As a potent semi-synthetic opioid drug, oxycodone is the active ingredient in many formulations of prescription painkillers. In addition to its generic form, oxycodone is available in the brand-name drugs Roxicodone, OxyContin, Percocet (which also contains acetaminophen), and Percodan (which contains aspirin as well).
Oxycodone is highly effective at blocking pain sensations. Within the brain, it binds to opioid receptors and influences levels of dopamine. Heightened levels of dopamine create a flush of euphoria, or a high, as well as relaxation and suppression of functions of the central nervous system like body temperature, respiration, blood pressure, and heart rate.
The U.S. Drug Enforcement Administration (DEA) warns that oxycodone is highly addictive and a common drug of abuse. Nearly 4 million Americans misused a product containing oxycodone in 2016, the National Survey on Drug Use and Health (NSDUH) publishes.
With regular use, oxycodone can actually make changes to the way the brain sends, receives, and absorbs its chemical messengers. Dopamine levels will drop when oxycodone processes out of the brain, and with long-term use, the brain will struggle to level out again. The result is physical and emotional withdrawal.
Oxycodone withdrawal is specific to the level of dependence a person struggles with. It can, therefore, vary in intensity and duration from person to person.
The prescribing information for OxyContin (an extended-release brand-name pain reliever with oxycodone as the main ingredient) reports that within several days to weeks of regular use of the medication, even under direct supervision and direction from a medical professional and for medicinal purposes, oxycodone can cause physical dependence. This means there will be significant withdrawal symptoms when the drug wears off. Withdrawal symptoms can include both physical and emotional side effects.
Physical withdrawal symptoms
Psychological withdrawal symptoms
Typically, withdrawal symptoms begin when the drug processes out of the body, which is often determined by the drug’s half-life and how long it remains active in the bloodstream. In the case of oxycodone, the half-life depends on which formulation of the drug is involved — the immediate-release version or the extended-release variety.
The journal Clinical and Translational Oncology reports that for immediate-release oxycodone, the half-life is between three hours and four hours on average. For extended-release oxycodone, the half-life is around 12 hours. This means the drug will process out of the body in eight hours to 24 hours respectively, so this is generally when withdrawal symptoms begin.
A general oxycodone withdrawal timeline looks like the following:
About eight hours to 24 hours after the last dose, early symptoms of withdrawal begin with general unease both physically and mentally.
Withdrawal symptoms usually peak and include most of the symptoms at the highest level of intensity within the first two to three days.
Acute withdrawal lasts between three and seven days. Symptoms will start to ease a bit after about days three to five on average.
Mood swings, sleep disturbances, drug cravings, and cognitive issues can continue for a few weeks or months during protracted withdrawal.
Oxycodone withdrawal can depend on a lot of individual factors that can influence the withdrawal timeline. For example, personal metabolism can affect how quickly oxycodone is processed out of the body and, therefore, when withdrawal is likely to start. Men typically have faster metabolisms than women, which can mean that a woman may begin withdrawal later or have prolonged symptoms as the drug can be stored differently in the body.
Along with sex, race, and size, other biological and genetic factors can influence metabolism and withdrawal. A personal or family history of addiction can make withdrawal more significant. It also brings about a genetic component, as addiction is heritable about half the time, per the journal Psychiatric Clinics of North America.
Environmental aspects, including stability in the home and stress levels, can also affect the significance and duration of the withdrawal timeline for oxycodone. Taking other drugs or drinking alcohol at the same time can exacerbate withdrawal, and the presence of any co-occurring mental or medical health concerns can complicate it as well.
One of the biggest indicators regarding the intensity and potential duration of withdrawal is the level of drug dependence on oxycodone, which can be determined by the following contributors:
Factors Affecting Withdrawal Timeline
Oxycodone withdrawal will be different for each individual. It should, therefore, be managed accordingly in a professional program.
Detox is when the body processes oxycodone after use has stopped. Detox programs provide a secure environment and support to allow the drug to process out safely.
Abrupt discontinuation, or stopping use cold turkey, of oxycodone is not recommended, as it can induce significant withdrawal symptoms. A medical detox program often uses substitution opioids, such as methadone or buprenorphine, which have longer half-lives than oxycodone. Oxycodone itself or methadone or buprenorphine can then be slowly tapered off over a set period to gently wean the body off opioids. This can prevent the shock that can occur if oxycodone use is stopped suddenly.
A specialized detox program can help to manage oxycodone withdrawal symptoms, control cravings, and even potentially shorten the withdrawal timeline overall. Some questions to ask when researching detox centers are:
Is the program inpatient or outpatient? An inpatient program is often ideal for managing significant oxycodone dependence.
A licensed opioid treatment program (OTP) can provide substitute medications that are approved by the U.S. Food and Drug Administration to treat opioid dependence, such as methadone, buprenorphine, and naltrexone. Medications for specific symptoms of opioid withdrawal can be beneficial during detox as well.
A comprehensive medical detox program generally has licensed medical staff on site to monitor vital signs and dispense medications. Mental health professionals can offer supportive and therapeutic care as well. All staff should be licensed in their fields.
An oxycodone medical detox program is generally between five and seven days on average and should be directly followed with a complete opioid addiction treatment program.
Generally, a combination of pharmacological, therapeutic, and supportive care is ideal during oxycodone detox.
A co-occurring medical or mental health disorder can complicate oxycodone withdrawal. The disorder should be managed simultaneously and treated in an integrated fashion during detox and addiction treatment by a team of trained professionals working together.
Often, complementary and alternative medicine techniques, such as acupuncture, chiropractic care, nutrition planning, fitness programs, mindfulness meditation, and massage therapy, can be helpful to alleviate stress and manage withdrawal symptoms during oxycodone detox.
Detox centers that can provide a seamless transition into an addiction treatment program offer the benefit of a full continuum of care to minimize relapse and enhance recovery.
Oxycodone. Drug Enforcement Administration. from https://www.dea.gov/factsheets/oxycodone
(September 2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm
(September 2018). OxyContin. Purdue Pharma. from http://app.purduepharma.com/xmlpublishing/pi.aspx?id=o#section-12.3
(May 2007). Oxycodone: a Clinical and Pharmacological Review. Clinical & Translational Oncology. from https://www.ncbi.nlm.nih.gov/pubmed/17525040
(June 2012). The Genetic Basis of Addictive Disorders. Psychiatric Clinics of North America. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506170/
(October 2018) Information About Medication-Assisted Treatment (MAT). U.S. Food and Drug Administration. from https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm600092.htm