OxyContin: How It Works, Who It’s For, and Why It’s Controversial

OxyContin is one of the most powerful prescription painkillers available in the UK. It’s used to treat severe, long-term pain—often when other medications have failed. But behind its strength lies serious potential for addiction, dependence, and misuse. In our top 10 painkillers in the UK post, Oxycontin featured as the strongest painkiller prescribed in the UK.

What makes OxyContin different from many opioids is its extended-release formula. It delivers a steady dose of oxycodone, the active ingredient, over 12 hours. That’s why it’s commonly prescribed for chronic pain conditions such as cancer pain or major injury recovery. When used correctly, it can offer relief and restore function. When misused, it can be deadly.

In this guide, we’ll focus specifically on OxyContin, its medical use in the UK, how it compares to oxycodone, and what you need to know about side effects, dosage, withdrawal, and addiction. We’ll also briefly touch on other forms of oxycodone, like immediate-release tablets and liquid solutions, which are sometimes used alongside or instead of OxyContin.

What is OxyContin used for?

OxyContin is prescribed for managing severe, ongoing pain that can’t be controlled by weaker painkillers like codeine, tramadol, or paracetamol. It’s often used in cases where pain is constant and expected to last for weeks or months—not for occasional aches or short-term injuries.

In the UK, OxyContin is commonly used for:

• Cancer-related pain, especially in advanced stages
• Chronic back pain, joint pain, or nerve pain when other treatments fail
• Post-surgical pain, especially following major operations
• Palliative care, to improve quality of life in terminal illnesses
• Pain in patients who are already tolerant to other opioids

Because it’s extended-release, OxyContin provides a slow, steady stream of oxycodone over 12 hours. This helps prevent breakthrough pain and avoids the rollercoaster effect of short-acting opioids that wear off quickly. For that reason, it’s almost always prescribed on a twice-daily schedule.

Doctors may also combine OxyContin with immediate-release oxycodone or other fast-acting analgesics for breakthrough pain episodes—but this is done under strict supervision.

OxyContin dosage and forms available in the UK

OxyContin comes in extended-release tablets designed to release oxycodone slowly over 12 hours. These tablets should be swallowed whole—never crushed, chewed, or split—as tampering with the release mechanism can cause a dangerous overdose.

Available tablet strengths in the UK:

• 5mg
• 10mg
• 15mg
• 20mg
• 30mg
• 40mg
• 60mg
• 80mg
• 120mg

Doctors will usually start patients on the lowest effective dose, especially if they haven’t taken opioids before. Dosage is then adjusted gradually based on:

• Severity of pain
• Response to treatment
• Previous opioid exposure
• Age and general health

For patients already on strong opioids, the dose may be higher from the outset—but only under specialist guidance.

How often is it taken?

OxyContin is usually prescribed every 12 hours—for example, one tablet in the morning and one in the evening. It’s crucial to stick to this schedule to maintain stable pain control and reduce the risk of withdrawal.

Other forms of oxycodone in the UK:

While OxyContin is long-acting, immediate-release oxycodone is also available in:

• Capsules (e.g. OxyNorm)
• Oral solution (liquid form)
• Injections (hospital use)

These may be used alongside OxyContin to manage breakthrough pain—sudden spikes in pain not covered by the extended-release dose.

How long does OxyContin last and how it works

OxyContin is an extended-release form of oxycodone, a strong opioid that works by binding to pain receptors (called μ-opioid receptors) in the brain and spinal cord. Once attached, it blocks pain signals and produces a sense of relief—sometimes even euphoria in higher doses.

How long does it last?

Each dose of OxyContin is designed to work for 12 hours. This long-lasting effect is why it’s often used for around-the-clock pain control, especially in people with chronic conditions or cancer-related pain.

The slow-release coating on OxyContin tablets means oxycodone is absorbed into the bloodstream gradually, maintaining a steady level of pain relief and reducing the need for frequent dosing.

