Oxycodone Addiction: Abuse Signs, Effects & Treatment


Oxycodone Addiction Treatment Guide

Although oxycodone was created in 1916 in Germany and used to manage the pain of soldiers in World War I, it took over 20 years to cross the ocean to the United States. In 1996, an extended-release version, called OxyContin, was introduced and quickly gained popularity.

Pharmaceutical companies produced data that seemed to indicate that opioid pain relievers such as oxycodone and OxyContin would not be addictive. Because these drugs were so effective for those experiencing severe pain, they were regularly prescribed.

Thanks to the popularity of oxycodone, both in its original and its gradually released form, there has been an unfortunate increase in the misuse of this medication that has led to addiction and, in some cases, death. This is not a localized problem but rather a global one.

In Ontario, Canada, it was recorded that the use of oxycodone increased more than eight times between 1991 and 2007. In the United States, in 2019, an estimated 1.6 million people were dealing with opioid dependence issues.

While there is some evidence that the use of oxycodone may have plateaued, it is still a heavily prescribed substance given to relieve moderate to severe pain in many situations, such as for those recovering from surgery. Often, while in the hospital, individuals will receive morphine, then be discharged with a prescription for oral oxycodone.

Unfortunately, the more these medications were prescribed, the more they were abused. Instead of using them judiciously for a very short period and then turning to less-addictive forms of pain relief, many people took them for months or even years. This led to the declaration of a public health emergency in 2017. In the period from June 2019 to June 2020, over 46,000 deaths were reported due to opioid abuse. Of these fatalities, approximately 40% occurred with people who were on a prescription for the drug at the time.

What Is the Difference between Opiates and Opioids?

Often the two terms, opiates and opioids, are used interchangeably. However, there are differences. Opioids are substances that can attach to the opioid receptors in the brain. They can be natural, synthetic, or a hybrid of the two.

Opiates are naturally derived drugs such as opium, morphine, and codeine, which all come from the poppy. Medications like Tramadol, methadone, and fentanyl are synthetic opioids. Heroin, hydrocodone, and oxycodone are semi-synthetics. They are partially derived from plants but then manipulated further in the lab.

Opioids can be safely used. In fact, they have been used since ancient times in some parts of the world. However, when people were chewing poppy seeds for their euphoric or pain-relieving effects, the dosage was, by its very nature, fairly small.

Today, the drugs are still beneficial for millions of people. When taken under a doctor’s supervision for short periods, it can be safe to take oxycodone. The problem is that many people are tempted to take it recreationally since it relieves pain and creates a sense of well-being.

How Does Oxycodone Work?

Oxycodone is considered an opiate agonist. That means it provides relief from pain by interacting with the opioid receptors that are present in the brain and the spinal cord. There is some evidence that it also acts directly on other types of tissue. It is one of the most effective analgesics for many types of pain. It has been shown to reduce pain of many types enough to improve a person’s quality of life when the individual is suffering from chronic pain.

Drugs in this classification, whether naturally occurring or synthetically manufactured, are among the most efficacious remedies for pain that exist. OxyContin is a version of oxycodone that is particularly popular as it is a time-released pill. It lasts for about 12 hours, whereas other forms of oxycodone typically last four to six hours. Depending on the level of pain that an individual experiences, he or she may be prescribed two to four tablets a day.

In addition to being time-released, OxyContin can provide much higher dosages of oxycodone than other medications in this category. For example, some products containing oxycodone only have between 2 mg and 5 mg of the drug. However, OxyContin at the minimum dosage provides 10 mg. This may be considered equivalent since the user would only take one OxyContin pill every 12 hours versus a pill every four to six hours. However, there is a version of OxyContin that contains 160 mg, as well as ones that provide 40 and 80 mg.

In order to formulate oxycodone, thebaine is modified. This is one of the alkaloids found in naturally occurring opium, which contains less than 1% of this substance. Thebaine is toxic and is not a natural analgesic. However, when modified in a lab, it forms the basis for oxycodone.

Often, in a postoperative setting, oxycodone is combined with acetaminophen to help with moderate pain following surgery. In its time-released form, it is often provided to those suffering from cancer or chronic pain from osteoarthritis or neuropathy.

From a chemical viewpoint, oxycodone bears a close resemblance to morphine. The drug itself has been used for over 100 years, and therefore there should be a vast body of research on it, but unfortunately, there is not as much information as would be expected. It is known, however, that long-term use of oxycodone can cause damage to the liver and kidneys. It can also lead to respiratory distress since it has a depressive effect on the respiratory system.

While considered a depressant of the body’s central nervous system, oxycodone use can lead to increased serotonin levels. In fact, it reacts with the same receptors that heroin does. This means that those who use oxycodone can experience euphoria. Because of this effect, the drug can be addictive.

