It’s no secret that the United States opioid epidemic is quickly reaching critical mass, with a 30 percent increase in opioid overdoses across the country between 2016 and 2017, as reported by the U.S. Centers for Disease Control and Prevention.
Prescription opioids remain at the heart of the problem, and many claim that they were the start of it as well, specifically, the substance oxycodone, the active ingredient in the prescription painkiller OxyContin.
Oxycodone was first synthesized in Germany in 1917 in an attempt to create a safer alternative to heroin, which was meant to be a safer drug than morphine. Oxycodone, which is approximately one and a half times more potent than morphine, was classified by the DEA as a Schedule II substance in the 1970s due to its high potential for abuse and addiction.
However, in the late 1990s, a company called Purdue Pharma released OxyContin, a time-released name brand version of oxycodone that was insistently marketed as being safer than other prescription opioids, with a much lower risk of abuse and dependence.
But the rapid climb of prescription opioid addiction and overdose rates that soon followed showed that this was not the case, and in 2007, Purdue Pharma faced criminal charges for misleading and defrauding both doctors and consumers.
In the meantime, the battle against opioid addiction continues, and oxycodone remains one of the most widely recreationally used opioids in the country, with the U.S. Department of Health and Human Services estimating roughly 11 million people annually consuming oxycodone for nonmedical purposes.
How Does Oxycodone Work?
Like most, if not all opioid drugs, Oxycodone works by entering the brain and binding to neurotransmitters known as opioid receptors. Opioid receptors transmit pain signals to areas like the brainstem and spinal cord and control how we process and experience pain. Opioid receptors also play a role in regulating stress levels.
What oxycodone does is mimic the chemical makeup of these neurotransmitters and attaches to them, stimulating their activity and producing more opioids than the brain ever could on its own. Flooding the brain and central nervous system with opioids creates stronger blocks at different parts of the brain to prevent it from receiving pain signals and also inhibits the spinal cord from sending them, which is what creates the feelings of sedation and pain relief.
Oxycodone also works on non-opioid-related brain chemicals like dopamine. Dopamine is a neurotransmitter that operates in what is commonly referred to as the brain’s “pleasure center” and controls cognition, emotion, and how we respond to motivation and reward. Oxycodone increases dopamine levels to produce feelings of euphoria and pleasure, which is the “high” that accompanies the masking of pain.
It’s the dopamine that can play the largest role in fostering an addiction, as the brain rewires itself so that oxycodone use becomes completely tied up in the motivation and reward process, creating the learned behavior that oxycodone use hits the reward button, so to speak.
Eventually, if someone abuses enough oxycodone for a significant period of time, they become tolerant to its effects and require more and more of it to achieve the same high as before. The brain also stops making its own dopamine and opioids in response to the overwhelming amounts provided by oxycodone and then instead becomes reliant on oxycodone to continue functioning as normal.
That’s why, when oxycodone use is suddenly stopped, and the brain is deprived of these neurotransmitters and the feelings of euphoria and pain relief they provide, it goes into shock as it tries to cope with the shortage, which is what causes oxycodone withdrawal symptoms.
What are the Symptoms of Oxycodone Withdrawal?
The symptoms of oxycodone withdrawal are consistent with those of opioid withdrawal in general, including a mix of psychological and physical symptoms that, while not usually life-threatening, can be extremely uncomfortable and often painful. Some of the most common oxycodone withdrawal symptoms include:
- Nausea
- Vomiting
- Muscle pain
- Dizziness
- Insomnia
- Confusion
- Exhaustion
- Depression
- Mood swings
- Diarrhea
- High blood pressure
- Elevated heart rate
- Abdominal cramps
- Headaches
- Fever and chills
- Anxiety and panic attacks
- Restlessness
- Difficulty concentrating
- Disassociation
- Suicidal thoughts
Oxycodone withdrawal cannot, in and of itself at least, kill someone. The dangers the symptoms of oxycodone withdrawal can present; however, can lead to some dangerous and sometimes life-threatening situations, especially if someone attempts an oxycodone detox on their own without some form of medical supervision.
One of the biggest risks of oxycodone withdrawal is the possibility of relapsing during the process due to the wide range of extremely unpleasant symptoms and drug cravings that occur. If someone is trying to get through oxycodone withdrawal on their own, there’s a high likelihood that they will relapse and return to using in order relieve their symptoms.
What makes relapsing during detox so dangerous is that someone taking oxycodone in an effort to curb their withdrawal symptoms as quickly as possible is at an extremely high risk of taking too much and accidentally overdosing, possibly even fatally.
The other dangers include the side effects of mood-based symptoms like confusion, mood swings, depression, and suicidal thoughts, which can lead to self-harm or even overtly suicidal behavior without careful monitoring. Still, under the supervision of a medical professional at a detox center, these dangers and more are easily avoided.
What Are the Stages of the Oxycodone Withdrawal Timeline?
