What is the UK equivalent of Oxycontin?

[LindorDoubleChoc]

I haven't watched the film and documentary series about the USA problems with addiction to common painkiller medications, but I know they exist (and I do intend to get round to it when I can handle some grim watching).

I caught a few minutes of Jamie Lee Curtis talking about her Oxycontin addiction and I think Matthew Perry was also addicted before getting into ketamine (?). So I can understand it and get a handle on it - what would be the equivalent drugs in the UK?

I have been prescribed oxycodone for 7 years as morphine doesn’t work on me. I can pretty much get it on request. I was never given any warnings around it so watching the documentaries was a shock! Luckily im sensible with it, but I don’t think it’s really monitored properly

I was given luquid Oxycodon in hospital with a complicated broken leg because I am allergic to maize which is in practically every painkilling pill ever made. I had soluble paracetamol, too and upon discharge, I was prescribed soluble co-codamol a month at a time for about 6 months post discharge

As you've probably figured out by now OP, the UK equivalent of Oxycontin is Oxycontin! It's a slow release form of oxycodone which is a opioid painkiller from the same family of drugs as morphine, fentanyl, codeine etc. It is an extremely useful drug when used appropriately. I have prescribed it many times and taken it myself post operatively. I would have no qualms about taking it again should the need arise. It's a very effective painkiller and, for me, it has less side effects than other opioids, though that varies from person to person.
It is addictive - all opioids are unfortunately, so like all the others it should generally be used at the lowest effective dose for the shortest time possible, but it's not intrinsically a "bad" drug. It's a drug that was marketed and prescribed badly and very unethically in the US particularly. In my opinion at least, the real issue was unethical behaviour by corporations and individuals within a money driven healthcare system, not the pharmacology of the drug.
There are lots of drugs that when used correctly are extremely helpful, life saving even, but prescribed unwisely, taken incorrectly or used as recreational drugs can be very harmful or even fatal. Unfortunately sometimes drugs get a bad name when they are known to be abused. Take ketamine. People know it as a drug of abuse or a "horse tranquilliser" and are scared of it, but it's a very useful anaesthetic agent and painkiller in certain situations. And propofol. I lost count of the number of patients who told me that they didn't want to be given it after Michael Jackson died because it's very dangerous. And indeed it is very dangerous if given in an uncontrolled, unmonitored situation by someone not suitably qualified. But in the hands of a qualified anaesthetist in an operating theatre it's one of the most useful drugs we have.
All drugs need to be treated with respect and used properly of course, but it's humans that are the problem, pretty much always.

I think the drugs market in the UK is different to the US for a number of reasons. These both stem from the failings and endemic corruption in US healthcare /welfare (the kickbacks to doctors, the outsize influence of big pharma, relative weakness in monitoring of prescribed drug use, the lack of support for people who suffer serious injuries, the cost of healthcare in general) and the way in which the cartels and other organised crime groups have exploited the market. In particular, collaboration between the South American cartels and Chinese organised crime groups has really turbo charged the market, making it extremely easy and extremely lucrative to supply fentanyl and other synthetic opioids to the US. While the UK has some of those issues, and clearly has a growing issue with drug harms, the market dynamics are different and the general appetite for illegal drugs is different.

The UK equivalent of OxyContin is usually just modified-release oxycodone sold under UK brand names such as:
OxyContin
Longtec
Oxypro
All contain oxycodone hydrochloride and are used for severe or chronic pain. The NHS lists OxyContin, Oxypro, Longtec and Shortec as UK oxycodone brands. �
nhs.uk +1
A quick distinction in the UK:
Longtec / OxyContin / Oxypro = slow-release (“extended release”) oxycodone
Shortec = immediate-release oxycodone for breakthrough pain �
nhs.uk.

I have a weekly morphine patch of slow release 10mg.
I can't take it orally.. nor can l take codeine/ ibroprofen and asprin.
( Broken pelvis and both hips/ Cervical spondylosis radiculopathy and stenosis). Having spinal surgery in two months.. next year new hips.. hopefully will come off the morphine patch then.. never needed anything higher or more and more. It works for me.
Don't smoke/ drink.
.

Oh, is that why people talk about getting a high off codeine as they are getting morphine hits instead?

Tramadol makes me vomit/migraines and codeine does nothing except remove a certain level of pain, eg takes it from an 8 to a 4. Never had this floaty sensation that others talk about.

Yes I don't find codeine exciting
i must not have the enzyme

I worked in the Pharma industry on cancer research. Then vaccines. It is not a con. It is lots of hard working smart people striving to cure disease and sickness.

Dopesick is very good much better than the one on Netflix

Totally agree. I work in cancer trials. Without collaboration with pharmaceutical companies treatment would be stuck in the dark ages.

My dad takes Oxycontin for fibromyalgia. So it has the same name here.

