Opana was a brand of oxymorphone, a potent opioid pain medicine. In 2017 the FDA requested removal of reformulated Opana ER because of the public-health consequences of misuse, and its manufacturer agreed. This action concerned that extended-release product; it should not be described as a worldwide ban on every oxymorphone medicine.
Misuse of reformulated Opana ER was associated with serious harms, including injection-related outbreaks of HIV and hepatitis C and cases of thrombotic microangiopathy. These findings contributed to the FDA’s decision; they do not establish that Opana was the most frequently misused prescription medicine.
Oxymorphone is the generic name for Opana which is a drug that belongs to the Opioid class of medicine. Opana is a semi-synthetic opioid. Opioids are substances that act on opioid receptors in the body and produce a morphine-like effect by alleviating moderate to severe pain. Opioids are referred to as narcotics which means the drugs that produce pain relief (analgesia), stupor, and sleep (narcosis), and cause addiction. Opioids are prescribed when other pain medications have failed.
Read Also: Methocarbamol Addiction and Abuse Symptoms
Drug Enforcement Administration (DEA) has categorized Opana as a Schedule II drug. Schedule II drugs, substances, and chemicals are compounds with a high potential for abuse, leading to physical and psychological dependence with increased use of the drug. Consequently, these drugs are very hazardous to health if used in excess or abused.
Oxymorphone products have included different formulations; availability and authorized indications depend on the country and product:
- Immediate-release tablets have a shorter release profile and require product-specific prescribing.
- Extended-release tablets release medicine over longer periods. The withdrawn reformulated Opana ER product should not be presented as a current prescribing option.
Use any prescribed oxymorphone only according to its current label and your prescriber’s directions. This article does not provide a dosing or opioid-conversion schedule.
Choice of formulation and dose requires assessment of pain, previous opioid exposure, organ function and other medicines. Opioid doses are not interchangeable, and dose increases should never be made independently.
Do not stop other prescribed pain medicines on your own. Ask the prescriber to review all medicines and explain which should continue or change.
Furthermore, Oxymorphon should not be taken with food. It should be taken 1 hour before or 2 hours after a meal. It is best to take the drug at the same time each day. You should swallow the tablet as a whole and avoid crushing, chewing, or dissolving it. It is strictly prohibited to break your Opana pill to inhale the powder or mix it with any liquid to inject it into your body as it can simply result in death.
Opana is an opioid agonist which means that it exerts its effect by interacting with the opioid receptors present in the central nervous system and other parts of your body such as the gastrointestinal tract and urinary bladder. Opana acts by impeding the neuronal firing and transmitter release at the synapses which are meant to carry pain signals.
Activation of opioid receptors changes pain signaling and perception. It can also cause sedation and dangerous respiratory depression, so relief of pain does not guarantee preserved alertness or safe breathing.
Oxymorphone acts on opioid receptors and can affect reward-related dopamine signaling. It does not work by blocking dopamine reuptake in the bloodstream. Risk of opioid use disorder reflects biological, psychological and social factors, not a single chemical mechanism.
Oxymorphone has addiction and overdose potential. Tolerance and physical dependence can occur during prescribed use without opioid use disorder; addiction is not an inevitable consequence of appropriate treatment.
Prescription opioids contributed to the US overdose crisis, but national totals for prescription-opioid deaths must not be attributed entirely to Opana. There is no evidence here that oxymorphone alone caused 14,000 deaths in 2014.
Opana which comes in an octagon-shaped tablet is crushed, sniffed, and snorted for recreation. It is known in the streets with other popular names such as:
- Stop signs
- Mrs. O
- Octagon
- New blues
- Pink lady
- The O bomb
- Pink heaven
- Oranges
- OM
Oxymorphone is potent, but potency comparisons vary by route and clinical context and should not be used to calculate doses. Tolerance and dependence do not automatically become addiction, and a prescriber should review reduced pain relief rather than the person increasing the dose.
Opioid use disorder can impair daily functioning and lead to continued use despite harm. Physical dependence is a separate adaptation that can occur even when treatment is followed correctly.
