Oxycodone has been the second-most prescribed opioid pain reliever in the US. In 2016, 5 billion oxycodone tablets were distributed in the United States.
It is available as a standalone product as well as in combination with other drugs such as aspirin and acetaminophen. In either case, it is available by prescription only and is classified as a Schedule II controlled substance by the DEA.
Generic oxycodone hydrochloride was approved by the FDA in 2004 and is now widely available. The drug is marketed under various FDA-approved brand names:
- Combunox (combined with Ibuprofen)
- Percodan (combined with Aspirin)
- Percocet (combined with Acetaminophen)
- Xartemis XR (combined with Acetaminophen)
Single-ingredient Oxycodone brand names:
- Xtampza ER
Is Oxycodone an Opiate or Opioid?
Like hydrocodone, oxycodone is also a semi-synthetic opioid derived from the opium poppy flower with powerful opiate pain-relieving effects similar to morphine. As with other opiate analgesics, it works by attaching to the opioid receptors in the brain and changing the brain's perception of pain and has similar side effects and withdrawal symptoms.
The distinction between an opiate and opioid is whether the entity is derived from a natural source (opium poppy flower) versus synthetically developed to mimic and act like the natural substance but with different chemical structures. Oxycodone is semi-synthetic because it is a hybrid developed by modifying naturally occurring thebaine (obtained from the opium poppy) and contains both natural and synthetic ingredients. Hence technically it would be classified as a semi-synthetic opioid.
Oxycodone vs Hydrocodone
Oxycodone and hydrocodone are both heavy weights in the opiate painkiller world. Both have powerful pain-killing effects and both are synthesized from the opium poppy plant. These two drugs work in very similar ways and have similar side effects.
Oxycodone and hydrocodone have been cited as the two main prescription pain relievers contributing to the crisis though now fentanyl is by far the largest culprit responsible for the most number of overdose deaths.
These two depressant narcotics are notably misused by those addicted to opioids due to their powerful euphoric and sedative effects. Both of these prescription-only drugs hold the potential to be abused and are a particular concerning source (sometimes inadvertently) for opioid dependence and addiction among school-aged children.
What are Oxycodone and Hydrocodone Used For?
Oxycodone and hydrocodone are commonly prescribed for the relief of moderate to severe pain. Both drugs work well independently but each can also be used in combination with other analgesic drugs for greater benefit. There are numerous combinations of both drugs available that are FDA approved.
For example, oxycodone can be combined with acetaminophen, another prescribed analgesic drug, to make a separate effective narcotic painkiller. Common brand names of this combined analgesic include Percocet.
Oxycodone can also be combined with aspirin or antihistamines, as can Hydrocodone.
Hydrocodone is also commonly combined with acetaminophen and prescribed under the common brand names of Vicodin and Lortab.
Both hydrocodone and oxycodone are semi-synthetic opiates; they belong in a class of medicines known as opioid analgesics. Hydrocodone additionally serves as a cough suppressant and belongs to a class of drugs called antitussives.
Whilst these drugs are intended for palliative care and severe pain conditions, it has been shown that they have been commonly prescribed for mild to moderate pain conditions, including back pain. 40% of opiate abusers obtain these drugs from relatives and friends. This shows that there is a huge surplus of these drugs in circulation.
Both oxycodone and hydrocodone are Schedule II drugs in the US, meaning they both have a high potential for misuse.
How Oxycodone and Hydrocodone Work
Oxycodone and hydrocodone both work to relieve pain by attaching to the brain's opioid receptors and changing the way the brain interprets pain signals from the body.
In addition to relieving pain, both drugs produce a euphoric high through the mass release of dopamine and endorphins into the user's brain. It the euphoric high produced by these drugs that makes them the most sought after prescription opioid by drug addicts and drug abusers in the United States.
Which is Less Addictive, Oxycodone or Hydrocodone?
When considering the options regarding adequate pain relief, it is best to have a frank discussion with your physician. Both of these narcotic drugs can cause drug dependence and drug addiction.
When opioid addicts were questioned as to which drug they preferred, they named oxycodone as having a more desirable high but that hydrocodone was more readily accessible.
The truth is that both of these opioid painkillers, despite increased awareness, are still over prescribed in the US.
Both oxycodone and hydrocodone are incredibly addictive. As they work on the brain's pain receptors the drugs induce chemicals that rewire the brain. It doesn't take very long before a regular user finds that they need these drugs in order to avoid opiate withdrawal syndrome (tolerance and dependence)
Neither drug has been medically noted to be less addictive that the other in terms of tolerance and dependence, so it is safe to assume that both oxycodone and hydrocodone are equally as addictive.
Which Drug is Best for Pain Relief, Oxycodone or Hydrocodone ?
Two separate studies have been conducted regarding the effectiveness of these two drugs in treating moderate to severe pain. However, the studies do contradict one another.
One study showed that in comparison oxycodone was 1.5 times more potent than hydrocodone and at higher doses oxycodone had slightly more abuse potential than hydrocodone.
In another scientific study conducted with an ER department both drugs were used to treat acute pain in patients with fractures. This study found that there was little difference in their effectiveness and practicality. The only difference found was in the side effects, which showed that hydrocodone has a slightly higher incidence of constipation.
Oxycodone & Hydrocodone Dosage
Both oxycodone and hydrocodone are intended for conditions that require around the clock pain relief such as a acute physical trauma, postoperative pain and palliative cancer pain. They are not intended to be taken on an as needed basis.
With the exception of cancer, these drugs should only be prescribed for a short period of time, after which the prescription is stopped or tapered off.
They are both available in short acting and extended release forms. Both narcotics are prescribed in tablet form, capsules, syrup to be taken orally, transdermic extended release patches and a clear liquid for intravenous or muscular infusion or injection.
Short release tablets and capsules are to be administered every 4 to 6 hours and long release every 12 hours.
Side Effects of Oxycodone and Hydrocodone
Both of these drugs share many common side effects, including:
- shallow or light breathing
- water retention, difficulty in passing urine
- dry mouth
- motor skill impairment
Oxycodone has been shown to cause more dizziness, drowsiness, fatigue and euphoria. Hydrocodone has been shown to cause more stomach pain and constipation.
Oxycodone vs Hydrocodone Final Thoughts
Based on research it would seem that oxycodone is the more desirable drug to opiate addicts in terms of the euphoric high that it produces. However, hydrocodone has historically been easier to obtain.
Until October 2014, hydrocodone combination drugs were a Schedule III drug. Recognizing its potential for abuse, overdose and addiction, hydrocodone combination products were put on the same schedule as pure hydrocodone, oxycodone and oxycodone combination products. All products are now Schedule II drugs in the US.
Whichever codone is being used, it needs to be done so with great care. And, given these are the two most-prescribed and most-abused opioids, disposal of leftover or unused medication must be done properly, ideally at drug disposal stations at retail pharmacies and similar venues.