Oxymorphone Addiction: Causes, Effects and Treatment

Oxymorphone, a powerful opioid analgesic, is prescribed for severe pain management. However, its high potency and addictive nature have contributed to a rise in misuse and addiction. According to Babalonis, S., Comer, S.D.,  Jones, J.D. et al. 2021 in an article titled “Relative potency of intravenous oxymorphone compared to other opioid agonists in humans.” published by Psychopharmacology, Oxymorphone has been found to be significantly more potent than other opioids in several key measures, including the intensity of drug liking and the severity of respiratory depression (p <0.05). Specifically, for abuse-related subjective outcomes, oxymorphone is 2.3 to 2.8 times more potent than hydromorphone and an astonishing 12.5 to 14 times more potent than oxycodone.

The causes of Oxymorphone addiction start with using oxymorphone for legitimate medical reasons but can quickly develop a tolerance, leading to increased dosages and dependency. Psychological factors, such as stress and a history of substance abuse, also play a significant role. Additionally, social and economic factors, including lack of access to healthcare and support systems, can exacerbate the risk of addiction​.

The effects of oxymorphone addiction include severe health issues, like respiratory depression, liver damage, and increased risk of infectious diseases due to needle sharing. Psychologically, addiction causes cognitive impairments, anxiety, depression, and drastic changes in behavior. Socially, it leads to strained relationships, unemployment, and legal issues. 

Treatment for oxymorphone addiction involves a comprehensive approach that includes medical, psychological, and social interventions. Medically, detoxification and the use of medications are standard practices to manage withdrawal symptoms and reduce cravings. Psychological support, through counseling and therapy, is standard for addressing the underlying causes of addiction and developing coping mechanisms. Social support systems, including support groups and rehabilitation programs, provide an essential network for individuals recovering from addiction. 

What is Oxymorphone?

Oxymorphone is a powerful semi-synthetic opioid medication prescribed for the relief of severe pain. Oxymorphone, was first developed in 1914 and introduced to the market in 1959. It is derived from thebaine, an alkaloid of the poppy plant. Over the years, it has been recognized for its effectiveness in pain relief but also for its high potential for abuse and addiction. 

Oxymorphone is primarily prescribed for the relief of moderate to severe pain in patients who require continuous, around-the-clock opioid treatment for an extended period. It is also used in cases where other pain treatments are inadequate. The medication is available in both immediate-release and extended-release formulations to manage different pain needs.

Forms and Dosage: Immediate-Release (IR) vs. Extended-Release (ER) Tablets

Immediate-Release (IR) TabletsDesigned for quick onset of pain relief, typically prescribed for acute pain episodes that require immediate attention.Usually taken every 4 to 6 hours, depending on the patient’s pain level and medical condition.Provide rapid pain relief but require more frequent dosing due to their shorter duration of action.
Extended-Release (ER) TabletsFormulated to release the medication slowly over time, providing prolonged pain relief. Intended for continuous, long-term pain management.Generally taken every 12 hours, allowing for more consistent pain control with fewer doses.Help maintain stable drug levels in the body, reducing the need for frequent dosing and managing chronic pain more effectively.

What are other names for Oxymorphone?

Oxymorphone is known by various names, including its chemical name and several brand names. Common brand names include Opana and Numorphan. It is also referred to by its chemical name, 14-hydroxydihydrocodeinone.

Street Names for Oxymorphone

Oxymorphone, like many opioids, is often referred to by various street names. These names can vary by region and among different user communities. These drugs are also known to be laced with fentanyl making them extremely dangerous and potentially fatal. Some common street names for oxymorphone include:

  1. Blues
  2. Mrs. O
  3. O Bomb
  4. Octagons
  5. Oranges
  6. Pink Lady
  7. Stop Signs

“Blues,” often counterfeit oxymorphone pills laced with fentanyl, have a high addiction potential. Fentanyl is 50 to 100 times more potent than morphine, making these pills extremely addictive and dangerous. According to the National Institute on Drug Abuse (NIDA), fentanyl’s high potency significantly increases the risk of addiction and overdose.

What are the Causes of Oxymorphone Addiction?