There are several reasons for Opana’s addiction. Firstly, its availability as a prescription medicine makes people presume that it is not illicit to use even when they are abusing it. In 2012, 1.2 million Oxymorphone prescriptions were given for the treatment of pain as reported by the Drug Enforcement Administration (DEA). Unfortunately, people develop a habit of using Opana more than the given dose and longer than the prescribed time as they develop tolerance to the drug and they remain unaware of the fact that they have become dependent on the drug. As soon as they stop taking Opana, they experience withdrawal effects which leads them to continue taking the drug long after their pain has resolved.
Percocet Addiction and Side Effects of Abuse
Stress, mental health conditions, genetic vulnerability and social circumstances can contribute to substance-use problems. Opioids are not a safe way to manage emotional distress; effective support should address pain and mental health together.
Crushing, snorting or injecting tablets can deliver unpredictable exposure and cause fatal overdose or other serious harm. Extended-release tablets must not be altered; no route of non-prescribed use is safe.
Changes in behavior or appearance can raise concern but do not reliably diagnose opioid use disorder. A respectful clinical assessment considers the wider pattern, medication effects and other possible causes.
Signs and symptoms of Oxymorphon abuse include physical, psychological, and behavioral alterations and they may be as follows:
- Physical signs can include sedation and small pupils, but pupil size alone is not diagnostic. Difficulty waking or slow or abnormal breathing requires immediate emergency help, regardless of pupil size.
- Psychological: People who are abusing Oxymorphone tend to be more distracted, less focused during work or studies. They will experience anxiety and depression if they do not get the drug. They are often in an unexplained state of ecstasy and a false sense of well-being. People who abuse Opana are known to hallucinate and experience frequent mood swings.
- Behavioral concerns can include impaired control, time spent obtaining or using opioids and continuing despite harm. These do not occur identically in everyone, and stereotypes should not replace assessment.
There are a plethora of side effects linked with Opana addiction. Some of them are as follows:
- Change in the threshold of pain
- Anxiety, depression, or unease
- Sedation
- Nausea and vomiting
- Hormonal imbalances
- Hallucinations
- Paranoia
- Delusions
- Worsening of mental condition
- Sexual dysfunction
- Impotence
- Impaired immune system
- Loss of consciousness and coma
- Many drug abusers who use injections are at the risk of getting HIV, Hepatitis C, and thrombotic microangiopathy.
Short term side effects of Oxymorphone Addiction
Being a narcotic drug with a potential for addiction, Oxymorphone has its fair share of side effects one of which is drug dependence, and the risk of overdose. Opana addiction affects not just the brain, but the overall health of an individual.
However, these side effects depend on the amount of drug a person consumes regularly, his previous drug abuse history, his health status, and age among other factors.
Tramadol(Ultram) Abuse and Symptoms
Following are some of the short time side effects of Opana:
- sudden unexplained weight loss
- decreased appetite
- nausea and vomiting
- dry mouth
- increased sweating
- increased heart rate
- reddening of eyes
- flushing
- itching
- headaches
Long-term side effects of Oxymorphone Abuse
Longer-term opioid use can cause constipation and hormonal or sexual effects. Injection adds infection and vascular risks. Organ injury is not an inevitable result of dependence; symptoms and individual risks need medical assessment.
Some of the long-term side effects of Oxymorphone addiction are listed below:
- Disorders of the gastrointestinal system
- Blood infection
- Impaired immune system
- Sexual dysfunction
- Impotence
- Fertility problems
- Liver damage
- Kidney problems
- Hormonal imbalances
- Skin abscesses
Drug clearance varies with formulation, dose, repeated use and organ function. A half-life calculation is not a guarantee that oxymorphone has completely left the body or that combining it with alcohol or sedatives is safe.
However, some points that you need to know is that the time needed for the elimination of Opana varies from individual to individual based on many factors, such as:
- Age: Younger people eliminate the drug at a faster rate as compared to older adults.
- Health: People who are healthy with maximum functioning of kidneys and liver, tend to eliminate the drug at a faster rate as compared to people who are combating with a diseased liver or kidney as these two are the principal organs of metabolism and elimination of a drug respectively.
