About 2.5 million people in the United States struggled with opioid addiction in 2015, per the American Society of Addiction Medicine (ASAM). More than three-quarters of those who battle opioid addiction suffer from addiction involving a prescription opioid, such as oxycodone.
Oxycodone is a potent opioid drug that is contained in brand-name products like OxyContin, Percocet (oxycodone/acetaminophen), Percodan (oxycodone/aspirin), and Roxicodone. Even when taken exactly as prescribed for pain relief, oxycodone can be habit-forming, the U.S. National Library of Medicine (NLM) warns.
Any use of oxycodone in a way other than as prescribed or without a prescription is abuse. Misuse of oxycodone increases the risk of drug dependence and addiction.
Addiction is a disease that ASAM defines as a lack of control over drug use because of changes that are made to brain pathways and the natural chemical workings of the central nervous system. Addiction is not only a physical brain disease but also a behavioral one, as it affects nearly all parts of a person’s life. The good news is that oxycodone addiction is treatable.
What Exactly is Oxycodone? What is the Scope of Opioid Misuse?
Oxycodone is the active ingredient in many brand-name prescription opioid pain relievers, with the most notable likely being OxyContin. Oxycodone is a semi-synthetic opioid drug, which means that it is manufactured in a lab from thebaine. The Center for Substance Abuse Research (CESAR) explains that thebaine is derived from the opium poppy plant.
Opioid drugs work to block pain sensations by changing the chemical makeup of the brain and altering the way some of the naturally occurring chemical messengers interact with the central nervous system. Oxycodone binds to opioid receptors in the brain. Levels of dopamine, one of the brain’s neurotransmitters that helps to regulate emotions and feelings of pleasure, are increased. This relaxing high makes oxycodone products a hot target of abuse.
The U.S. Drug Enforcement Administration (DEA) classifies oxycodone as a Schedule II controlled substance, which is the highest level of control for legal drugs with accepted medicinal uses. The National Survey on Drug Use and Health (NSDUH) reports that in 2016, nearly 4 million adults in the United States misused a product containing oxycodone.
Oxycodone is a central nervous system depressant, which means it slows down autonomic functions like breathing, blood pressure, body temperature, and heart rate. It can make a person feel sleepy, uncoordinated, sluggish, and have trouble with thinking clearly or remembering things.
Oxycodone intoxication is similar to being drunk from alcohol, as both substances are depressants. They both interfere with reaction time, movement functions, and cognitive skills.
Inhibitions are lowered by oxycodone use, and decision-making abilities are impaired, making a person more likely to act in ways that are out of character and potentially risky. The potential for accidents, injuries, and being involved in possible criminal activities goes up with oxycodone misuse.
Since it is a powerful opioid drug, too much oxycodone at once can lead to a potentially fatal overdose. The U.S. Centers for Disease Control and Prevention (CDC) publishes that around 115 people die from an opioid overdose every day in the United States. Trouble breathing, drowsiness, limp muscles, lack of coordination, pinpoint pupils, cold skin, goosebumps, mental confusion, and a possible loss of consciousness are all signs of a possible oxycodone overdose that requires immediate medical attention.
How Do I Recognize Oxycodone Addiction?
Addiction is a brain disease with far-reaching consequences socially, economically, emotionally, physically, and behaviorally. The most current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) explains that compulsive drug use is one of the main components of drug addiction.
The National Institute on Drug Abuse (NIDA) publishes that 11 main criteria signify addiction. These criteria fall into both physical and behavioral symptoms. There are varying degrees of addiction ranging from mild (when a person suffers from two or three criteria), moderate (when someone struggles with four or five criteria), and severe (when a person is battling six or more of the criteria). These criteria are outlined below.
