This is one of the root causes of the mess the oxycodone creates. Unlike other narcotics like codeine that are not normaly addictive in the amounts that used to be given out for surgical or dental pain, oxycodone is highly addictive. There rise of oxycodone co-incided with an edict to all hospitals that pain was the "fifth vital sign" and hospitals were reviewed on the pain relief that patients required. They couldn't risk low scores so physicians and hospitals would push giving pain meds. Oxycodone was so effective it became the narcotic analgesic of choice and was given out very freely, as if it was codeine.
But physicians and hospitals were not really told by the manufacturers how dramatically addictive it was and created a whole generation of normal citizens who became addicts. One of the surgeons I know told me she was sure she created addicts from those days when she had to keep giving patients these rx's.
Even when addicted, opiate addicts can function quite well. They hold jobs, they take care of their kids, they participate in school activities, they have normal friends. If they titer themselves well, they aren't nodding off inappropriately and are not creating violence around them like meth addicts do. Think of "opium dens". However, the withdrawl from narcotics is so severe, as described above, they will do anything to stop going into withdrawl. Anything. So when their doctor stops the Rx, they go to the street. And heroin is easy and cheap. This is how the 50 year old female office worker who had a hysterectomy and was given exended post-op pain rx becomes a heroin addict. If they could stave off withdrawl with Rx meds they would. If they cant get them or afford them, they turn to the street because withdrawl is so very bad.
The only cure is very controlled withdrawl with support from addiction specialists. And that is expensive and not always easy to get into. That's why so many fail multiple times.
Here's a good article about the start of the opiate epidemic
The fifth vital sign: A complex story of politics and patient care
And here is the most damning sentence: "In a recent CNN report on the opioid epidemic, it was noted that the Joint Commission published a book in 2000 for purchase by doctors as part of
required continuing education seminars, and that the book cited studies claiming “there is no evidence that addiction is a significant issue when persons are given opioids for pain control.” According to the CNN report,
the book was sponsored by a manufacturer of narcotic analgesics. "
That's right:
Doctors were required to consider opiates non-addictive for pain control, as written by the very same drug manufacturers