- Generic Name or Active Ingridient: Oxycodone And Acetaminophen
- An inability to abstain from drug abuse consistently
- Impaired behavioral control
- Diminished ability to recognize significant problems with one's own behaviors and relationships
- Dysfunctional emotional response
Endocet addiction and prescription drug abuse is on the rise in the United States, eclipsing illicit drug abuse rates. About 1.9 million Americans were addicted to prescription painkillers like Endocet in 2010, as compared to only 359,000 addicted to heroin.
The need for adequate treatment for Endocet addiction is growing in the United States as well. Admission rates for opioids other than heroin have skyrocketed 414 percent in just one decade. In 1997, only seven people in every 100,000 needed treatment for non-heroin opioid abuse; in 2007, this number had grown to 36 people per 100,000.
The rise in addiction and treatment rates could be due, at least in part, by the fact that the people in the United States take more opioid pain relievers than anywhere else on earth. While Americans account for about 5 percent of global population, they consume about 80 percent of the world's supply of opioids.
Information about Endocet
Endocet contains various strengths of oxycodone and acetaminophen, ranging from 5 mg to 10 mg of oxycodone and 325 to 600 mg of acetaminophen. Doctors prescribe Endocet to relieve moderate to moderately severe pain. Recreational users abuse Endocet to get high.
Oxycodone is a semi-synthetic pain reliever. Drug manufacturers create oxycodone tablets from thebaine extracted from the poppy plant, Papaver somniferum. Abusers consume these tablets whole, or crush them and snort the powder, or mix the powder with liquid and inject it into a vein. Some people heat the powder in a spoon and inhale the vapors.
Excessive doses, improper use and non-medical use of Endocet increases the risk for dependence and addiction. To use a drug non-medically means to take it to get high or to treat a condition for which it was not prescribed. In 2010, approximately 7 million people took psychotherapeutic drugs like Endocet non-medically.
Risk for Abuse
The U.S. Drug Enforcement Agency, or DEA, ranks drugs according to their relative risk for abuse. Schedule I narcotics, such as heroin or cocaine, carry a relatively high risk for abuse as compared to schedule V drugs, like the cough suppressant Robitussin AC.
The DEA classifies all drugs containing oxycodone, including Endocet, as a schedule II narcotic. This means Endocet poses a relatively significant risk for abuse, equal to that of OxyContin or raw opium. To reduce this risk, Endocet is available only by prescription.
The Definition of Addiction
According to the American Society of Addiction Medicine, addiction is a disease of the brain's reward, motivation and memory circuits. Dysfunction in these neurological circuits results in characteristic physical, psychological and behavioral changes that include cravings and drug-seeking behaviors. Endocet addiction is a primary condition, meaning it arises on its own and not as the result of another illness or injury. Addiction is a chronic disease lasting months or years, and frequently involving multiple instances of relapse and remission.
Doctors look for certain characteristics when considering a diagnosis of addiction, including:
Without adequate treatment, Endocet addiction is progressive and may result in disability or premature death.
Addiction versus Dependence
Closely related through drug abuse, addiction and dependence are two distinct and separate conditions. A person may be addicted to Endocet, or physically dependent upon it, or both.
Opioid Dependence and Tolerance
The human body adapts to the presence of certain foreign substances by altering its own chemistry to maintain a safe chemical balance. Long-term use of some substances causes these changes to become more permanent - the body learns to depend on a certain level of oxycodone to feel "normal." If oxycodone levels fall drastically, the body struggles to maintain chemical balance. Doctors call this process "detoxification."
The individual feels the battle for chemical stability through unpleasant withdrawal symptoms. Detoxification causes withdrawal. A doctor will diagnose someone as being opioid-dependent if the patient feels withdrawal symptoms a few hours after his last dose.
Taking Endocet for a long time may increase tolerance to this drug. A person who is tolerant to Endocet must taking increasingly stronger doses to achieve the same pain-relieving or euphoric effect. Reduced tolerance to Endocet means a person is more sensitive to the effects of Endocet.
A doctor will diagnose a person as being addicted to Endocet if the patient displays certain physical and behavioral characteristics, such as craving and drug seeking when his supply of Endocet runs low.
Drug Seeking and Diversion
An addicted person engages in drug-seeking behaviors to keep a steady supply of Endocet. An addicted person may go "doctor shopping" to acquire as many written prescriptions as possible. He might present fake or altered prescriptions at pharmacies. Many people get free prescription drugs illegally from friends and family, either with permission or by stealing it from medicine cabinets. Some individuals purchase Endocet and other opioids on the black market.
Doctors call these practices "diversion" because of the way they divert drugs from therapeutic use to recreational use.
Addiction: What Family Members Should Know
Family members should know that addiction is a disease, and not necessarily an indication that someone has a bad moral character. It is important to avoid blaming the victim for his disease; counseling can give family members the tools they need to provide support for the addicted individual.
