that has no associations with the disease and the past. Residential treatment provides a supportive environment where the person addicted to alcohol can focus all of their energy and attention on making a new start apart from the stresses and temptations of the past.

PCP education is a top priority in the nation’s Food and Drug Administration (FDA) program, Risk Evaluation and Mitigation Strategy (REMS). Inflexxion, a company that observes and researches behavioral health, conducted the study entitled Identifying Primary Care Skills and Competencies in Opioid Risk Management. The FDA hopes that this study will help guide PCPs in the proper use of opioids for their patients and reduce the number of patients who fall victim to misuse and addiction to their pain medication.

A Comparison of Views

Scientists from Inflexxion interviewed sixteen PCP and pain management and addiction specialists with questions about general medicine and safe practices in chronic pain management. The results revealed differing views between the two groups.

PCPs rated the following as the most important chronic pain management issues:

• Monitoring therapy
• Knowledge of behavioral side effects
• Safe prescription of opioids

Pain and addiction specialists believe that the most important issues are for PCPs to have a treatment plan for their patients, to have a better overall knowledge of chronic pain management, and to be able to teach their patients responsible and safe use of medications.

Lack of Treatment

Co-author of the study, Dr. Kevin Zacharoff, is concerned that PCPs are not offering enough treatment for their patients. Inflexxion’s VP of Medical Affairs says that PCPs may avoid treating their patients with opioids because they lack the proper training on how to address and treat patients with chronic pain.

For fear of overdose and addiction, some PCPs may not be prescribing enough opioids to effectively treat pain; others may not have an efficient treatment plan for opioid use which may put the patient at greater risk for opioid abuse.

Future Plans For Chronic Pain Management

Dr. Zacharoff believes that more training for PCPs will further the FDA’s plans to help monitor and provide education on the safe use of prescription drugs. The number of patients who see their primary care physician for chronic pain is rising. With this increase of patients who need treatment, comes an increase in individuals who are at risk for prescription drug abuse. Proper training of PCPs will give physicians a greater confidence and knowledge in safely dispensing medicine to their chronic pain patients.

A new study explores the impact of environmental and biological factors by studying drug abuse in adopted individuals. The study provides confirmation that an increased risk of drug abuse stems from both environmental and biological sources, in addition to the effects of the two being combined.

The study focuses on adoptive children whose birth parents abused drugs to see if their biological ties influenced them to do the same. The researchers discovered that adoptive children with drug-abusing biological parents were twice as likely to abuse drugs. In addition, their adoptive siblings were also twice as likely to do drugs.

The study was led by Kenneth Kendler, MD, of Virginia Commonwealth University and was recently published in the online version of Archives of General Psychiatry.

The study’s findings show that drug abuse is a complicated process as it develops, with both genetic and environmental factors impacting the behaviors. Each factor is also complex, explained the authors of the study.

While there has been extensive research to document the influence of various factors on the development of drug abuse, the work as been focused on intact families, in which both environmental and genetic factors would be the same among siblings.

The researchers used a Swedish group of adopted individuals to examine records of adoptive and biological family members. The study sample was composed of 18,115 adopted children born between 1950 and 1993, in addition to 78,079 biological relatives and 51,208 adoptive relatives. The relatives included both siblings and parents.

The researchers discovered that for those whose biological parents had a drug problem, the risk for abusing drugs was considerably higher. In addition, the risk was increased for biological siblings of adopted children who used drugs. This finding was true for both full siblings and half siblings.

The researchers also discovered strong support for environmental factors. The study showed that the threat of abusing drugs was also increased among adoptive siblings of the adopted children who had engaged in drug abuse.

The findings showed that when adoptive parents used drugs, there was an increased threat of abusing drugs in the adopted child, but the measure was not significant. This finding is important, because it shows that some social pressures, such as drug availability, are stronger predictors of abusing drugs than the influence of parent to child.

The researchers used regression analyses to show that genetic and environmental influences were strong predictors of drug abuse in the children examined.

Some patients are at a higher risk for abusing a prescription painkiller because they have a history of other substance abuse problems related to illegal drugs, tobacco or alcohol. A new study provides information about alternatives in pain treatment that may help reduce addiction problems.

Presented at the American Academy of Pain Medicine by researchers from the Mayo Clinic Pain Rehabilitation Clinic located in Rochester, Minnesota, the study’s findings show that a program centered on intensive pain rehabilitation can help those at high risk for abusing prescription painkillers.

The study found that those who were identified as high-risk for developing a substance abuse problem when treated with prescription painkillers had similar outcomes to low-risk patients when they were treated in a pain rehabilitation program.

When the high-risk patients were discharged from the program, which focused on substance abuse, they exhibited improvement on all measures. The results were similar to those noted among low-risk patients. There is a 97 percent taper rate for the program, and while the program is not focused on decreasing pain, patients do experience some lessening of their pain.

The focus of the program, say the authors, is the restoration of the patient and discontinuing use of opioids and combinations of drugs. The researchers examined the medical reports of 476 patients with a diagnosis of chronic pain that started a interdisciplinary pain management program that spans three weeks. The patients all entered the program between February 2010 and May 2011.

There were 246 participants identified as high risk for substance abuse and 230 identified as low risk. In order to meet criteria for high risk for substance abuse, a person had a history of substance abuse or a history of dependency on prescription painkillers or mood-altering drugs.

The two groups were similar in their pain history, with the patients reporting about 11 or 12 years of pain. They also generally had been using opioids for five to seven years. However, those in the high-risk group used painkillers at higher frequencies and doses, in addition to reporting more depression, pain catastrophizing and poorer management of pain.

Both groups were treated in the three-week program using cognitive-behavioral therapy, occupational therapy, physical therapy, relaxation training, wellness instruction, and several other types of pain management strategies.

The program is aimed at teaching the patients how to manage their high-risk situations and learn effective pain management through other methods than medication. When the program was complete, despite differences in the patient’s risk levels, their outcomes were similar in respect to pain severity and pain management abilities.