However, how long it feels effective can vary depending on:

• The dose
• The individual’s metabolism
• Opioid tolerance
• Severity of pain

Some patients may still experience breakthrough pain between doses and may be prescribed a short-acting opioid like OxyNorm or morphine as a top-up.

Half-life and how it’s cleared from the body

Oxycodone has an average half-life of around 4.5 hours, but the extended-release design of OxyContin allows it to stay active in the body much longer. The full effects typically wear off after 12 hours, which is why the drug is taken twice daily.

It is metabolised by the liver and excreted through the kidneys, so people with liver or kidney problems may need dosage adjustments.

OxyContin side effects and warnings

Like all opioids, OxyContin can cause side effects—some mild, some potentially serious. The risk tends to increase with higher doses, long-term use, or when mixed with other sedating substances like alcohol or benzodiazepines.

Common side effects

These are the most frequently reported:

• Constipation – almost universal with opioids; may require laxatives
• Nausea and vomiting – especially at the beginning of treatment
• Drowsiness or fatigue
• Dizziness or light-headedness
• Dry mouth
• Itchy skin (pruritus)
• Headache
• Sweating

These often settle as your body adjusts, but not always. If side effects persist, doctors may adjust your dose or switch medications.

Serious side effects and risks

• Breathing problems (respiratory depression) – especially in elderly patients or if taken with other sedatives
• Low blood pressure
• Confusion or hallucinations
• Severe allergic reactions (rare)
• Addiction, misuse, or overdose – even when used as prescribed

Important warnings

You should not take OxyContin if you:

• Have severe breathing problems or lung disease
• Are suffering from paralytic ileus (blocked gut)
• Have a known allergy to oxycodone or similar drugs
• Are taking monoamine oxidase inhibitors (MAOIs) or recently stopped them

Special care is needed in:

• Older adults
• People with kidney or liver disease
• Those with a history of substance misuse
• People with mental health conditions
• Patients using alcohol or sleeping pills regularly

Misuse of OxyContin—crushing or injecting the tablets—can cause fatal overdose. This is why it’s classified as a controlled drug (Schedule 2) in the UK, and why it’s only available by special prescription.

Is OxyContin addictive?

Yes. OxyContin can be highly addictive—even when used exactly as prescribed.

This opioid contains oxycodone, a substance known to produce not just pain relief but also feelings of euphoria. Over time, your brain adapts to the drug, which can lead to tolerance (needing more to get the same effect), dependence (experiencing withdrawal without it), and ultimately addiction (compulsive use despite harm).

Dependence vs addiction: what’s the difference?

• Dependence is a physical response: your body gets used to the drug. If you stop suddenly, you may experience withdrawal symptoms like chills, cramps, anxiety, sweating, and insomnia.
• Addiction, on the other hand, is a behavioural issue—when you feel a compulsive need to keep using OxyContin, even if it’s harming your health, relationships, or finances.

Who is at higher risk of addiction?

• People with a history of substance abuse
• Those with mental health conditions like depression or anxiety
• Patients who use higher doses or take the drug long-term
• People who use OxyContin recreationally or without a prescription

Addiction doesn’t always look like street drug misuse. It can begin subtly—taking a bit more than prescribed, finishing prescriptions early, or doctor-hopping for refills.

What to do if you’re concerned

If you or someone you know may be misusing OxyContin, seek medical advice immediately. GPs, pharmacists, and addiction services can help. In the UK, support is also available from:

• NHS Addiction Services
• FRANK (confidential drugs helpline: 0300 123 6600)
• Turning Point
• Change Grow Live (CGL)

Stopping OxyContin suddenly can be dangerous. A supervised tapering plan may be needed.

Can you drink alcohol while on OxyContin?

Absolutely not. Mixing OxyContin and alcohol is dangerous—and potentially deadly.

