Combunox Withdrawal

  • Generic Name or Active Ingridient: Oxycodone Hydrochloride And Ibuprofen

Definition

Combunox contains the opioid pain reliever, oxycodone. Taking opioids such as oxycodone for a long time may cause a person to become opioid-dependent. When opioid levels fall in a dependent person, the individual feels uncomfortable withdrawal symptoms.

Combunox withdrawal is the normal, predictable consequence of taking Combunox for a long time. Experiencing Combunox withdrawal is not necessarily an indication of criminal activity - it is possible to become physically dependent on Combunox after using it as prescribed by a doctor.

Causes

The body adapts to the presence of some foreign substances, like the oxycodone in Combunox, by adjust its own body chemistry. Chronic use of Combunox can make these adaptations more permanent; the body relies on a certain level of oxycodone to feel "normal." If the levels of oxycodone were to drop drastically, the body would struggle to regain chemical stability. Doctors call this "detoxification." The individual experiences the battle for chemical balance through specific physical and psychological symptoms. Detoxification causes withdrawal symptoms.

Missing a dose, taking an insufficient dose, or using a drug that rapidly reduces opioid levels will initiate the detoxification process in an opioid-dependent person.

Chronic use of Combunox may cause the body to become more tolerant of oxycodone. Someone with a high tolerance to oxycodone must take a stronger dose or use this drug more frequently to achieve the desired effect.

Facts about Combunox

Combunox contains 5 mg of oxycodone, a strong semi-synthetic opioid. Pharmacologists create oxycodone from thebaine, an alkaloid extracted from the poppy plant, Papaver somniferum. Oxycodone is associated with high rates of abuse because of the euphoria it causes.

Recreational users consume Combunox orally or by crushing, then inhaling or mixing the powder with water and injecting it. Others heat the crushed tablet in a spoon, heat it over a flame and inhale the vapors. Using Combunox in these ways increases the risk for physical dependence, withdrawal and addiction.

Combunox also contains 400 mg of ibuprofen. Ibuprofen is a non-steroidal anti-inflammatory, or NSAID drug that relieves mild pain, fever and inflammation. Ibuprofen is not associated with high rates of abuse, but using ibuprofen for a long time increases the risk for serious medical conditions such as heart attack or stroke that can lead to death.

Potential for Abuse

More than 12 million people in the United States said they had used prescription painkillers like Combunox non-medically in 2010. To use a drug non-medically means to use Combunox to get high or to treat a condition for which the doctor had not prescribed. Using a drug non-medically increases the risk for physical dependence, addiction and withdrawal.

The U.S. Drug Enforcement Agency, or DEA, ranks drugs according to their relative risk for abuse. The DEA has classified Combunox as a schedule II narcotic, meaning people are relatively likely to abuse this drug.

Symptoms

Combunox withdrawal causes physical symptoms similar to the flu. These symptoms last five or more days, with the worst day occurring on or about the fourth day. Combunox withdrawal also causes psychological symptoms that can interfere with recovery because they make the individual feel incapable or unworthy of rehabilitation. Combunox withdrawal symptoms are painful and demoralizing, but usually not life threatening.

There are several ways to stop or reduce withdrawal symptoms. The individual can take medicine to address individual withdrawal symptoms or she can take a drug that mimics Combunox, like methadone. She can also take more Combunox to make the symptoms disappear. Overpowering and prolonged withdrawal symptoms prevent some people from quitting drug abuse.

Physical Symptoms

Detoxification usually causes symptoms to occur in two waves, with the first set of symptoms usually appearing several hours after the last dose. These early symptoms include agitation, anxiety, muscle aches and watery eyes. The individual may also experience insomnia, a runny nose, sweating and yawning. The second wave of symptoms includes abdominal cramping, diarrhea, dilated pupils, goose bumps, nausea and vomiting.

Psychological Symptoms

Combunox withdrawal causes psychological symptoms that can impede recovery efforts, especially when left untreated or undertreated. These psychological symptoms may include:

  • Agitation
  • Anxiety
  • Depression
  • Hallucinations
  • Irritability
  • Poor concentration
  • Restlessness
  • Social isolation

Possible Complications

While Combunox withdrawal is not itself life threatening, symptoms can cause dangerous complications. One complication is aspiration, which is vomiting and then inhaling stomach contents into the lungs. Aspiration may result in fluid in the lungs or lung infection. Excessive and prolonged vomiting, diarrhea and sweating may result in dehydration.

Relapse is the primary complication associated with Combunox withdrawal. Without adequate treatment, many individuals return to opioid abuse to stop the overpowering withdrawal symptoms.

Relapse increases the risk for toxic overdose, as detoxification lowers the body's tolerance to opioids. As a result, it is possible for a person to overdose on a smaller dose of Combunox than he used to take after experiencing even modest withdrawal symptoms.

Treatment options

Without adequate treatment, dependence on opioids like oxycodone can result in disability or premature death. Chronic drug abuse is associated with an increased risk for infectious diseases, such as HIV/AIDS, tuberculosis and hepatitis B and C.