Oxymorphone addiction arises from a complex interplay of medical, psychological, and social factors. Medically, individuals who are prescribed oxymorphone for chronic pain management may develop tolerance, necessitating higher doses to achieve the same pain relief, which can lead to physical dependence and addiction. Prescription misuse, such as taking larger doses or using the medication more frequently than prescribed, further exacerbates this risk​.

What are the Common Methods of Abuse of Oxymorphone?

Oxymorphone, like other opioids, is prone to abuse due to its potent effects on pain relief and euphoria. Common methods of abuse include:

  1. Oral Consumption: Taking higher doses than prescribed to achieve enhanced effects.
  2. Crushing and Snorting: Crushing the tablets into a powder and snorting it for a faster onset of effects.
  3. Injection: Dissolving crushed tablets in water and injecting the solution directly into the bloodstream for an immediate and intense high.
The Causes of Oxymorphone Addiction

What are the Medical Factors that Cause Numorphan Addiction?

  • Chronic Pain Management: Patients with chronic pain conditions who use oxymorphone over extended periods may develop tolerance, requiring higher doses to achieve the same level of pain relief. This can lead to physical dependence and addiction.
  • Prescription Misuse: Misuse of the prescribed medication, such as taking larger doses or using it more frequently than directed by a healthcare provider, can quickly lead to addiction.

What are the Psychological Factors Causing Opana Addiction?

  • Mental Health Disorders: Individuals with mental health issues such as anxiety, depression, or a history of substance abuse are at a higher risk of developing an addiction to oxymorphone as they may use it to self-medicate.
  • Stress and Trauma: High levels of stress or a history of trauma can increase the likelihood of substance abuse as individuals seek relief from their emotional pain.

What are the Social and Environmental Factors of Oxymorphone Addiction?

  • Accessibility: Easy access to prescription opioids, whether through legitimate prescriptions or illicit sources, increases the risk of abuse.
  • Peer Influence: Social circles that engage in drug use can significantly influence an individual’s likelihood of trying and becoming addicted to substances like oxymorphone.
  • Economic Hardship: Economic instability and lack of access to healthcare and support services can drive individuals to misuse opioids as a coping mechanism.

With Oxymorphone becoming more available to the public the risk of addiction is much higher. According to an article titled “Oxymorphone” published by the Drug Enforcement Administration, a study by the IQVIA National Prescription Audit™ found that the number of oxymorphone prescriptions dispensed saw a significant rise from 268,536 in 2007 to approximately 1.2 million in 2012. This number shows how these numbers have significantly increased.

What are the Effects of Oxymorphone Addiction?

Oxymorphone addiction has severe physical, mental, and behavioral effects on individuals, contributing significantly to the opioid crisis. According to the 2022 National Survey on Drug Use and Health (NSDUH) published by Substance Abuse and Mental Health Services Administration (SAMHSA), the misuse of prescription opioids, including oxymorphone, has significantly impacted public health. In 2021, SAMHSA reported that nearly 9.2 million people aged 12 and older misused opioids in the past year, highlighting the widespread issue of opioid misuse in the United States.

The Effects of Oxymorphone Addiction

What are the Physical Effects of Oxymorphone Addiction?

  • Respiratory Depression: A significant risk of life-threatening breathing problems, leading to a high risk of overdose and death.
  • Gastrointestinal Issues: Chronic constipation, nausea, and vomiting are common side effects.
  • Drowsiness: Extreme sleepiness and lethargy, impairing daily functioning.
  • Tolerance and Dependence: Increasingly higher doses are needed to achieve the same effect, leading to physical dependence and withdrawal symptoms such as muscle pain, sweating, and agitation​.

What are the Mental Effects of Oxymorphone Abuse?

  • Cognitive Impairment: Altered brain chemistry affecting decision-making, memory, and concentration.
  • Mental Health Disorders: Heightened anxiety, depression, and severe mood swings.
  • Anhedonia: Difficulty experiencing pleasure from activities that were once enjoyable.

What are the Behavioral Effects of Oxymorphone Misuse?

  • Drug-Seeking Behavior: Prioritizing drug acquisition and use over personal and professional responsibilities.
  • Social Isolation: Deterioration of personal and professional relationships due to addictive behaviors.
  • Risky Behaviors: Engaging in dangerous activities, such as driving under the influence or sharing needles, increasing the risk of accidents and infectious diseases.
  • Financial Difficulties: High costs associated with maintaining addiction, potentially leading to criminal activities to procure the drug​

What Treatment Options Are Available for Oxymorphone Addiction?

