Oxycodone and Hydrocodone Most Popular Among Opioid Abusers

Oxycodone and Hydrocodone Most Popular Among Opioid Abusers

Oxycodone and hydrocodone are the “drugs of choice” for abusers of opioid pain medication, according to a new survey of thousands of opioid addicts entering drug treatment programs across the United States.

While the results are not altogether surprising because oxycodone and hydrocodone are the two most commonly prescribed painkillers, the survey results do provide some insights into why abusers prefer them.

Drugs SignOxycodone, for example, is preferred for the quality of the high it gives. It is also more likely to be tampered with – inhaled or injected – by a drug abuser.

Hydrocodone is less popular because it has a lesser euphoric effect. But it is also cheaper and easier to obtain because it is so widely prescribed.

“The data show that hydrocodone is popular because it is relatively inexpensive, easily accessible through physicians, friends, and families, and is perceived as relatively safe to use, particularly by risk-averse users. This group includes generally risk-averse women, elderly people, non-injectors, and those who prefer safer modes of acquisition than dealers, such as doctors, friends, or family members,” says Theodore Cicero, PhD, of the Department of Psychiatry at Washington University in St. Louis.

“In contrast, we found that oxycodone is much more attractive to risk-tolerant young male users who prefer to inject or snort their drugs to get high and are willing to use riskier forms of diversion despite paying twice as much for oxycodone than hydrocodone.”

Cicero and other researchers at Washington University in St. Louis and the Center for Applied Research on Substance Use and Health Disparities at Nova Southeastern University in Miami surveyed over 3,500 opioid addicts, asking about their drug use, health care coverage and other factors involved in their choice of opioids.

The researchers found “compelling evidence” that over half of the addicts abused opioids not only to get high, but to help relieve their pain — suggesting that the drugs they were introduced to as pain patients led to their abuse.

“Participants who used hydrocodone as a primary drug, in addition to having far more associations with pain management than oxycodone users, also indicated that the ‘high’ was not euphoria in the typical meaning of the word. Rather, the relief of pain resulted in an increase in mood and energy, and it was this that led them to use opioids to alter their mood,” the researchers wrote.

Despite its high abuse rate among prescription opioid abusers, hydrocodone is viewed as less attractive than oxycodone by active abusers because hydrocodone is frequently combined with acetaminophen in combination products such as Vicodin. Acetaminophen overdoses are one of the leading causes of liver failure.

“One of the reasons I was abusing oxycodone in the end more than hydrocodone was because I was too scared about the APAP (acetaminophen) damage to my liver,” one drug abuser answered in the survey.

Hydrocodone is the most widely prescribed drug in the U.S.  Over 130 million prescriptions were filled for Vicodin alone in 2010. The Food and Drug Administration recently said it would seek tighter restrictions on hydrocodone by reclassifying it as Schedule II controlled substance, making it harder to obtain for both addicts and legitimate pain patients.

Oxycodone users in the survey were more likely to tamper with the drug in order to inhale or inject it, one reason why Purdue Pharma introduced a “tamper resistant” formula of OxyContin in 2010. Although the new formulation OxyContin was harder to crush or liquefy – many addicts said they continued to abuse it or switched to heroin.

“I was a user that did shoot them but if I couldn’t do it that way then I would have just swallowed them. Yes the initial rush would not be there but I would still get the after-effects of it and wouldn’t be sick from withdrawals so it really wouldn’t have changed my usage, just the route administered,’’ one addict said.

“Because of the change in the OxyContin formulation, I tried heroin for the first time,” another addict said. “I did that in part because you couldn’t smoke or snort the OxyContin pills anymore so I resorted to something you could do that with. EVERY single person I know now that used pills, now uses heroin because of the change in formulation.”

The study is published in the current issue of PAIN.