- Drug tolerance and needing to take more oxycodone each time to feel its effects in the same way
- Physical dependence and withdrawal symptoms when the drug wears off (flu-like physical symptoms and emotional distress)
- An inability to stop taking oxycodone even when the desire to do so is there, or multiple unsuccessful attempts to curb drug use
- Taking oxycodone for longer and in larger doses at a time than was intended at the start
- Cravings for oxycodone
- Continuing to use oxycodone even with the knowledge that using it is going to have adverse occupational, personal, and/or social ramifications
- Oxycodone use interfering with the ability to fulfill regular daily obligations
- Giving up activities or events to use oxycodone instead
- Using oxycodone in situations that are potentially physically hazardous
- Spending a lot of time working to obtain oxycodone, using it, and recovering from use
- Knowing that oxycodone use is going to have negative emotional and/or physical consequences and but deciding to use it anyway
Oxycodone is a prescription drug. When a person uses it without a prescription or in a way other than it is intended to be taken (crushing the tablets to snort, smoke, or inject them), it is medication misuse. Taking oxycodone between doses, taking more of the drug at a time, continuing to take the drug after a prescription has expired, or “shopping” different doctors to get more oxycodone are all signs of oxycodone misuse and cause for concern. The DEA warns that oxycodone has a very high potential for abuse and is significantly addictive.
Is Physical Dependence Involving Oxycodone the Same Thing as Addiction?
In short, no. Physical dependence is often a sign of addiction, but a person can become physically dependent on oxycodone and not struggle with addiction involving the drug.
Physical dependence occurs when the brain relies on oxycodone to maintain a chemical balance of its naturally occurring neurotransmitters like dopamine. Since oxycodone creates a flood of dopamine in the brain that is unnatural, levels of the chemical messenger can dip fairly low when the drug wears off. When this happens, it causes an emotional low, or crash, which can be unpleasant.
It can take some time for the brain to restore normal levels of dopamine. The normal level is not the same as the flood created by oxycodone, however, which can encourage a person to want to take more of the drug to recreate the high. This, in turn, spikes dopamine levels again.
When this extreme up-and-down pattern is repeated on multiple occasions, it can become difficult for the brain to keep up. It may stop producing, transmitting, and absorbing dopamine in the same way it did before, and it can take longer for it to restore chemical balance on its own.
Difficult withdrawal symptoms often occur when oxycodone wears off. This is a sign of physical dependence. The prescribing information for OxyContin explains that it can set in after several days to weeks of regular use.
Addiction is compulsive drug use; in this case, it is signified by an inability to control the use and abuse of oxycodone. Physical dependence can often play a role in this, as the lows of withdrawal coupled with physical drug cravings can make it difficult to stop taking it and encourage repeated dosing.
Physical dependence can occur even with medicinal use under the guidance and direction of a medical professional and when the drug is taken exactly as prescribed. This is not the same thing as addiction, however.
“Due to the severity of physical dependence and withdrawal, oxycodone is not a drug that is recommended to be stopped suddenly. Instead, it is generally recommended to slowly taper the dosage over a controlled period to minimize withdrawal. This weans the drug out of the body while allowing the brain to balance itself safely.”
What are the Side Effects of Oxycodone Withdrawal?
Oxycodone withdrawal is both physical and emotional in nature, and it can range in severity based on how physically dependent a person is on the drug. Physical dependence is related to how much oxycodone a person takes regularly and how long they have been doing so.
Higher doses more often mean a more significant level of dependence and, therefore, more intense withdrawal side effects. Biological and environmental factors coupled with any polydrug use or co-occurring disorders can also contribute to physical dependence and withdrawal.
The withdrawal timeline for oxycodone typically looks like this:
- Within 12 hours or so of taking the drug, physical side effects and mood swings can begin.
- Withdrawal side effects generally peak in two to three days of the last dose.
- Acute withdrawal lasts about five to seven days on average, with symptoms starting to lessen in severity after the first few days.
- Emotional symptoms, cognitive issues, cravings, and sleep disturbances can persist for a few weeks to months during protracted withdrawal.