Oxymorphone addiction is a serious condition that requires a comprehensive treatment approach. Effective treatment involves several methods tailored to the individual’s needs to address both the physical and psychological aspects of addiction.

Detoxification Process

Detoxification is the first step in treating oxymorphone addiction. It involves clearing the drug from the individual’s system and managing withdrawal symptoms. The detox process should be medically supervised to ensure safety and to alleviate severe withdrawal symptoms such as anxiety, nausea, muscle pain, and agitation. The duration of detoxification can vary depending on the severity of the addiction and the individual’s health.

Detox should always be conducted under medical supervision to ensure patient safety. Medications are administered to manage withdrawal symptoms and make the process more bearable.

Medication-Assisted Treatment (MAT)

Medication-Assisted Treatment (MAT) combines medications with counseling and behavioral therapies to treat oxymorphone addiction. MAT is effective in reducing opioid use, decreasing opioid-related overdose deaths, and improving social functioning and retention in treatment programs.

What medications are used for Oxymorphone Addiction?

  • Methadone: A long-acting opioid that helps reduce cravings and withdrawal symptoms.
  • Buprenorphine: A partial opioid agonist that helps to suppress withdrawal symptoms and reduce cravings.
  • Naltrexone: An opioid antagonist that blocks the euphoric effects of opioids, helping to prevent relapse.

SAMHSA reports that individuals receiving MAT for opioid addiction are 50% less likely to die from an opioid-related overdose than those not receiving MAT​.

Inpatient and Outpatient Rehab Programs

Choosing between inpatient and outpatient rehab depends on the severity of the addiction. It is important to set up an initial consultation with a healthcare professional to determine which type of treatment would be best to achieve the best result. 

Here is the comparison:

AspectInpatient Rehab ProgramsOutpatient Rehab Programs
Care and Support24/7 care providing constant medical and emotional supportFlexible care allowing individuals to continue with daily responsibilities
EnvironmentStructured environment helping individuals focus entirely on recoveryLess structured, enabling patients to maintain work, school, and family commitments
SuitabilityBeneficial for severe addiction, co-occurring mental health disorders, or previous outpatient treatment failuresSuitable for less severe addictions or those who have completed an inpatient program
Key Points24/7 Care: Provides constant medical and emotional support<br>Structured Environment: Helps individuals focus entirely on recovery without external distractionsFlexibility: Allows patients to maintain work, school, and family commitments<br>Continuing Support: Offers ongoing counseling and support groups to help maintain sobriety

Behavioral Therapy for Oxymorphone Addiction

Behavioral therapy is a crucial component of treating oxymorphone addiction, addressing the psychological and behavioral aspects of substance use disorders. This form of therapy helps individuals understand and modify their drug-use behaviors, develop healthier coping mechanisms, and improve their overall mental health.

Types of Behavioral Therapy

  1. Cognitive-Behavioral Therapy (CBT): CBT helps individuals recognize and change negative thought patterns and behaviors associated with drug use. It equips patients with skills to cope with triggers, manage stress, and prevent relapse. Techniques include cognitive restructuring, which helps patients identify and challenge distorted thoughts, and behavioral activation, which encourages engagement in rewarding activities.
  2. Contingency Management (CM): CM uses positive reinforcement to encourage sobriety and adherence to treatment. Patients receive tangible rewards for meeting treatment goals, such as maintaining drug-free urine tests. CM significantly increases abstinence rates and treatment retention.
  3. Motivational Interviewing (MI): MI is a client-centered approach that enhances motivation to change. Therapists help patients explore and resolve ambivalence about quitting drug use, fostering a commitment to treatment. Techniques include open-ended questions, reflective listening, and affirmations to support and guide patients toward change.
  4. Dialectical Behavior Therapy (DBT): DBT combines cognitive-behavioral techniques with mindfulness practices to help patients manage emotions and reduce self-destructive behaviors. DBT is particularly effective for individuals with co-occurring mental health disorders, such as borderline personality disorder.

Behavioral therapy has been shown to be highly effective in treating substance use disorders, including oxymorphone addiction. A study by Carroll et al. 2006 published in the American Journal of Psychiatry demonstrated that patients undergoing cognitive-behavioral therapy had significantly better outcomes in terms of reduced drug use and improved psychological well-being compared to those receiving standard treatment. Specifically, the study found that individuals who participated in CBT sessions had a 52% reduction in drug use, highlighting the efficacy of behavioral interventions in addiction treatment.

