Oxycodone and fentanyl are prescription opioids that treat moderate-to-severe pain symptoms. However, opioids have been a major factor in the addiction and overdose crisis over the past several years. Although many people who use oxycodone or fentanyl won’t become addicted to them, a disproportionate number will. As opioids, both drugs are in the same class, but the two have some significant differences.
Although oxycodone and fentanyl have made modern medicinal pain relief possible, they are still a concern. According to the U.S. Centers for Disease Control and Prevention (CDC), there were 107,622 drug overdose deaths in the country in 2021, which marks a significant increase from 2020. In 2020, an estimated 93,655 overdose deaths occurred.
Opioids account for a large portion of overdose deaths, especially in the past several years. In 2020, there were 70,029 overdoses on opioids like fentanyl and oxycodone. In 2021, that number rose to 80,816. Illegal fentanyl is believed to be responsible for this increase.
Globally, opioid addiction has been a significant problem for many years. Americans began using opioids for pain relief in the early 1860s. In the past, these drugs were used to treat wounded soldiers who were often given morphine. In the years that followed, many developed dependencies and addictions to opioids. The Bayer Company introduced heroin in 1898, claiming there were lower chances of dependence than with morphine. However, heroin is also extremely addictive with long-term use or misuse.
By 1995, Purdue Pharma introduced OxyContin as a prescription pain reliever, which is a brand-name drug containing oxycodone. OxyContin was a major contributor to the opioid crisis in the United States. It was marketed as safe with a low risk for addiction, though it had a significant risk for dependence and addiction, like most opioids.
OxyContin, and other opioid brands, were prescribed in high quantities. Overprescribing led to an increase in opioid availability. People who received more opioids than they needed would also give them to friends or keep them in medicine cabinets where others could find them.
Addictions that involve prescription opioid misuse could easily lead to the use of illicit opioids.
Heroin, a cheaper option, is easy to find in the United States, especially when compared to legitimate prescription opioids. Illicit heroin use is dangerous because of its unpredictable nature. Street heroin varies in strength and contents. In many cases, it contains powerful doses of illicit fentanyl.
Our country is experiencing epidemic levels of opioid use disorder (OUD) and opioid addiction, according to StatPearls. According to its study, an estimated 3 million people in the U.S. have an opioid addiction. In total, 16 million people are estimated to be addicted to opioids around the world. Poor prescribing practices and mental illness have led to this crisis, which shows no signs of easing.
How Does Oxycodone Work?
Oxycodone belongs to the opioid class of drugs also known as narcotic analgesics since it acts similarly to central nervous system depressants. An opioid prescription is used when someone is suffering from moderate-to-severe pain or if other pain medications do not provide the desired relief. Oxycodone comes in many forms, including OxyNorm and OxyContin.
Oxycodone blocks the transmission of pain signals all over the nervous system and brain. As a liquid and capsule, pain relief can be achieved within 30 to 60 minutes after administration. After four to six hours, it wears off. Unfortunately, oxycodone has a high risk of addiction. Before prescribing this medication, your doctor should discuss its benefits and drawbacks with you. Additionally, they should also explain the risks of addiction. Alternative options may be available if you don’t feel comfortable with using the drug.
In cases of chronic pain, where you will need oxycodone for over a few weeks, your treatment plan should specify when and how to stop taking it.
Oxycodone Side Effects
Opioids such as oxycodone are extremely powerful. Side effects can occur even in small doses. These side effects can range from mild to severe. Consult your doctor if you experience unwanted side effects after taking a new prescription medication. Oxycodone’s most common side effects can include:
- Cold sweats
- Tightness in the chest
- Difficult or labored breathing
- Chest pain
- Difficulty with swallowing
- Decreased urine output
- Irregular heartbeat
- Muscle pain
- Lack or loss of strength
- A relaxed and calm feeling
Tolerance, dependence, and addiction are some of the potential side effects associated with oxycodone. Eventually, the prescribed dosage will no longer produce the desired effect as your body becomes accustomed to the medication.