Another factor that can lead to addiction is that long-time users of oxycodone will need higher dosages to receive the same effect. While it is generally therefore not advised for anyone to take oxycodone for long periods, in some cases, such as terminal cancer patients, there are often no better options for relieving pain. In that case, the dosage needed for pain relief might be so high that it would kill someone who is taking the medication for the first time.

Those who take higher doses of oxycodone may find themselves feeling not just pain relief, but also pleasure. They will feel a real reduction in their anxiety levels and find themselves relaxed. Because of this, addiction is a real possibility, particularly for those who are taking the drug recreationally.

While it is understandable that a dying person in pain might have no other options, for other users, oxycodone can lead to addiction that destroys lives. Because of this, oxycodone is considered a Schedule II controlled substance.

In 2017, a survey showed that approximately 1.4% of respondents had used oxycodone. Researchers questioned some people as young as 12 years of age. While many users began to take the medication to manage pain, others began to take it recreationally.

Those who used the drug for recreational purposes often take it in ways that are not cleared by doctors. For example, they may crush pills into powder form and then swallow or snort it. Or they may try to inject it. All these methods lead to a more powerful effect, greatly increasing the chance of addiction. Of course, larger doses also lead to quicker development of tolerance and dependency.

Side Effects of Oxycodone

There are many side effects that can affect someone who is taking oxycodone. These can include:

• Mood swings
• Trouble staying focused
• Aggression
• Paranoia
• Reduced anxiety
• Poor decision making and impulsive behavior
• Euphoria
• Memory issues
• Sleep disorders
• Loss of interest in relationships, work, school, and other activities
• Intense relaxation
• Inability to stop taking oxycodone
• Trouble forming words
• Exhaustion
• Weight loss
• Heart problems
• Respiratory problems
• Constipation
• Drowsiness
• Poor hygiene

While it is unlikely that a carefully supervised, short-term use of oxycodone will cause serious problems, the longer someone uses the drug and the higher the dosage, the greater the likelihood of problems. For those who have a loved one exhibiting these changes, their oxycodone use could be a cause for concern.

Factors that Contribute to Oxycodone Dependence

There are many reasons that people can become dependent on oxycodone. Family history is one factor. If the client’s parents or a sibling have struggled with addiction, that increases the client’s propensity for dependence. It’s likely that shared genetic factors play a role.

Those who lack a support system, are isolated, or have emotional issues may be more at risk. So may younger people whose brains aren’t fully developed.

Signs of Addiction

There are many classic signs of addiction that apply to someone who is dependent on oxycodone. These include people who try to steal or forge prescriptions, go to multiple doctors for multiple prescriptions, and spend most of their time and money on their habit. If they are neglecting their regular responsibilities, that is another sign of addiction.

Overdose Symptoms

Because someone who is addicted to oxycodone needs progressively greater amounts to achieve the same effect, it is easy for an accidental overdose to occur. If someone is combining oxycodone with other drugs or alcohol, that raises the risk significantly.

These are some signs of an oxycodone overdose:

• Labored breathing
• Clammy skin
• Blue lips or fingertips
• Slow heart rate
• Losing consciousness
• Confusion and disorientation

When someone is in this condition, paramedics should be called. They may use Narcan to counteract the overdose. Even if someone does not have a fatal overdose, there are many horrible consequences of oxycodone addiction. They include everything from marital issues to incarceration and unemployment. In addition to the social and financial ramifications, a person who has overdosed may also experience vision problems and damage to organs.

Treatment Options

If someone is ready to stop using oxycodone, it is important to find a professional treatment center. There are several reasons for this.

Due to the nature of the addiction, clients need a dedicated support system. Additionally, due to the dangers of withdrawal, it is critical to have medical supervision.

Oxycodone withdrawal symptoms can include:

• Nausea
• Watery eyes
• Runny nose
• Tremors
• Tics
• Muscle spasms
• Sweating
• Insomnia
• Intense craving for the drug

Because of the severity of withdrawal and the changes in brain chemistry that have occurred due to the addiction, the client must receive not only a medically supervised detox but all the other facets of a complete treatment program as well.

The underlying cause of the dependence must be addressed through counseling and education. Often there are medications and supplements that can make the process easier. There are also transitional options such as outpatient services, group living situations, and other community-oriented programs that can help someone in recovery transition at their own pace to a sober lifestyle.

For those in the grip of addiction, the outlook may seem dim, but there are resources and programs available that can help clients reach sobriety. Even someone who has dealt with an oxycodone addiction for years can find hope and be able to have a healthy and happy life.

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Reviewed By:

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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