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Drug diversion of Oxycontin in chronic pain syndrome

Published online by Cambridge University Press:  13 June 2014

Sean O'Domhnaill
Affiliation:
St Loman's Hospital, Mullingar, Co Westmeath, Ireland
Declan O'Keeffe
Affiliation:
Pain Management Service Programme
Kevin Malone
Affiliation:
Department of Psychiatry and Mental Health Research, St Vincent's University Hospital, Dublin 4, Ireland

Abstrsct

A case is described in which a man with chronic pain syndrome (CPS) presented to a city General hospital in suicidal crisis after referral from a provincial psychiatric unit, having taken an overdose of a variety of medications, precipitated by the absence of his opioid (Oxycontin) analgesia which he had been abusing intra-nasally. This is to our knowledge the first reported case in Europe of drug diversion from oral to intranasal use of Oxycontin, a controlled-release preparation of the synthetic opiate, oxycodone hydrochloride. There is also a dearth of reference to the abuse potential of this agent in the European literature. As sufferers from chronic pain syndrome increase in number, and opiate prescription rates worldwide are maintained, this case highlights the potential of opiate abuse or dependence and drug diversion emerging as a significant medical problem in CPS patients in Europe.

Type
Case Reports
Copyright
Copyright © Cambridge University Press 2006

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References

1.Moran, R, O'Brien, M, Dillon, L, Farrell, E. Overview of Drug Issues in Ireland 2000. Drug Misuse Research Division. Health Research Board. 2001.Google Scholar
2.Fishdain, DA. The Association of Chronic Pain and Suicide. Semin Clin Neuropsychiatry 1999; 4(3): 221–7.Google Scholar
3.Hendler, N. Depression caused by chronic pain. J Clin Psychiatry. 1984; 45: 3038. Fisher BJ, Haythornthwaite JA, Heinberg U, Clark M, Reed J. Suicidal Intent in Patients with Chronic Pain; Pain 2001; 89(2-3): 199-206.Google ScholarPubMed
4.Hitchcock, LS, Ferrell, BR, McCaffery, M. The Experience of Chronic Non-Malignant Pain. J Pain Symptom Manage 1994 07; 9(5): 312–8.CrossRefGoogle Scholar
5.Chronic Pain. David J., Rowbotham. Edited by M. Dunitz. 2000.Google Scholar
6.Reich, J, Tupin, JP, Abramowitz, SI.. Psychiatric diagnosis in chronic pain patients. Am J Psychiatry 140: 14951498, 1983.Google ScholarPubMed
7.Melzack, R. Pain and the Neuromatrix in the Brain. Journal of Dental Education. 2001. Vol 65; 13781382.CrossRefGoogle ScholarPubMed
8.Suleman, R, Abourjaily, H, Rosenberg, M. Oxycontin-Misuse and Abuse. J Mass Dental Society. 2002; 51: 5658.Google ScholarPubMed
9. Physicians Desk Reference. 67th Edition. 2003.Google Scholar
10.Dale, O, Hjortkjaer, , Kharasch, ED. Nasal administration of opioids for pain management in adults. Acta Anaesthesiol Scand 2002; 46(7): 759–70.CrossRefGoogle ScholarPubMed
11.Greene, D. Total necrosis of the intranasal structures and soft palate as a result of nasal inhalation of crushed OxyContin. Ear Nose Throat J 2005; 84(8):512516.CrossRefGoogle ScholarPubMed