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?

The real issue in the US is nurse practitioners (who have prescribing privileges) working in regions where actual doctors are few and far between - deprived rural regions like Appalachia, for instance - and where many experience genuine pain problems. These NPs have only a rudimentary grasp of pharmacy; many started out in community colleges and patched together enough credits to get their job titles. Nurse practitioners are very loosely regulated in most states in the US, and the very powerful nursing unions resist all efforts to increase oversight of NPs.

There's endone and palexia which operate similar to oxy. Just had a total hip replacement and palexia was the initial pain killer. They tried to transition me to endone but I didn't react well to that, so stayed with the palexia. I had both slow release and fast acting over 2 weeks. Still have half the fast acting and I take one if pain levels increase (getting second hip replaced soon, also have advanced degeneration in other joints) as mobility is essential for surgery recovery.

Generally my pain is managed with diclofenac which does a good job. On script I can get stronger dosage and larger packs than over the counter.

Yup.
for all those saying how much more monitoring happens in the uk:
I’ve been prescribed tramadol and tapentadol for the best part of twenty years, I’ve also had fentanyl and it was only stopped because I kept complaining it was too strong and I didn’t feel safe on it , nobody is particularly monitoring my intake or dependence so all the people saying it’s heavily monitored in the uk: it really isn’t.

things like benzodiazepines and medication taken for sleeping seem to be far more monitored than opiates / synthetic optiates, certainly in my experience

Funnily they threw morphine at me for cauda equina
endo? “Have some paracetamol”
it took a complaint from gynae for me to get proper pain relief

It’s not an NP problem. That’s an odd take. There were doctors running pill mills and the abuses were systemic.

My DS is a doctor working in a deprived rural area who regularly sees the results of NPs writing painkiller prescriptions willy nilly.

The pill mill doctors used to be a huge problem, but not so much any more.

They are opiates but not all the same and have different strengths. I was pretty shocked you could buy codeine OTC as cocodamol when I moved here.

I have never had an addiction but I did go through a period where I was really struggling with lower abdominal pain - no cause, probably IBS, but I would go days of being at a 7-8 pain level and just trying to carry on pretending it was fine. I finally tried co-codamol (I do not do well on opiates so really wasn’t keen) and when the pain went away, I felt like I understood how you could get addicted. It didn’t make me high but it didn’t HURT anymore after days of pain and living in fear that the pain would come back and there would be nothing I could do. I ended up finding a dietary solution and the pain stopping, but if someone was post surgery or with a slow recovery from a painful injury, I could understand how it would start with just wanting the pain to go away and end with dependence and addiction.

Very true! You can buy codeine OTC but you can’t get melatonin?!

Oxycodone. I’m on it now in hospital for pain for a bulging disc. It’s incredibly controlled. I’m on a very very low dose and even tgg if at outside me to sleep.

I was on oxycodone for about two years here in the UK. I started off on oxynorm (instant release) and moved to oxycontin as I was waking up during the night in pain very often.

I then had a surgery that changed how my digestive system worked and I was unable to digest the tablets anymore (TMI but they were passing through with the markings still intact). I tried a few other options trying to find a good balance between being able to sleep without waking in pain and not too many side effects. Eventually I went with Buprenorphine patches as they only need to be changed once a week, with a bottle a month of liquid morphine for breakthrough pain.

Most of the drugs you hear about in the US causing issues are widely used here, but tighter regulation means it doesn't spiral out into addiction as easily. It does still happen though - a cousin ended up using street drugs after struggling to quit his prescription painkillers after a surgery that was highly delayed by the pandemic.

We do risk going too far the other way and leaving people in chronic pain with horrific quality of life due to fears around addiction. Some pain isn't fixable and a lifetime of painkillers is the only way to lead a relatively normal life.

Correct there is no financial incentive in the UK or very little. People in the US can choose whomever they want to prescribe what ever they want and morals and ethics are much more at the heart of the medical industry

healthcare in the US is the 3rd biggest economic industry. It simply does not exist in this way int he UK.

this was an eye opener

It’s excellent and explained really well why there was an opioid epidemic in the US. Heartbreaking.

I'd wondered the same after watching Dopesick and another excellent series. Might of been Painkiller. Awful.

It's got it in Australia for broken ribs. I don't really get it from a buzz perspective tbh but then again I used to abuse benzodiazapines which are infinitely more delicious. Definitely had withdrawals after only a few days and felt like there was cotton wool in my head.

It really is a good look at the whole thing.

Codeine as cocodamol, not as pure codeine. Important distinction.

We’ve never dished out opioids here, that’s the reason it’s not an issue - that said there are people addicted to them but not in the same numbers /percentage of population. A combination of nhs, no advertising of prescription drugs and a population who is used to doctors telling us what we need rather than us demanding of doctors means we didn’t use as many

My dad was given Oxycontin for pain management at end of life. He refused morphine and fentanyl as he was a former heroin addiction and was afraid of getting addicted.

This was during Covid and he also wasn't great at reordering his medication there were times when he ran out of Oxy. The withdrawals were horrific. It was the first time he ever spoke about wanting to die, and he had been a heroin, crack addict and alcoholic at various stages in his life. He said the Oxy withdrawals were like nothing he ever experienced before. He was up to about 30mg by then I think.

After he died I found hundreds of pills he had stashed around and forgotten about. I tried to give them back but no one would take them during Covid. I was in a dark place myself at the time and did consider taking some. Thank god I never did!

One thing I found odd even as a child visiting relatives in America was the drug adverts. Not just things from a pharmacy or now supermarket but anything - ask your doctor about the cholesterol drug and begin to be able to go in rivers again??? It worked (together with things to doctors) and became a market leader

in previous post

You are right I don't, so sorry if I offended you. I meant short term pain (not chronic, long term pain) is part of the body's natural process. It would be weird if you didn't hurt when you'd broken a bone for example.

Opiods being addictive is not really new knowledge.
Glad to hear it has been tightened up significantly now.

I agree that it's a great series. I thought the problem with Germany was that the Germans (rightly) refused to licence it?

Without a doubt the pharmaceutical industry is guilty of some appalling breaches of ethics in the US, but that has a lot to do with the kind of unregulated capitalism they have over there.

I find it a bit strange when British people start banging on about "Big Pharma", as if circumstances were identical over here.