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Opana (Oxymorphone) Abuse: Effects, Treatment, and FAQ

Opana is a brand name for the opioid medication oxymorphone.

Similar drugs include heroin, morphine, oxycodone, hydrocodone, codeine, and many others.

Oxymorphone is a controlled substance that is classified at the highest level of drugs that can be obtained legally with a prescription from a physician (Schedule II).

Drugs in this classification are prescribed for medical reasons, but they are identified as having a serious potential for abuse and likely to produce physical or psychological dependence in people who take them for more than a few weeks.

What Is Opana Prescribed for?

According to MedlinePlus, Opana is primarily prescribed for the treatment of chronic pain or pain that occurs following a surgical procedure. Its uses include:

  • To control moderate-to-severe pain
  • To reduce anxiety in people who are about to undergo anesthesia
  • To maintain anesthesia in individuals undergoing lengthy operations
  • To assist people who are having trouble breathing as a result of a cardiovascular or lung condition like pulmonary edema, which is the accumulation of excess fluid in the lungs

In some cases, physicians may prescribe it for off-label uses, but given the status of this medication and the current opioid epidemic in this country, Opana use for any other reason other than to control severe pain or the above situations would be very rare.

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Is There an Extended-Release Form of Opana?

Yes, there is an extended-release form, Opana ER; however, in 2017, the U.S. Food and Drug Administration (FDA) asked the manufacturer of Opana (Endo Pharmaceuticals) to recall the medication and no longer make it available. The extended-release form of Opana was available in doses that were potentially dangerous when the drug was abused (see below), and this is the reason the FDA asked for the drug to be discontinued.

The extended-release form of Opana is no longer being manufactured, but there may be generic and other versions of extended-release oxymorphone on the market. Opana IR (immediate-release) remains available in 5 mg (milligrams) and 10 mg pills.

What Are the Immediate Effects?

According to MedlinePlus and The Complete Guide to Prescription and Non-Prescription Drugs, the effects of using Opana (oxymorphone) include:

  • A reduction in the experience of pain
  • A reduction in the experience of anxiety or stress
  • A depressing effect on the functions of the central nervous system (CNS), which will result in slower breathing, heart rate, response times, and rates of thinking
  • Sedation, relaxation, or even lethargy
  • Feelings of euphoria

The analgesic effects of the drug will most often last between three and four hours with medicinal doses.

What Are the Potential Side Effects?

All medications have a side-effect profile. In most cases, the side effects of Opana are relatively rare or can be alleviated rather easily, especially when the drug is taken at medicinal doses and under the supervision of the physician.

When people abuse opiate drugs like Opana, they typically take far larger doses than would be prescribed and use it at more frequent intervals. This can result in serious side effects. According to the above sources and The Essence of Analgesia and Analgesics:

  • The most common side effects of Opana are dizziness, lightheadedness, sedation, and clumsiness.
  • Many individuals will experience constipation as a result of using any opiate drug.
  • Some of the other more common side effects include gastrointestinal issues like mild nausea, diarrhea, and vomiting.
  • Some individuals may experience mild insomnia, dry mouth, headache, itching, sweating, decreased appetite, or fatigue.

Rarer and potentially more dangerous side effects can occur.

  • Serious respiratory suppression (slowed breathing rate) can occur in some individuals. This can lead to serious health issues due to a lack of oxygen to organs such as the brain if the person continues to take the drug for a lengthy period.
  • There is a potential for allergic reactions to any drug, and these typically will appear as significant itching, rash, hives, and/or serious breathing problems. Allergic reactions can be serious.
  • Chronic hypotension (low blood pressure) is a potential serious side effect of using Opana for extended periods.
  • Adrenal failure or adrenal insufficiency, where the adrenal glands do not release their hormones in sufficient amounts, can occur in some individuals. This can lead to numerous health issues.
  • Individuals with pre-existing seizure disorders may be at an increased risk of seizures when they take Opana.
  • Because drugs like Opana slow down a person’s reflex and motor functioning, it may be dangerous to drive a car while using the medication.
  • Pregnant women should only use the drug under the supervision of a physician, as there may be potential for the unborn child to develop a physical dependence on the drug.
  • There are numerous potential interactions with other drugs that can be serious. For this reason, the drug should only be used under the supervision of a physician.

As mentioned above, anyone taking Opana for more than a few weeks may develop a physical dependence on the drug, even if the drug is used for medical reasons.

Is the Development of Physical Dependence on Opana a Problem?

When a person uses Opana under a doctor’s supervision and according to its prescribed instructions, they may develop a physical dependence on the drug if they use it for an extended time. This is not a significant issue for a person who uses the drug medicinally while being treated by a physician. The physician can slowly taper down the dosage of the drug when it is time for the person to stop using it.

Individuals who abuse opiate drugs will develop far more severe withdrawal symptoms, and these symptoms will typically result in their abuse of the drug worsening. This can lead to a downward cycle of using more and more of the drug to avoid withdrawal symptoms, which can lead to a more-serious physical dependence.

