Oxycontin ER or SR are designed to release a set dose of the medication gradually over each hour of the day. The "contin" at the end of the name is short for continuous (as in continuous release).

The reason you should never crush them is that they have an enteric covering that dissolves slowly in the gut, gradually releasing the drug over the 12 hour period. Should you crush that covering, the entire 20mgs would be released into your blood stream, possibly having dire effects.

As you're on 20mgs of Oxycontin every 12 hours, you just divide that dose by the 12 hours, which then gives you a release rate of approximately 1.6mgs of Oxycontin every hour.

If that dose is no longer giving sufficient pain relief, you probably need to have the dose increased. 20mgs twice daily (or 1.6mgs per hour) is a very tiny dose, and the idea of putting people on medications like this one, is because (a) it's a very effective drug, and (b) it's easy to manipulate the dose to maintain optimum pain relief.

If you don't have pain every day, then maybe a short acting drug like it's sister "Oxycodone" could be ordered for those occassions when the twice daily dose isn't quite enough. Have a talk to your doctor. No-one should have to suffer in pain these days considering the wide range of medications available for this purpose.

Although 1.6mgs per hour doesn't sound very much, remember the key to good pain control is to find the right dose that can be delivered each hour to keep a person pain free, and even in the area palliative care, often these hourly doses can be quite small.

I hope you get some relief soon.