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Both oxycodone and hydrocodone are strong narcotic pain killers and cough suppressants that act by stimulating the opioid receptors present in the brain. Although they do not eliminate pain, they increase a person's pain tolerance. Besides increasing pain tolerance, they can also cause respiratory depression.

Oxycodone and hydrocodone are the most highly abused drugs and are the preferred choice of over 75% of prescription drug abusers. According to research published in the journal Pain, 44.7% of drug abusers prefer oxycodone. Hydrocodone is the choice of 29.4% drug abusers.

This is because 54% of opioid dependents found oxycodone to be more potent, compared to 20% who found hydrocodone to be stronger. Oxycodone and hydrocodone were the drugs of choice for an overwhelming 90% of people who abuse drugs for mood alteration, making them more popular than any other opioid analgesic.

Let's look at some of the prime differences between oxycodone and hydrocodone:

  • Potency: Oxycodone is stronger than hydrocodone. Five mg of oxycodone is equivalent to 7.5 mg of hydrocodone. Therefore, hydrocodone is more suitable for lighter-weight patients, or those who have a weak stomach. Oxycodone is tolerated well by patients who have a heavier build and can tolerate stronger stuff.

  • Prescription rules: As oxycodone is more potent than hydrocodone, it is classified as a Schedule II controlled substance and cannot easily be prescribed. Purchasing it requires a relevant prescription as a hard copy, and no refills are allowed on the prescription. Compared to this, hydrocodone, which is considered to be relatively mild, is classified under Schedule III controlled substances. Medicines containing hydrocodone can be can be bought easily if the prescription is phoned or faxed to the pharmacist and it is easy to get refills too.

  • Preparations available: Oxycodone is usually available as a separate preparation. Hydrocodone, on the other hand, cannot be administered alone and is available in combination with other medicines like acetaminophen. This is one of the main reasons why oxycodone is the preferred choice of drug abusers. They avoid using hydrocodone as increasing the dose in order to get a high may lead to poisoning because of the second medicine present in the preparation (acetaminophen poisoning is well known in people who abuse hydrocodone).

  • Risk of constipation: Patients taking hydrocodone preparations are more likely to suffer from subsequent constipation.

  • Difference in the profile of abusers: Hydrocodone preparations are easily available through prescriptions or through family and friends. They are less expensive than oxycodone and drug abusers who do not like taking risks like women, elderly people and those who do not like injecting themselves are more likely to choose them. Drug abusers who like to take risks prefer oxycodone as it gives a better high. As oxycodone preparations contain only oxycodone, they can be taken orally, be snorted or taken as injections without the risk of poisoning caused by the presence of a second medicine. Though it may be twice as expensive as hydrocodone preparations, people hooked on oxycodone would go to any length to Procure it. If a medical prescription is hard to get, such people are not averse to going to drug dealers and peddlers to get their fix. In fact, by keeping in mind the personality, age and profile of the patient, physicians may be able to decide what would be ideally suited for their patient -- oxycodone or hydrocodone.

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