Opana (oxymorphone) is a very potent semisynthetic opioid drug that is used for pain control. Opana is available in an immediate-release form (Opana IR) and an extended-release form (Opana ER). Dosages of oxymorphone in Opana IR are 5 mg and 10 mg, whereas dosages are 5 mg, 7.5 mg, 10 mg, 50 mg, 20 mg, 30 mg, and 40 mg for the extended-release version. The analgesic effects of the immediate-release version last 3-4 hours, whereas the extended-release version provides pain relief for up to 12 hours. There is also an injectable form of Opana that is primarily used in hospitals and clinics.
The active narcotic ingredient in Opana, oxymorphone, is classified as a Schedule II controlled substance by the United States Drug Enforcement Administration (DEA). This means that the drug is considered to have significant medicinal uses, but also has a high potential for abuse and for the development of physical dependence when the drug is used consistently over time.
The extended-release version is obviously used for the control of pain over longer periods of time and the reduced need to keep taking the medication throughout the day.
The medicinal uses for Opana include:
- Relief of moderate to severe pain
- Uses a preoperative medication to control anxiety in individuals who are about to receive anesthesia
- May be used to maintain anesthesia during specific types of operations
- May be useful to controlled labored breathing in patients who have certain types of heart problems and/or pulmonary edema (the buildup of excess fluid in the lungs)
Effects of Using Opana
The most salient effects that are associated with using any opioid medication are the reduction of the subjective experiences of pain, stress, and anxiety. In addition, individuals often feel sedation and mild euphoria even when using the drug as recommended. Numerous side effects have been reported as a result of using Opana; however, in most cases, the side effects are rare.
Some of the more common reported side effects that can occur with medicinal use of Opana include:
- Nausea
- Vomiting
- Constipation
- Dizziness
- Sleepiness
- Headache
- Itching
- Sweating
- Dry mouth
- Diarrhea
- Fatigue
- Decreased appetite
- Stomach pain
According to the two-volume series Martindale: The Complete Drug Reference, in addition to the above common side effects, there are some rare but potential serious side effects that can occur as a result of using Opana.
Rare side effects of Opana include:
- Significant respiratory depression is a potentially serious side effect that can occur in individuals who use opiate medications. Severe respiratory depression can lead to significant brain damage and death. People who have respiratory issues or respiratory diseases should only use Opana under the supervision of a physician as the normal actions of the drug will produce some decrease in one’s breathing rate.
- All opioid drugs can lead to decreased response times and issues with motor coordination. Physicians are required to explain this to their patients and tell them not to drive an automobile while on the medication. In addition, the medications have warning labels on them that advise patients not to drive or use potentially dangerous machinery while taking the medication.
- Allergic reactions can occur in some individuals. The most common allergic reactions include swelling in the face, tongue, hands, or throat as well as itching, labored breathing, rash, and hives. Some individuals may experience severe nausea and vomiting in addition to these symptoms. If a person using the drug develops any of these symptoms, they are advised to stop taking the drug and immediately contact emergency medical services as allergic reactions to medications can be serious and can even result in fatal consequences for some individuals.
- Adrenal insufficiency/adrenal failure has been rarely associated with the use of opioid drugs like Opana. This condition occurs when the adrenal glands do not release hormones in sufficient amounts. The symptoms typically consist of lower back pain, leg pain, abdominal pain, severe vomiting, severe diarrhea, low blood pressure, high potassium levels, low sodium levels, and a potential loss of consciousness. Individuals are at risk to become severely dehydrated due to vomiting and diarrhea, and this condition should be treated immediately.
- Hypotension (low blood pressure) may be a potentially serious side effect of using Opana. This can lead to several potentially serious issues.
- Individuals who have significant head injuries or brain tumors are at risk for potential brain damage due to increased carbon dioxide levels in the brain as a result of respiratory suppression.
- The use of Opana in pregnant women can result in neonatal opioid withdrawal syndrome, a condition where newborn children have developed physical dependence on the drug and undergo withdrawal when they do not get it.
- Of course, there are a number of potential untoward interactions that can occur when one is using Opana and other medications/drugs. One class of drugs that deserves special mention is the use of Opana with other central nervous system depressant drugs, such as alcohol or benzodiazepines. Combining central nervous system depressant drugs can increase the respiratory suppression that occurs from either drug and result in a number of other enhanced effects from these drugs. Increased risks for overdose and fatalities occur when individuals use multiple central nervous system depressant drugs concurrently.
- Opana was designed with abuse-deterrent technology, such that the extended-release version of the drug has a hard shell over it to prevent users from crushing and snorting it. This hard shell may make the medication difficult to swallow for some individuals. In addition, in very rare cases, some individuals have suffered intestinal blockages as a result of the hard shell on the pills.
- Individuals with seizure disorders may be at risk for increased seizure activity if they use Opana.
- Long-term use of Opana is associated with the development of tolerance. Tolerance occurs when the individual needs more of the drug to achieve the effects that were once achieved with lower doses.
- Long-term use of Opana is also associated with the development of withdrawal symptoms. The withdrawal syndrome that is associated with opiate drugs is not generally considered to be potentially fatal; however, individuals may be at risk for accidents, poor decision-making, and dehydration as a result of withdrawal symptoms. An individual using Opana should consult with their physician before deciding to discontinue use of the drug.
Side effects that are associated with the medicinal use of Opana are most often relatively mild, and physicians are able to address these issues on a case-by-case basis. Side effect profiles that occur in individuals who abuse drugs are significantly more severe, significantly more frequent, and significantly more distressing than the side effects that occur in individuals who use the drug under the supervision of a physician and according to its prescribed instructions. In addition, individuals who abuse different combinations of drugs are at risk to develop side effects that may not be associated with the use of those specific drugs taken in isolation.
When individuals have developed both the symptoms of tolerance and withdrawal to any drug, they have developed physical dependence on the drug. Physical dependence to a drug is generally not considered to be a serious issue when the drug is being used for medicinal purposes and under the supervision of a physician; however, in individuals who abuse drugs, the symptoms of physical dependence can be considered to be signs that the individual has a substance use disorder (a serious abuse issue or addiction). In addition, the development of physical dependence on a drug in individuals who abuse the drug often results in the person compulsively using the drug to avoid potential withdrawal symptoms. The repetition of this practice results in exacerbation of their addictive behavior.