The formulation of the oxycodone product will determine how long the drug stays in the system and how long it will take to wear off, and, therefore, how long it takes for withdrawal symptoms to begin. For example, extended-release OxyContin remains active for at least 12 hours, while immediate-release Roxicodone is intended to remain active in the bloodstream for four to six hours.
The withdrawal timeline and the significance of the symptoms are influenced by the environment, biology, genetics, and behavioral aspects, making it highly personal and different for everyone.
Withdrawal side effects of oxycodone can include the following:
Withdrawal Side Effects Of Oxycodone
- Dilated pupils
- Chills and sweats
- Nausea and vomiting
- Stomach cramps
- Muscle and joint aches
- Increased sensitivity to pain
- Watery eyes
- Runny nose
- Increased heart rate and blood pressure
- Loss of appetite
- Mental confusion and clarity issues
Researchers have identified extreme cases of oxycodone withdrawal that have led to death. Withdrawal symptoms, such as severe vomiting and diarrhea, can lead to dehydration, which can cause elevated blood sodium levels in the body when left untreated. This, in turn, can lead to heart failure and death.
Through proper medical management of withdrawal symptoms, safe medical detoxification and positive treatment outcomes can be achieved.
How Does Addiction Affect Everyday Life?
When a person is struggling with addiction, they may have issues functioning normally and continuing to keep up with daily tasks. For example, drug use often makes it hard to keep up with school work or job duties as well as family and home obligations. Financial burdens can increase as more money is spent on drugs, and someone battling oxycodone addiction may also lose their job as a result of reduced workplace production.
Oxycodone affects the ability to reason and make sound decisions. It also impacts memory and learning functions. Criminal behaviors involving drug use or through attempts to obtain drugs can cause further strife and legal issues.
Addiction can make it so that a person will struggle to think about much else other than the drug. This then creates focus and attention issues. Personal hygiene can slide as showering and taking care of oneself become less important. Weight loss and appetite changes are also common side effects of oxycodone addiction.
Opioid addiction can cause health issues, such as constipation, respiratory issues, heart and blood pressure irregularities, and potential liver damage, particularly when taking oxycodone products that also contain acetaminophen. Sleep patterns become disturbed, and mood swings are common as a result of oxycodone addiction. These issues can interfere with and complicate interpersonal relationships. Homelessness can be a potential side effect of addiction as well.
Addiction doesn’t just affect the person who struggles with the disease. It affects virtually everyone around them in some manner.
What are the Treatment Methods for Opioid Addiction?
Oxycodone addiction is considered chronic and also highly treatable. NIDA explains that drug addiction treatment can be provided in a variety of settings (generally outpatient or inpatient) and via many different methods, including both pharmacological and behavioral components.
A medical detox program is often the first part of an oxycodone addiction treatment program. During medical detox, other longer-acting opioid medications, such as methadone or buprenorphine, may be used to replace oxycodone. They will then be tapered off slowly to minimize withdrawal symptoms. Medical detox provides a safe environment where vital signs can be monitored, and medical care can be provided around the clock while the brain and body stabilize as oxycodone processes out.
After medical detox, a comprehensive addiction treatment program that contains the following is often helpful:
- Group and individual counseling
- Behavioral therapies
- Relapse prevention and educational programming
- Supportive care and support group meetings
- Medication management
- Treatment for co-occurring disorders
- Nutritional planning
- Holistic methods, including exercise programs, mindfulness meditation, yoga, and creative expression therapies
- Family counseling and support
- Aftercare support
Addiction treatment should be individualized. It begins with a detailed assessment to determine what level of care and treatment methods are best for each person.
Regardless of the specific oxycodone addiction treatment program chosen, NIDA recommends spending at least 90 days in addiction treatment to form and solidify healthy habits, allow the brain and body time to heal, and learn new coping tools and strategies for dealing with stress and minimizing relapse. This will all help to form the basis of a sustained recovery.