The FDA’s decision to have the extended-release version of Opana removed from the market is a result of the significant abuse of the extended-release version. Because the dosages in the extended-release version are higher, and individuals were grinding up the drugs and snorting or injecting the medication, there was an increased risk of overdoses when Opana ER was being abused.

What Are the Symptoms of Opiate Overdose? 

The major symptoms of an overdose on any opiate include:

  • Pinpoint pupils of the eyes
  • Very slow and shallow breathing
  • Significant lethargy or unconsciousness

Other symptoms can include slurred speech, confusion, irritability, poor motor coordination, decreased heart rate, severe nausea, and vomiting.

Can an Overdose of Opana Be Fatal?

Yes. A person’s breathing can completely stop, or they can choke if they throw up.

How Many People Abuse Opana?

There are no accurate figures on the abuse of Opana, but the Substance Abuse and Mental Health Services Administration (SAMHSA) releases yearly reports on the use and misuse of numerous drugs. The misuse of a drug refers to a person using the drug in a manner that is not in accordance with its prescribed purposes and can be used as a potential gauge to determine the number of individuals reporting abuse of a particular type of substance.

According to the latest information provided by SAMHSA:

  • In 2016, 840,000 people reported using some product that contains oxymorphone.
  • In 2017, 706,000 people reported some use of a product containing oxymorphone.
  • In 2016, it was estimated that 212,000 individuals reported misusing an oxymorphone product at least once.
  • In 2017, it was estimated that 223,000 individuals reported misusing an oxymorphone product at least once.

How Is Opana Abused?

Those who abuse the drug may take numerous pills orally, or they may grind up the pills and snort them or inject them after they mix them with a solution such as water. When people grind up the pills and snort or inject them, the drug is delivered much more quickly into the bloodstream than when they take the drug in pill form orally. There are also significant risks associated with snorting or injecting Opana.

What Are the Dangers of Snorting the Drug?

According to Lowinson and Ruiz’s Substance Abuse: A Comprehensive Textbook, snorting ground-up pills can lead to additional risks.

  • Physically damage to the septum of the nose (the cartilage that divides the nostrils), including:
    • Perforations
    • Ulcers
    • Chronic nosebleeds
    • Irritation of the mucous membranes
    • Infections (sinusitis)
    • Chronic headaches

Chronic runny nose

  • Damage to the ability to smell things
  • Chronic irritation of the throat
  • Lung damage

What Are Some Specific Dangers of Injecting Opana?

According to the text Neuropathology of Drug Addictions and Substance Misuse Volume 1: Foundations of Understanding, Tobacco, Alcohol, Cannabinoids and Opioids, injecting opiates like Opana can lead to additional potential risks such as:

  • Blockages, collapses, or inflammation of the veins
  • Infections of the skin, including gangrene
  • Other potential infections as a result of needle sharing
  • Cardiovascular conditions or infection that can be extremely serious

Numerous other problems can occur, including damage to the organs such as the liver, kidneys, and even the brain.

Are Users at Risk to Develop Other Psychiatric Problems?

Yes. According to the American Psychiatric Association (APA), having any form of a substance use disorder is associated with an increased risk of having some other type of mental health disorder.

How Is Abuse of Opana Treated?

According to the National Institute on Drug Abuse (NIDA), the abuse of any opiate drug, including Opana, requires professional treatment from physicians, therapists, counselors, and other mental health professionals. According to the APA and numerous other sources, the general approach to addressing an individual with an opiate use disorder will include:

  • Initial enrollment in a medical detox program
  • The use of medications in many cases
  • Involvement in behavioral interventions
  • Support from friends and family members
  • Long-term involvement in treatment

What Is Medical Detox?

NIDA reports that medical detox is a process where the withdrawal syndrome is addressed by a physician. Typically, the physician will administer a medication such as Suboxone to control the withdrawal symptoms from Opana once the person stops using the drug. Then, the physician will lower the dose of the drug at specific intervals over time to wean the person off the drug. This allows the person to start treatment without experiencing withdrawal symptoms that can lead to an increased potential to relapse on Opana.

Is Medical Detox Enough for Recovery?

No. According to the APA and NIDA, individuals in recovery must continue with treatment following the medical detox process if they are to successfully recover from their substance use disorder.

What Are Behavioral Interventions?

According to NIDA, behavioral interventions include nonmedical interventions, such as substance use disorder therapy, support groups like 12-step groups, and other types of interventions that do not use medicines. These are the cornerstone of the treatment for any substance use disorder. Therapy can be provided in group or individual sessions, or the person can attend both group and individual sessions.

How Long Should a Person Remain in Treatment?

Treatment for any substance use disorder is a long-term proposition. In general, individuals will remain in therapy and support groups for years after they have become abstinent from their drug of choice. The longer a person remains in therapy, the better their outlook is.

Is Treatment Successful?

Yes. According to the APA and NIDA, although many individuals may experience a relapse in the course of their recovery, treatment providers will often consider relapses as learning experiences that can be used to guide the individual to long-term success. Ultimately, people who get treatment have much higher long-term success rates than those who don’t.




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