Tolerance will require you to increase your dose to maintain the same levels of pain relief or feelings of intoxication. Abuse can quickly lead to addiction, which can be dangerous. It’s difficult to keep oxycodone use under control when it’s used for too long, even if you’re taking it to relieve pain. In a short period of time, it can become an addiction.
What Is Fentanyl?
Fentanyl has become the subject of new coverage as it has grown in prevalence as an illicit drug. But it’s also used as a prescription opioid in various settings. The National Institute on Drug Abuse (NIDA) describes fentanyl as a very powerful synthetic opioid with characteristics similar to morphine. Although it works in the brain in a way that’s similar to morphine, it’s 50 to 100 times more potent.
Fentanyl is used as a treatment for moderate-to-severe pain symptoms. It works relatively quickly when compared to other opioids. It is sometimes prescribed to people who are not benefiting from their pain management regimens after becoming tolerant to opioids such as oxycodone. Although it’s legally prescribed, illicit versions flood the streets and cause negative press, which has caused an increase in overdose deaths.
The use of fentanyl for treating extreme pain, especially after surgery, is similar to that of morphine or oxycodone. Tolerance will develop after long-term use, leading to the need for higher or more frequent doses to get the relief you want. Fentanyl can be used safely and effectively as prescribed by a doctor, but abuse can lead to chemical dependence and drug addiction that are challenging to overcome.
Synthetic opioids, such as fentanyl, commonly cause U.S. overdose deaths. The drugs accounted for 56,516 overdoses in 2020. Most of these cases involved fentanyl and its analogs.
How Is Fentanyl Used?
A licensed physician can administer the drug as a shot, patch, or lozenge. However, addiction and overdose are most commonly associated with illegally made fentanyl. Clandestine labs outside of the country manufacture fentanyl powder that is illegally trafficked and distributed in the U.S.
Fentanyl has also been reportedly found on blotter paper, in nasal sprays, and even in eye droppers. Drug dealers can also press substances into pills that look like legitimate prescriptions. For instance, fentanyl may be pressed into pills made to resemble prescription drugs like Xanax or OxyContin. The Drug Enforcement Administration (DEA) recently created a campaign to raise awareness about illicit pills that contain fentanyl.
Fentanyl is often mixed into other substances or replaces them entirely. Since the drug is so potent, a small amount goes a long way. It’s relatively easy and cheap to produce, making it a cost-effective product for drug dealers. However, including fentanyl in other substances is risky. A person may mistakenly purchase fentanyl when they think they’re buying oxycodone. One reason for the high number of fentanyl overdoses in the country is the fact that people take the powerful drug without knowing. There is a high risk of overdosing on fentanyl since their bodies are not tolerant of it.
Fentanyl’s Side Effects
Fentanyl works similarly to oxycodone and other opioids by binding to opioid receptors throughout the body. Continuous fentanyl intake adapts the brain to the presence of opioids. Your pain receptors will become less sensitive to opioids over time, which can lead to tolerance. Opioid tolerance can make your opioid prescriptions less effective at controlling pain. The pleasurable effects of illegal fentanyl use will also be harder to achieve.
To compensate, you will need to take higher doses, which can lead to chemical dependence and addiction over time.
Other common side effects of fentanyl use include:
- Extreme euphoria
- Decreased sexual desire
- Appetite loss
- Irregular menstruation
- Inability to get or keep an erection
- Changes in vision
- Dry mouth
- Issues breathing
What’s the Difference Between Oxycodone and Fentanyl?
The drugs have a few key differences between them despite their similarities as opioid pain relievers. Fentanyl and oxycodone differ dramatically in their potencies. Very few opioids on earth can compare to fentanyl when it comes to potency. Oxycodone’s potency is 1.5 times greater than that of morphine, but fentanyl is 50 to 100 times stronger. There is a possibility of overdose when either drug is misused or abused.
But even a small amount of fentanyl can prove fatal when misused or abused. On the illicit market, this is especially true if you aren’t sure what is in the drug you’re taking or how pure it is. If you are prescribed fentanyl, a doctor will tell you if you can safely take it.