- Metabolism: Those who have a faster metabolism quickly remove Opana from their system in comparison to those with a slower metabolism.
- Hydration: normal fluid intake supports health, but drinking extra water does not reliably speed oxymorphone elimination and excessive water intake can be harmful.
- Duration of the drug usage: People who are consuming Opana for a long time, tend to hold the drug for a prolonged period in their bodies. While people who have been using the drug less frequently remove Oxymorphone at a quicker rate.
How long does Opana stay in your urine?
Urine detection depends on the test, dose, timing and individual factors. A fixed two-to-four-day window or five-day guarantee is not reliable for every person and does not indicate current impairment.
Hair testing can reflect past exposure over a longer interval, but interpretation depends on the sample and laboratory method. It cannot establish a precise day of use or current safety.
When someone using Opana over a long period such that he developed dependence and tolerance to it, stops using it, is referred to as Opana withdrawal. It is said that you should not go cold turkey when you want to withdraw from Oxymorphone as withdrawal effects can be quite serious and it is suggested that you slowly taper off the drug dose before stopping completely.
Symptoms of Oxymorphone Withdrawal
Withdrawal onset and peak vary with formulation, use and individual health; a fixed 14-to-18-hour onset is not a safe planning rule.
The early features of Oxymorphone withdrawal present as common flu, with generalized body aches, feeling lethargic, anxious, and agitated. Cravings for drugs set in along with nausea, vomiting, and chills.
Following are the symptoms of Oxymorphone withdrawal that results when the brain is adapting to regulate the body without the drug:
- extreme cravings
- sweating
- watering eyes
- runny nose
- chills
- joint pain
- diarrhea, nausea, and vomiting
- disturbed sleep
- high blood pressure
- changes in heart rate
- changes in breathing rate
- restless and agitated behavior
- intention of suicide
Discuss withdrawal with a clinician. Suicidal intent, serious breathing changes, collapse or severe dehydration require urgent assessment; do not wait for a routine appointment. In Spain or the EU call 112 for an emergency.
Opana withdrawal timeline
Symptoms may change over time, but there are no two mandatory phases with fixed deadlines:
- Early symptoms can include restlessness, aches, sweating, a runny nose and gastrointestinal upset. Timing and severity depend on the medicine and person, and symptoms need monitoring.
- Late withdrawal phase: This stage is mostly linked to psychological alterations such as staying anxious and feeling depressed and a person can stay in this state as long as months after the withdrawal.
Oxymorphone overdose can suppress breathing and be fatal, but death is not inevitable. Rapid emergency response and naloxone can save a life.
The FDA’s 2017 removal request concerned reformulated Opana ER and its overall public-health risks. National opioid-overdose totals include many substances; they must not be presented as oxymorphone-specific death counts.
Opana overdose results in depression of the respiratory system and it is the most common cause of death in acute opioid overdose. When the respiratory system is depressed, less oxygen diffuses in the blood and consequently disrupts the oxygen supply to the brain and other vital organs such as the heart. As a result brain damage ensues that further results in coma or death. Likewise, the heart receives suboptimal oxygen resulting in hypotension and bradycardia which means a decrease in blood pressure and heart rate respectively.
Oxymorphone Overdose Signs
- Difficulty breathing due to the depressed respiratory system
- Cold clammy skin due to decreased blood pressure
- Bluish discoloration of lips, fingernails due to decrease in oxygen supply
- Decrease in the pupil size- pinpoint pupil
- Slowed or stopped heartbeat due to decreased activity of the heart
- Weak muscles
- Extreme drowsiness due to depression of the brain
- Unusual snoring sound due to sedation
Call emergency services immediately for suspected opioid overdose. Give naloxone if available and repeat according to the product instructions or dispatcher advice. If the person is not breathing normally, begin dispatcher-guided CPR; if unconscious but breathing normally, place them in the recovery position. Stay until help arrives because opioid effects can return after naloxone wears off. Availability and supply rules differ by country.