My husband has been on tramadol for about 6 years for back pain. According to scans his herniated disk doesn't look bad enough to operate on but without his pain relief he walks at the speed of a 95 year old and spends a lot of time lying down, so the system has just left him on opiods. One of the too many on it!

Codeine is available over the counter in the UK so I wouldn't agree it's closely monitored. In Germany where I live now you can't get it except for on prescription, and they rarely give it on prescription. But you also can't buy painkillers at all in supermarkets. Everything like that is over the counter at pharmacies and is a lot more expensive than the 16p packs you can get in the UK.

To be fair to the US, since I live here, they cracked down hard on opioids at least a decade ago. They are not easily prescribed and come in very small quantities. I was given 5 oxycodone after a pretty significant surgery. You can’t even buy codeine here like you can in the UK.

A few decades ago no one knew any better. For every person that becomes terribly addicted there are two or three others that have no problems with it at all, take it as prescribed and quit when they no longer need it. But the risk usually isn’t worth it since most patients won’t say “by the way, I’m prone to addiction so let’s go easy on the painkillers.” I’m sure some of them didn’t even realise until it was too late.

chemical isotopes

Isotopes are different atomic weights of the same element, like normal hydrogen (aka protium), heavy hydrogen (aka deuterium), and radioactive hydrogen (aka tritium). Do you mean "chemical formulas" or "chemical structures"?

rebranded pain as always bad

Tell me that you don't live with chronic pain without telling me...

Are you saying it was a British company that produced, introduced and supplied OxyContin in the US? @tourdefrance

Yes me too since 2016. I am prescribed the max dose and get it in 100 pill boxes. Also tramadol, diazepam, pregabalin and oramorph.

The only time they’ve ever flagged it is the odd pharmacist telling to make sure I don’t take the cocodamol and tramadol within the same four hour period. I’ve never had a med review so definitely not highly regulated for me!

Depending on the underlying condition, the prescriber may just expect you to need this much pain relief.

Having ended up getting oramorph in A&E because of a migraine so painful that I was crying uncontrollably and throwing up every sip of water, I can believe that some pain needs everything you've listed.

The reason it was an issue in the US, isn't an issue in the UK and isn't an issue in the US any more is entirely down to sales and marketing regulation. In the UK pharma companies aren't even allowed to give a doctor a pen but just watch Dopesick to see what they could do in the US and how they could influence community doctors and pharmacists, and the effects it had. Not to mention the lobbying of the FDA.

@onemorerose @tourdefrance ims health wasn't a British company, is now Iqvia. They do have UK offices though. All pharma companies are global and operating in different territories to those territories' rules.

UK Equivalents: The British National Formulary (BNF) lists several brand names, including Longtec (modified-release/prolonged-release), Shortec (immediate-release), Oxeltra, and OxyNorm.

The dosages taken by some people that documentary were insane, and from memory the manufacturer kept increasing the maximum dose.

I can't remember the specific amounts, but at the time I watched it I was temporarily on oxy for a broken bone which had me nodding off most of the day. Some people in that doco were being prescribed pills that were 20x stronger.

We have Oxycontin in the UK. It’s just a brand of modfied-release Oxycodone tablets which are prescription-only, and not easily prescribed.

I was given oxycodone after surgery. They said it would relax me and send me to sleep but I had a weird adrenaline reaction to it and was shaking/highly anxious/heart racing on it. Very odd. I can take codeine and morphine and have had fentanyl with no problems.

The US situation is a bit complex. Patrick Radden Keefe's Empire of Pain is an essential read if you want to understand. The thing is that Purdue Pharma actively lied and told doctors that patients couldn't become addicted to Oxycontin, that the formulation prevented addiction. It was a lie. So pharma marketing was part of it, but the other issue is that the NHS and NICE mean much stricter guidelines that doctors have to follow. With doctors being independent in the US this doesn't happen even though the various colleges will give advice as will FDA, etc. So some doctors became "pill mills", sometimes for profit — get enough patients in on a fee for service basis and you can make a lot of money. There was actually advice to treat pain quite aggressively with whatever worked and there were patients with good doctors who developed addictions to oxycodone after surgery for example, sometimes quite rapidly. Oxycodone is also prescribed in the US alongside paracetamol as Percocet. I was given it after my Caesarean sections here just like I was given co-dydramol in the UK. Now they are very strict on post-surgical opioids (sometimes needlessly so, to be honest, I know people who had difficult recoveries). It's also very difficult to get opioids if you go into an ER because of drug-seeking. (Again this can have downsides, see the sickle-cell patient in The Pitt. Sickle cell patients are often treated as drug-seekers.)

The Oxy epidemic also coincided with rises in disability and economic crashes in parts of the US (eg Ohio, West Virginia). People were coming into doctors offices with chronic pain issues and being treated with opioids. In some ways it was a perfect storm: with just the poor advice and marketing it would have been bad but not a crisis, but add in a huge and growing pool of potential patients and now you get an epidemic.