Authored by: Pat Anson, Editor

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Toni Kresen

If those that abuse would STOP, then those of us that NEED an opioid/narcotic for our CONTINUOUS VARIOUS MYRIAD PAINS would NOT end up with no “QUALITY OF LIFE” whatsoever. 4/5 of my days (NOT an exaggeration), unless I have a doctor’s appointment, is spent in my bedroom in bed because I can no longer have hydrocodone or oxycodone to lower my PLETHORA of pains. I NO LONGER, because doctors are too afraid to prescribe said painkillers, have what anyone could consider a “LIFE”. Remove the opioids/narcotics and the abusers will find OTHER medications to abuse. Abusers are abusers and will abuse EVEN OTCs (Over the Counter medications). Those of us in FULL pain that take the painkillers as prescribed AND have doctors that truly DO care about their patients should NOT be punished and have to live in INORDINATE amounts of PAINS because of the addicts that will misuse ANYTHING!!!

The problem with tamper resistant formulations is that only the lowest dose is tested in healthy volunteers. They rely on osmosis, so higher doses suffer lower bioavailability. Also, they don’t test them on the unhealthy people who need them.

My wife and I both get SIGNIFICANTLY more relief from 30mg OxyIR every six hours (120mg/day) than new OxyContin 80mg three times a day (240mg/day).


I am so tired of these meds being taken away or restricted because of abuse. I am a nurse. Well, make that was, because although I still have a license, I am too sick to practice anymore. Chronic pain (and then cancer, and many other health problems) took that from me. I am still young. Late 30’s now, and have had pain for 15 years. I am scared to death at what will happen to me when I am older. I am always worried about being sick, because every time I get admitted, I am given the “look” by nurses and other health care workers. My pain is NEVER treated adequately, because most of the staff is scared to death by the amount of meds needed to treat my pain. They all think they’re going to kill me, or that I am just using the meds to get high. I am on methadone now, have been for about 5 years. Best thing I ever had to go on, although I fought it for years because of the stigma of it. I have taken every med out there for pain over the years. Been on the same dose of methadone for the whole 5 years (almost 6) I’ve been on it. It works better than anything I’ve been on. Oxycodone was the worst for me just because it never lasted. One thing I always hate, is the word “drug seeker”. We all know that word, that look, that type of treatment. Really, isn’t ANY person in pain, an addict or not (and please, don’t get me started on the whole addict subject!), acute pain or chronic pain, simply looking to RELIEVE their pain? “Seeking” to relieve their pain? Of course! Of course we would do just about anything to find relief at that point. Yes, there are those who abuse the system. Those are the few. There are millions of us, quietly, behind the scenes, trying to live day to day in severe pain. Sometimes its hour by hour. Or even minute by minute. Some days the pain meds keep the pain just a hair under the “I want to die” level. Other days are better. I am so weary of hearing about addicts and abuse, and the ignorance of not only the public, but of our own health care providers (nurses and doctors and everyone). Those that take narcotics on a daily basis for chronic pain are NOT addicts. The fact that you take a medication daily does not an addict make. I have lost friends and some family over this perceived “addiction” madness. I now never tell most people I am on pain meds. The few who do know in my life tell me they’d never know I took them. I don’t act “high” or give any indication that I am on a narcotic. I do the best I can, doing what I can on good days and trying to manage on the bad. But always, always, worried about… Read more »


I have chronic back pain and the hydrocodone does one thing, it takes me from suicidal levels to “It still hurts like hell but I won’t kill myself today” level. For people living as I do, losing the slight pain relief is a death sentence. But by all means sacrifice those barely hanging on to make it harder for some junkie who is just going to go find some heroin. Our society, the way it damages the most vulnerable, is a shame.

Trudy McGee

Sadly, instead of treating the problem, the country chooses to eliminate a very good medication. What do the addicts do? Turn to heroin. Much more dangerous, much more criminal activity involved, but hey, we beat those Oxy abusers!!


all this is about is the people that will abuse the druggs will abuse any drug .. whatever gets them ”high” .. if painmeds are not available they’ll just use heroin ,meth, what ever they can find .. so it just the people that are in horrindous pain ,that wouldn’t abuse any med, or pain med including opiate ,that are the target and the casualty!