What Are the Signs of Oxymorphone Addiction?

The symptoms of addiction manifest in both physical and behavioral changes, indicating the severity and impact of the substance use disorder. Recognizing the signs of oxymorphone addiction can be crucial for early intervention and treatment. According to the National Institute on Drug Abuse (NIDA) in an article titled “Opioid Facts and Statistics.”, misuse of prescription opioids is a major public health issue. In 2020, about 10.1 million people in the United States misused prescription opioids, including oxymorphone, highlighting the widespread issue of opioid misuse and the potential for addiction.

What are the Physical Symptoms of Oxymorphone Addiction?

  1. Tolerance: Needing higher doses of oxymorphone to achieve the same pain-relieving effects and reduced effectiveness of the drug over time.
  2. Withdrawal Symptoms: Experiencing symptoms such as muscle pain, sweating, nausea, vomiting, anxiety, and agitation when not using oxymorphone.
  3. Physical Health Issues:
    • Respiratory depression or difficulty breathing.
    • Chronic constipation and gastrointestinal problems.
    • Drowsiness, dizziness, and impaired coordination.
    • Noticeable weight loss or gain.

What are the Behavioral Indicators of Opana Misuse?

  1. Drug-Seeking Behavior:
    • Frequently visiting different doctors or emergency rooms to obtain prescriptions (doctor shopping).
    • Persistently requesting early refills or higher doses of oxymorphone.
    • Using oxymorphone in larger amounts or over a longer period than intended.
  2. Neglecting Responsibilities:
    • Failing to meet obligations at work, school, or home due to drug use.
    • Decreased performance in professional or academic settings.
    • Neglecting personal hygiene and appearance.
  3. Social Changes:
    • Withdrawal from family and friends, leading to social isolation.
    • Changes in social circles, spending more time with other individuals who misuse drugs.
    • Engaging in secretive or suspicious behaviors.
  4. Psychological and Emotional Changes:
    • Increased anxiety, depression, or mood swings.
    • Irritability or agitation when unable to use the drug.
    • Loss of interest in previously enjoyed activities and hobbies.
  5. Financial and Legal Problems:
    • Spending excessive amounts of money on obtaining oxymorphone.
    • Stealing or borrowing money to purchase the drug.
    • Legal issues arising from drug possession, theft, or other drug-related activities.

Can Oxymorphone Use Lead to Overdose?

Yes, oxymorphone use can lead to overdose, particularly when the drug is misused or taken in higher doses than prescribed. Overdoses occur due to the drug’s potent effects on the central nervous system, which leads to severe respiratory depression and other life-threatening symptoms. Oxymorphone has been linked to a significant number of opioid-related overdose deaths. According to an article called “Drug Overdose Deaths.” from the Centers for Disease Control and Prevention (CDC), opioids were involved in nearly 75% of all drug overdose deaths in 2020, with synthetic opioids like oxymorphone playing a critical role 

What are Symptoms of Oxymorphone Overdose?

  • Respiratory Depression: Slow or shallow breathing, or complete cessation of breathing.
  • Extreme Drowsiness: Profound sedation or inability to wake up.
  • Pinpoint Pupils: Constriction of the pupils, which may not respond to changes in light.
  • Cyanosis: Bluish tint to lips or fingertips due to lack of oxygen.
  • Muscle Weakness: Flaccid muscles, limp body.
  • Cold and Clammy Skin: Skin feels unusually cool and sweaty.
  • Bradycardia: Slow heart rate.
  • Hypotension: Low blood pressure, which can lead to shock.
  • Unconsciousness or Coma: Lack of responsiveness to stimuli.

According to an article titled “We Level Up CA” published by Zinnia Health in 2024, the risk of overdose with Blues is extremely high. The Drug Enforcement Administration (DEA) reports that as many as 6 in 10 oxymorphone pills sold on the street contain a lethal dose of fentanyl. This has led to a significant number of overdose deaths, as even a tiny amount of fentanyl is fatal.