While there is an established withdrawal timeline for opioids that oxycodone does, for the most part, align with, there is no way to determine with exact specificity how long any given individual’s oxycodone withdrawal period will last.
This is because everyone’s oxycodone detox experience is going to be a little different due to a variety of factors that are, in many cases, going to be unique, or at least widely vary from person to person. Some common variations that have a significant impact on the length of a person’s oxycodone withdrawal timeline include:
- How much oxycodone someone was abusing and how often
- How long they were abusing oxycodone
- If they were abusing oxycodone in conjunction with other drugs or alcohol
- How they were using oxycodone (orally as a pill or a tablet, crushed into a powder and snorted, etc.)
- If they have any co-occurring disorders
- If they have a history of previous addictions
- If they are detoxing with medication-assisted treatment
- If they are detoxing on a tapered schedule
- If they are stopping oxycodone use cold turkey
The type of oxycodone they someone has been abusing also impacts how long an oxycodone withdrawal can last. For example, extended-release OxyContin tablets are meant to last as long as 12 hours per dose and therefore remain in the body longer than other versions.
Many users will abuse extended-release OxyContin by crushing it into powder and snorting it for a more immediate and powerful high, which will extend the withdrawal timeline due to its much longer half-life.
With the knowledge of these different elements and how they influence any given person’s oxycodone withdrawal experience, the stages of the established oxycodone withdrawal timeline will generally match up with the following:
8 to 12 Hours
Most versions of Oxycodone have a pretty short half-life, so someone undergoing oxycodone detox can expect to begin experiencing withdrawal symptoms within about eight hours after the last use and definitely by 12 hours, starting with the physical symptoms. However, if someone is taking the extended-release, it might be 24 hours or longer before withdrawal symptoms start appearing.
One to Three Days
Over the course of the next few days, both the psychological and physical symptoms will have manifested and will eventually reach their peak strength, which makes this stage of the oxycodone withdrawal timeline the period in which people tend to be the most vulnerable to relapsing.
7 To 10 Days
Generally after a week or so, the majority of the withdrawal symptoms should have either faded or diminished to the point where they are much less uncomfortable and more easily managed, although drug cravings and certain psychological symptoms such as depression and anxiety are likely to persist for longer.
Two Weeks and Beyond
About two weeks after someone’s last dose of oxycodone, they should be at the end of their withdrawal period and no longer be experiencing the symptoms of oxycodone withdrawal. However, insomnia, anxiety, and other mood-related symptoms can linger for up to several weeks or more after finishing an oxycodone detox.
What Can Help With Oxycodone Withdrawal?
As previously mentioned, while not deadly, oxycodone withdrawal is, as illustrated, a difficult and uncomfortable process that is best done at a professional detox facility. There, a doctor can implement several measures to make the oxycodone withdrawal process as painless as they possibly can.
One of the ways they do is through what is known as a tapering schedule, which is the process of slowly weaning people dependent on oxycodone off the drug. The dosage is tapered down until it has become small enough that it is safe to stop using entirely, rather than dealing with the more severe withdrawal symptoms that come from trying to quit oxycodone cold turkey.
Many detox facilities will also provide medication-assisted treatment to complement a tapering schedule, using drugs that work to lessen oxycodone cravings while also blocking its effects.
These medications have varying degrees of potency and can work in different ways. The medication a detox professional may choose to administer will depend on the severity of someone’s oxycodone addiction and how they respond to treatment.
Some common medications involved in the tapering process include methadone and buprenorphine, which are significantly weaker forms of prescription opioids that take up space in the opioid receptors so as to both decrease cravings while also blocking the high caused by oxycodone use.
Suboxone is another popular medical maintenance drug and is a combination of buprenorphine and a drug called naloxone. Naloxone is generally considered too strong for medication-assisted treatment on its own, as it completely blocks out all of the effects of oxycodone and is often used to help reverse overdoses. Combining it with buprenorphine makes its effects less harsh, but also removes much of the addictive risk of using buprenorphine on its own.
What is the Next Treatment Step?
The step forward in treatment after oxycodone treatment should be some form of an addiction recovery program. The importance of not stopping treatment after detox cannot be overstated, as detox merely flushes oxycodone from the body, and does not cure addiction or the mindset and behaviors behind it.
In order for someone to change their addictive behaviors and avoid relapsing, they need to understand the issues behind their addiction and gain the tools and coping skills necessary to manage it successfully.
Addiction rehabilitation treatment can provide all of these things, whether it is through inpatient or outpatient treatment, depending on the severity of the addiction, through treatment elements such as:
- Individual therapy
- Group therapy
- Addiction education
- Treatment of co-occurring disorders
- Family therapy
- Holistic therapy
Typically, upon checking into treatment, the individual’s needs will be evaluated to help design a customized treatment plan that will work best for them. In many cases, they can collaborate with their therapist or counselor to help choose the therapies that will be most beneficial to ensuring recovery in the long-term after they have finished their treatment program.
