It is estimated that nearly a third of people who abuse drugs started with prescription opioid medicines. Approximately, 11.5 million Americans used prescription drugs recreationally in 2016, and in 2018, 46,802 Americans died as the result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl (National Institutes on Drug Abuse (2020) Opioid Overdose Crisis. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis. Accessed 06 June 2020). Yet physicians will continue to prescribe oral opioids for moderate-to-severe pain in the absence of alternative therapeutics, underscoring the importance in understanding how drug choice can influence detrimental outcomes. One of the opioid prescription medications that led to this crisis is oxycodone, where misuse of this drug has been rampant. Being one of the most highly prescribed opioid medications for treating moderate-to-severe pain as reflected in the skyrocketed increase in retail sales of 866% between 1997 and 2007, oxycodone was initially suggested to be less addictive than morphine. The false-claimed non-addictive formulation of oxycodone, OxyContin, further contributed to the opioid crisis. Abuse was often carried out by crushing the pills for immediate burst release, typically by nasal insufflation, or by liquefying the pills for intravenous injection. Here, we review oxycodone pharmacology and abuse liability as well as present the hypothesis that oxycodone may exhibit a unique pharmacology that contributes to its high likability and abuse susceptibility. We will discuss various mechanisms that likely contribute to the high abuse rate of oxycodone including clinical drug likability, pharmacokinetics, pharmacodynamics, differences in its actions within mesolimbic reward circuity compared to other opioids, and the possibility of differential molecular and cellular receptor interactions that contribute to its selective effects. We will also discuss marketing strategies and drug difference that likely contributes to the oxycodone opioid use disorders and addiction.

据估计，近三分之一的吸毒者是从处方阿片类药物开始的。 2016 年，大约有 1150 万美国人消遣性地使用处方药，2018 年，有 46,802 名美国人因阿片类药物过量死亡，包括处方阿片类药物、海洛因和非法制造的芬太尼（美国国家药物滥用研究所 (2020) 阿片类药物过量危机。 https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis，访问日期：2020 年 6 月 6 日）。然而，在缺乏替代疗法的情况下，医生将继续开口服阿片类药物来治疗中度至重度疼痛，这强调了了解药物选择如何影响有害结果的重要性。导致这场危机的阿片类处方药之一是羟考酮，这种药物的滥用现象十分猖獗。羟考酮是治疗中度至重度疼痛的处方最多的阿片类药物之一，其零售额在 1997 年至 2007 年间飙升了 866%，最初人们认为羟考酮的成瘾性低于吗啡。虚假声称的羟考酮非成瘾配方奥施康定进一步加剧了阿片类药物危机。滥用通常是通过压碎药丸立即爆发释放来进行的，通常是通过鼻腔吹入，或通过液化药丸进行静脉注射。在这里，我们回顾了羟考酮的药理学和滥用倾向，并提出了这样的假设：羟考酮可能表现出独特的药理学，这有助于其高受欢迎度和滥用易感性。 我们将讨论可能导致羟考酮高滥用率的各种机制，包括临床药物喜好性、药代动力学、药效学、与其他阿片类药物相比在中脑边缘奖赏回路中作用的差异，以及导致羟考酮滥用的不同分子和细胞受体相互作用的可能性。其选择性作用。我们还将讨论可能导致羟考酮阿片类药物使用障碍和成瘾的营销策略和药物差异。