Question 5: Is oxycodone more addictive than previously realized?

Raymond Sinatra, MD: Dave, I'd like to get back to you again, a similar question. But the outbreak of oxycodone diversion and abuse, does it mean again that oxycodone is more addictive to patients than previously realized?

David Joranson, MSSW: I think that's a really important question and I'm not sure I have a complete answer for that. But what you're reading about in the newspapers, to pick up from where Commander Burke was discussing the sensationalized media coverage, we're hearing about the abuse of these medications, not about pain patients who are using it as directed by a physician for the treatment of pain and who are suddenly becoming addicted in large numbers which would be an unexpected and untoward outcome, but we're just not hearing that. I really would like to toss that question back out to the other panel members to see what they think about this question.

L. Jean Dunegan, MD, JD, FCLM: Well, I understand that's a difficult question to answer. I have heard tossed around dysphoria versus euphoria, that is to say when people abuse and divert a long acting morphine preparation then they will become dysphoric, sit in the corner, just kind of la-la land, look at the ceiling. When they take OxyContin long acting, abuse and divert it, they become extremely euphoric, that is to say the jiggling(?), life is great, I have never felt this way before. I would be very, very anxious to see some figures that show the number of people who take OxyContin the way it was manufactured, the way it is instructed to be taken, who have actually had any problem with OxyContin. I mean we don't hear anything about numbers. What we do hear is about a minority of people who are illegally or fraudulently obtaining a product and I mean let's face it, they're all very intelligent. I mean they all know that Percocet, five milligram oxycodone, gives them a certain buzz and then they heard about Oxy-40s and they all know that's eight times as much of a buzz. So I would love to see some figures that show us how many people actually had a problem taking OxyContin the way it's supposed to be taken.