Both substances depress the central nervous system, which controls breathing, heart rate, and alertness. When combined, their effects don’t just add up—they amplify each other, increasing the risk of:

• Severe drowsiness or unconsciousness
• Slow or stopped breathing
• Low blood pressure and heart rate
• Fatal overdose

This risk is especially high in the first few days of treatment, when your body hasn’t yet adjusted to the medication, or if your dose has recently increased.

What if I just have one drink?

Even a small amount of alcohol can interact with OxyContin. Because OxyContin stays in your system for up to 12 hours, a drink at lunch could still affect your evening dose—and vice versa.

The NHS and UK drug safety agencies strongly advise avoiding alcohol altogether while taking any oxycodone-containing medication.

OxyContin withdrawal — what happens when you stop?

Stopping OxyContin suddenly, especially after prolonged use, can trigger intense withdrawal symptoms. These occur because your body has become physically dependent on the drug to function normally.

Even if you’re not addicted, your body may still react strongly when the drug is reduced or removed.

Common withdrawal symptoms

• Muscle aches and joint pain
• Sweating and chills
• Nausea, vomiting, or diarrhoea
• Anxiety, restlessness, or irritability
• Runny nose and watery eyes
• Trouble sleeping (insomnia)
• Yawning or fatigue
• Goosebumps and tremors
• Strong drug cravings

These symptoms can begin within 12–24 hours of the last dose and peak over the next 2–3 days. Some people feel back to normal in a week; others experience lingering symptoms for longer—known as post-acute withdrawal.

Safe withdrawal: don’t go cold turkey

If you’ve been taking OxyContin regularly, never stop abruptly. Your doctor will help you taper off slowly, reducing your dose step-by-step to minimise withdrawal effects.

They may also recommend:

• Clonidine to ease symptoms like anxiety and high blood pressure
• Loperamide for diarrhoea
• Anti-nausea meds
• Short-term sleeping aids

In severe cases, supervised withdrawal through an NHS or private detox service may be required.

Legal status and how to get OxyContin in the UK

In the UK, OxyContin is classified as a Schedule 2 controlled drug under the Misuse of Drugs Regulations. This means it is strictly regulated due to its high potential for abuse and addiction.

What does Schedule 2 mean?

• Prescriptions must be written on a special controlled drug prescription form
• Only qualified healthcare professionals can prescribe it
• Pharmacies must keep strict records of dispensing
• Prescriptions cannot be repeated; a new prescription is needed each time
• Doctors and pharmacists monitor usage closely for signs of misuse

How to get OxyContin legally

• OxyContin is prescribed only for moderate to severe pain that other painkillers cannot be managed.
• Usually prescribed by specialist pain clinics, oncologists, or hospital consultants, not typically by GPs unless under specialist guidance.
• Patients must have a care plan and regular follow-ups to assess pain relief and side effects.
• Prescriptions are dispensed by registered pharmacies under strict protocols.

Can you buy OxyContin online?

• No, OxyContin cannot be legally purchased online without a prescription from a UK healthcare provider.
• Beware of illegal sellers and counterfeit drugs online, which pose serious health risks.

Summary and key takeaways

OxyContin is a powerful, long-acting opioid painkiller designed for managing moderate to severe pain over 12 hours. Its slow-release formula helps provide steady pain relief, but it carries risks including addiction, serious side effects, and dangerous interactions.

• It’s prescribed under strict controls in the UK due to its potency and abuse potential.
• Side effects like constipation, drowsiness, and nausea are common, but serious risks such as respiratory depression require careful monitoring.
• Combining OxyContin with alcohol or other sedatives is extremely dangerous.
• Dependence and addiction can develop even with prescribed use, making supervised tapering essential when stopping.
• Always follow your healthcare provider’s instructions, never alter doses or stop suddenly.
• If you have concerns about side effects, addiction, or withdrawal, seek professional help immediately.

Used responsibly and under medical supervision, OxyContin can be a valuable tool for pain management—but awareness and caution are vital.