OPANA: A BRIEF HISTORY

Opana – a powerful painkiller that went on the market less than two years ago – is twice as strong as OxyContin, with a potential for addiction that rivals the prescription drug that has ravaged the lives of thousands of abusers.

Little is yet known about the potential for Opana abuse, because of its relatively short shelf life in the pharmaceutical marketplace. Significantly more potent than morphine, itself a powerful painkiller with potentially fatal side effects if abused, its existence has created a possible new menace for those who use pain medications for recreational purposes. Those numbers have grown significantly in recent years, as the addictive properties of prescription drugs like OxyContin and Vicodin have become better known.

In that time, reports of abuse have grown widespread for OxyContin, introduced in 1995 and once known as “hillbilly heroin.” In its first six years of existence, news reports put revenues from OxyContin at nearly $3 billion for its manufacturer, Purdue Pharma.

The effects of Opana are closer to those of morphine than of OxyContin, doctors say. Whereas OxyContin has a more stimulating effect, Opana can cause a user to fall asleep. Like morphine, Opana’s greatest danger to abusers is the possibility of “respiratory depression,” or reduced lung functioning.

As with all prescription painkillers, the addictive properties of Opana present another possible danger, especially to recreational users. According to James Zacny, a professor of anesthesia and critical care at the University of Chicago, users could eventually become physically dependent on the drug, depending on dosage and frequency of administration.

Why did Opana get introduced now? Its manufacturer, Endo Pharmaceuticals, said the drug was developed in part to provide an alternative to patients who’ve developed a tolerance for a specific painkiller.

But an Endo spokesman also cited Opana’s added benefit to patients as a “true” twice-a-day opioid. He suggested that while OxyContin is advertised as a 12-hour medication, its users “tend” to take OxyContin more frequently. Doctors say that excessive doses of OxyContin can lead to abuse.

A spokesman for Purdue Pharma, the makers of OxyContin, took issue with Endo’s assessment. “OxyContin is indeed a true 12-hour medication,” he said. “All of our clinical studies were conducted using the medication at 12 hour intervals and the product was both safe and effective."

But the main reason for the drug’s arrival in the marketplace may be yet more simple: the market for prescription painkillers grows with every passing day. An Endo spokesman put Opana prescriptions at 8,500 a week, and growing.

An injectible form of the drug – known under the generic name of oxymorphone hydrochloride – has been available since 1959, but was available only as a intravenous drip to hospitals. The oral form was originally approved by the Food and Drug Administration in 5, 10, 20 and 40 milligram extended release tablets, and immediate release tablets in 5 and 10 milligram doses. On March 3, the FDA approved three additional doses. The Opana pill has a waxy consistency designed to deter users from crushing it into a powder, which would defeat the timing mechanism if snorted. The drug’s warning label specifically cautions users not to break the tablets down before ingesting orally, because it “leads to the rapid release and absorption of a potentially fatal dose of oxymorphone.”

This isn’t the first time oxymorphone hydrochloride has been available in tablet form. Until it was taken off in the market in the 1970s, it was available in 10 milligram tablets under the brand name Numorphan. That was the drug referred to as “blues” in the 1989 Gus Van Sant film, “Drugstore Cowboy,” about a family of traveling drug addicts set in the early 1970s.

[ Read a first-person account of one person's illegal use of Opana here.]