Emergency Response Strategies: Oxymorphone Overdose

Emergency Response Strategies: Oxymorphone Overdose

In the event of an oxymorphone overdose, immediate medical intervention is critical. Here are the recommended emergency response strategies:

  1. Call 911: Immediately call for emergency medical assistance. Provide the dispatcher with all relevant information, including the person’s symptoms and any known use of oxymorphone.
  2. Administer Naloxone: If available, administer naloxone (Narcan®), an opioid antagonist that can reverse the effects of an overdose. Naloxone can be given as an injection or nasal spray. It’s essential to follow the instructions carefully and administer it as soon as possible.
  3. Perform CPR: If the individual is not breathing or has no pulse, begin cardiopulmonary resuscitation (CPR). Follow the instructions given by the 911 operator until medical personnel arrive.
  4. Monitor and Support: Stay with the individual until help arrives. Monitor their breathing and pulse, and be prepared to administer additional doses of naloxone if necessary, as its effects may wear off before the oxymorphone is entirely out of the system.
  5. Provide Information: Inform medical personnel about the type and amount of drug taken, the time of ingestion, and any other relevant medical history or information.

What is the Importance of Aftercare with Oxymorphone Addiction?

Aftercare is imperative for maintaining sobriety and preventing relapse in individuals recovering from oxymorphone addiction. It provides ongoing support through therapy, support groups, medical follow-ups, and life skills training. Aftercare helps prevent relapse by offering coping strategies for triggers and cravings. It also addresses co-occurring mental health issues, enhancing overall recovery outcomes.

Support groups like Narcotics Anonymous (NA) provide peer support and a sense of belonging, reducing feelings of isolation. Individual and group therapy, including cognitive-behavioral therapy (CBT), helps address personal issues and develop healthier behaviors. Family therapy repairs relationships and builds a supportive home environment. Life skills training improves job readiness, financial management, and healthy lifestyle choices, essential for long-term recovery.

How Can I Prevent Oxymorphone Addiction?

Preventing oxymorphone addiction involves using the medication strictly as prescribed, discussing alternative pain management strategies with a healthcare provider, and being aware of the signs of addiction. Regular monitoring by a healthcare provider can help detect early signs of misuse.

Are There Any Legal Implications of Oxymorphone Misuse?

Yes, misuse of oxymorphone can lead to legal consequences, including charges related to possession of controlled substances, prescription fraud, and driving under the influence. Legal repercussions vary depending on the jurisdiction and the severity of the offense.

Can Oxymorphone Misuse Cause Hormonal Imbalances?

Yes, long-term use of oxymorphone leads to hormonal imbalances, such as opioid-induced hypogonadism. This condition results in decreased levels of sex hormones, causing symptoms like fatigue, depression, reduced libido, and menstrual irregularities​.

Is There a Risk of Developing Hyperalgesia with Prolonged Oxymorphone Use?

Yes, chronic oxymorphone use will lead to opioid-induced hyperalgesia (OIH), where patients become more sensitive to pain. OIH is caused by changes in the central nervous system due to prolonged opioid exposure. It often requires reducing or discontinuing the opioid and transitioning to alternative pain management strategies​.

How Does Oxymorphone Addiction Impact Mental Health?

Oxymorphone addiction significantly impacts mental health, exacerbating conditions like anxiety, depression, and mood swings. According to the American Psychological Association, chronic misuse can alter brain chemistry, leading to severe cognitive impairments and emotional instability. These mental health issues often require comprehensive treatment plans to address both addiction and psychological well-being.

In cases of Oxymorphone addiction, it is common to see co-occurring disorders. Dual diagnosis treatment is crucial as it addresses both the addiction and any underlying mental health conditions. This approach helps provide a holistic treatment, ensuring that all aspects of the individual’s health are managed effectively. For those with complex addiction issues, understanding the impact of substances like Methadone addiction can also be beneficial.

The Grove Editorial Team is a dynamic group of professionals at The Grove, a leading addiction treatment center in Indianapolis, Indiana. Comprising experienced therapists, medical experts, and dedicated support staff, this team brings a wealth of knowledge and compassionate insight into the complexities of addiction and recovery. Their collective expertise shines through in each article, offering readers valuable guidance, the latest in addiction science, and inspiring stories of healing and transformation. The Grove Editorial Team is committed to educating, supporting, and empowering individuals and families on their journey toward a healthier, substance-free life.

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