Metabolites
Oxycodone at the Crossroads of Pain Management, Misuse, and Toxicological Investigation
By Dawid Ślebioda, Marta Alicja Ślęczka, Izabela Skowron and 3 others.
Abstract
Background
Since the 1990s, the United States has been facing the recurring problem of widespread misuse, addiction and overdoses involving opioid compounds. This phenomenon is known as the opioid crisis or the opioid epidemic. Every day, around 200 Americans die due to opioid use. Nowadays the country is facing the fourth wave, dominated by fentanyl combined with stimulants. The problem of opioid abuse is not confined to the United States alone, but is a global issue.
Objective
In this paper, we do not focus on fentanyl, but on another painkiller, oxycodone, as it is often overlooked in discussions of the current crisis, whilst its sale and use are becoming increasingly common. In Poland alone, the number of prescriptions increased by 50% between 2019 and 2023, and nearly 200 Poles have died as a result of an opioid use disorder. This narrative review examines oxycodone at the intersection of pain management, non-medical use, and toxicological investigation, with emphasis on its pharmacology, clinical applications, abuse liability, overdose risk, and detection in biological matrices.