There is a growing need for specialized substance abuse treatment in the United States. About 23 million people needed treatment for substance abuse problems in the U.S. in 2010, but only 11 percent of those who needed treatment received it at a facility that specializes in treating substance abuse. The rest tried to overcome substance abuse problems on their own or in a general hospital.

People working at specialty facilities receive special training in providing substance abuse treatment, including detoxification and rehabilitation. These rehabilitation professionals help people overcome withdrawal symptoms or teach them how to live without drugs.

Self Detoxification

Many people try to overcome Combunox withdrawal symptoms alone, without the help of trained professionals. Doctors call this self-detoxification but it is commonly known as "going cold turkey." Cold turkey is a reference to the appearance of the skin during detoxification: pale, cold, clammy with goose bumps, much like a plucked turkey.

Self-detoxification is lengthy, uncomfortable, humiliating and demoralizing; self-detoxification also leaves the individual vulnerable to complications such as aspiration, dehydration and relapse. Without medicine to ease withdrawal symptoms or professional guidance to address psychological issues, many people resort to taking more Combunox before they finish detoxifying their bodies.

The Thomas Recipe

Some concoct homemade treatment plans that include multiple medications that address individual symptoms. One such remedy is The Thomas Recipe, which calls for valium or some other drug to calm anxiety and induce sleep, Imodium to curb diarrhea, plus vitamins and supplements to soothe muscle aches. A shot of L-Tyrosine with B6 gives a boost of energy.

While The Thomas Recipe reduces symptoms and the risk for developing complications somewhat, the person is still at great risk for relapse, potentially resulting in toxic overdose.

Overdose

It is possible to overdose on either the oxycodone component of Combunox or the ibuprofen, or both. Ibuprofen overdose is usually the result of taking multiple products containing this common analgesic.

Combunox overdose can be fatal. Drug overdose deaths have tripled since 1990; overdose from prescription painkillers claimed the lives of 15,000 people in 2008.

Overdose is a serious, potentially fatal medical emergency. In cases of suspected overdose, transport the victim to the nearest emergency department. There, doctors will administer naloxone to reduce opioid levels quickly. Nurses will establish an airway to help the patient breathe and monitor for complications. Emergency personnel may induce vomiting, pump the patient's stomach, or introduce charcoal into the stomach to absorb excess Combunox. Once the patient is in stable condition, she may participate in rehabilitation to address the behaviors associated with drug abuse.

Drug Replacement Therapy

Individuals who are not in immediate danger of toxic overdose may engage in DRT, or drug replacement therapy. DRT replaces oxycodone with other drugs that mimic its effects without causing euphoria - DRT drugs reduce withdrawal symptoms but do not get the patient high. This allows the individual to participate in behavior modification before he attempts detoxification.

DRT drugs include methadone, Suboxone and buprenorphine. Once he has learned how to live without Combunox, he weans himself from the DRT drug by taking smaller doses increasingly further apart. Supporters of DRT note this form of therapy allows people to continue their daily lives while participating in behavioral modification rather than spending time in a hospital, away from work and family responsibilities.
Opponents of DRT fear it is merely trading one drug dependence for another. Many people have trouble weaning themselves from methadone.

Standard detoxification

Many specialty facilities now offer detoxification procedures. During standard detoxification, doctors administer drugs like naloxone to reduce opioid levels along with other medications that address withdrawal symptoms. Nurses monitor the patient for complications.

Standard detoxification reduces the severity and duration of withdrawal symptoms but the detoxification process itself can cause psychological side effects. The patient must still endure a lengthy hospital stay and explain his absence to friends, family and co-workers. Many feel humiliated by the detoxification experience.

Rapid Detox

Rapid detox is the most humane form of detoxification treatment available. During rapid detox, board-certified anesthesiologists administer the standard detoxification and anti-withdrawal drugs, but also give the patient sedatives and anesthesia. The patient dozes in a comfortable "twilight sleep," unaware of the demoralizing and uncomfortable detoxification process.

Rehabilitation

Detoxification is only the first step in recovery and, by itself, does little to change the behaviors associated with drug abuse. Addiction and dependence are complex but treatable conditions that affect brain function and behavior. Rehabilitation gives the individual the tools he needs to live without Combunox.

Opioid dependence and Combunox withdrawal is a complex medical condition that requires a multi-faceted approach to recovery. Effective treatment must tend to the multiple needs of the individual and not just help her overcome Combunox withdrawal. Everyone experiences opioid-dependence a little differently, so no single treatment is right for everyone.

The individual may attend weekly or monthly meetings with a counselor at an outpatient clinic so he can continue working or taking care of his family, or he might choose treatment in a long-term residential facility.

Rehabilitation usually includes behavior modification along with individual, group or family counseling. Medications are an important part of treatment; many people with substance abuse problems also have medical conditions or mental health issues that may interfere with recovery efforts.

No matter what type of treatment the individual chooses, it needs to be readily available. It is critical to remain in treatment long enough to restore neurological function and behaviors altered by chronic drug abuse.

A rehabilitation counselor will develop a treatment plan based on an initial assessment of the patient's condition and then modify the plan continually to make sure it fits the patient's changing needs. The counselor may require drug testing, as relapses may occur during treatment. The counselor may also request testing for infectious diseases and provide information to reduce the patient's risk for contracting or spreading these diseases.