Besides the method of consumption, prescription fentanyl differs from oxycodone in other ways. Among the prescription fentanyl forms are nasal sprays, transdermal patches, sublingual tablets, lozenges, and solutions for intravenous or intramuscular injection. Oxycodone is available as tablets or capsules that must be swallowed orally. In many cases, however, drugs mix oxycodone-containing drugs like Percocet with fentanyl.
Additionally, oxycodone and fentanyl differ in their duration of action, which refers to how long a drug remains effective in the body. Each medication’s formulation and means of administration also affect this. An intramuscular injection of fentanyl lasts between one and two hours, whereas an intravenous injection lasts between 30 minutes and an hour.
Fentanyl has a half-life of about an hour as a nasal spray, one to two hours as a sublingual tablet, and up to 96 hours as a patch. Oxycodone immediate-release tablets, on the other hand, are effective for three to six hours. There is a 12-hour duration of action for controlled-release formulations such as OxyContin.
Also, the onset of action of these two drugs varies according to their formulation. The onset of action refers to the time it takes for a drug to start working after it has been administered. The effects of fentanyl intravenously can be felt within seconds, while intramuscular injections can take up to 15 minutes to take effect.
Fentanyl’s effects will be felt seven minutes after ingestion, 15 minutes after transmucosal administration, and six hours after the application of fentanyl patches. It takes about 15 minutes for immediate-release oxycodone pills to take effect, while controlled-release formulations take up to one hour.
A study found that oxycodone and fentanyl provide similar postoperative pain relief despite their differences in strength. Fentanyl is significantly more effective as a sedative than oxycodone, however. A difference in side effects was also found between oxycodone and fentanyl, but that difference was not significant enough to merit further exploration.
It’s possible for someone to develop a dependence on oxycodone and fentanyl, even when taking them as prescribed. An individual experiencing withdrawal symptoms might need medical detox to overcome them safely. There is no doubt that opioid withdrawal is among the most uncomfortable of all drug withdrawals. Many people get caught in a cycle of addiction and struggle to seek treatment or maintain sobriety.
Oxycodone and Fentanyl WithdrawalThe withdrawal symptoms associated with opioids like oxycodone make them hard to quit. At a certain point of dependence and addiction, abusing fentanyl or oxycodone no longer leads to euphoria but rather a sense of feeling normal. If you take less than your body is accustomed to or stop taking the drug altogether after becoming chemically dependent on the drug, withdrawal symptoms will occur. Depending on how much you take, these symptoms may be mild or severe.
Oxycodone withdrawal symptoms usually appear eight to 12 hours after your last dose. Chronic, heavy oxycodone abusers will experience more intense symptoms than less frequent users or those who take smaller doses. Oxycodone withdrawal symptoms are similar to flu symptoms.
Fentanyl’s withdrawal symptoms are similar to those of oxycodone. The potency of fentanyl, however, makes withdrawal symptoms more severe.
After taking your last dose of fentanyl, you will not experience withdrawal symptoms for up to 12 hours. Fentanyl’s effects in patch form will last for up to 72 hours. The half-life of fentanyl patches is 17 hours, so withdrawal may not begin for a day or more after you stop using them.
Some of the most common symptoms are:
- Runny nose
- Teary eyes
- Poor concentration
- Increased heart rate
- Body aches and pains
- Inability to feel pleasure
- Severe mood swings
Medical Detox for Oxycodone and Fentanyl It is also important to note that when it comes to stopping, both opioids can cause uncomfortable withdrawal symptoms that can require professional addiction treatment. In withdrawal from opioids, people often give in to their cravings and take more to relieve the pain. Oxycodone and fentanyl are both extremely potent opioid drugs to withdraw from. As a result, users will be trapped in the cycle of addiction until they seek help.
If you are going through this, the good news is facilities can treat this condition and help you get through withdrawal and reach sobriety. With opioid use on the rise, sobriety can set you free from a cycle of active drug addiction.