About 10 percent of people who try drugs such as Endocet become addicted to them. Several factors influence the development of Endocet addiction including genetics, stress and environmental causes.
Everyone related to the addicted person shares an increased risk for addiction. Heredity plays a large role in determining whether someone is vulnerable to addiction. While there is no single "addiction gene," scientists believe interactions between a specific set of genes may make some people more susceptible to becoming addicted at some point in life.
No one is doomed to addiction simply because he was born with certain genetic makeup - a variety of factors lead to the development of addiction. Stressful environments, hypersensitivity to stress and poor coping mechanisms also play a role.
Stress within the home, school or work environment increases the risk for substance abuse for everyone within that environment. Stress can be in the form of peer pressure, frequent arguments or violence, financial stress, relationship problems, inequitable workloads or drug and alcohol abuse. Counseling can teach family members how to reduce environmental stress within the home by improving communication skills, making workloads more equitable and curtailing substance abuse.
Some individuals are hypersensitive to this stress; these individuals seem to feel more anxious in relatively calm situations. Many turn to Endocet and other pain relievers as a way of self-medication for this hypersensitivity to stress. Scientists believe hypersensitivity is inherited, passed from parent to child.
Children also learn how to cope with these stresses by watching a parent. An adult who takes Endocet to deal with stress may be unconsciously teaching the child that taking drugs is an acceptable way to deal with pressure.
Family members should know that the collateral damage associated with Endocet addiction affects and endangers the entire family. Addiction can cause financial hardship, divorce, loss of child custody, criminal activity, homelessness, prison and high legal bills. Addiction can also cause high hospital bills from infectious diseases, Endocet side effects, toxic overdose and death.
Family member should know that it is illegal and unsafe to keep Endocet in the home without a prescription. Keeping illicit drugs in the house increases the odds of home invasion and burglary, police raid and forfeiture of the home or vehicle.
Maintaining a stash of Endocet also raises the risk that someone, especially a child, will accidently discover and consume a toxic dose of Endocet. In cases of suspected overdose, transport the victim to the nearest medical facility.
Addiction: What Parents Should Know
In a recent national survey, about 3 percent of respondents between the ages of 12 and 17 years said they were currently using a prescription psychotherapeutic drug for non-medical reasons. Psychotherapeutic drugs include opioid painkillers such as Endocet, depressants and stimulants. Abuse rates increase among older respondents; 5.9 percent of 18 to 25 year olds reported using psychotherapeutic drug the month before.
When substance abuse specialists consider a diagnosis of Endocet addiction, they look for characteristic behavioral changes, like losing interest in something the individual used to feel pIt is quite normal for a child to exhibit some behavioral changes as they grow, making it especially difficult to identify addiction in a teenager or young adult.
When a parent is concerned a child has developed an Endocet addiction, the parent should be alert for certain behavioral changes, such as a profound loss of interest in something the child used to love. The addicted child may no longer be interested in playing with a beloved pet or spending time with a childhood friend. The child may drop old friends and start hanging in new social circles. The child's academic and athletic performance may decline and he may quit an after-school job he used to enjoy.
The child may seem unmotivated, even for a teenager. He may not have the energy or interest in the activities normal for his age.
Parents should question a child who disappears frequently and has trouble explaining his absence. He may be sneaking off to get high. Drugs are expensive - an addicted child has financial troubles advanced for his age. Parents should remain vigilant for money or items missing from the home.
Caring for a Family Member with an Addiction
As with other neurological disorders, a strong family unit is critical to recovery from Endocet addiction. Family members should recognize that addiction is a chronic disease that often involve cycles of remission and relapse. Addiction requires long-term care and support.
The family is often the first line of defense against Endocet addiction. It is common for a family member to locate the rehabilitation facility the addicted individual eventually attends. Every member of the family should encourage the addicted individual to seek out and complete treatment.
After the addicted person chooses a treatment facility, the family can work as a supportive network to help the individual complete treatment. For example, a grandparent can take over meal preparation while the parent goes to counseling while a younger child does light housework. An older child can drive the addicted person to appointments and an aunt or uncle can do bill payment.
The progression of addiction can be halted at any time - it is not necessary to let someone hit rock bottom before intervening. Rock bottom can include social isolation, homelessness, prison, infectious diseases and death.
Counseling teaches family members how to support an addicted person without enabling him. It is a common reaction to shield a loved one from the effects of his disease, but recovery from Endocet addiction often starts when the addicted person recognizes the consequences of his drug abuse.
Signs of Addiction
Addiction to Endocet and other substances makes changes to the neurological system on a cellular level, resulting in specific behavioral changes. These changes affect the way a person behaves, thinks and feels. Doctors look for these changes when considering a diagnosis of addiction; friends and family members can use these same signs to determine whether someone they love has an addiction. Unfortunately, the behavioral changes associated with addiction can drive away friends and family, separating the addict from those who could best help him.
Behavioral, Cognitive and Emotional Changes
The neurological changes associated with addiction alter the way someone behaves, thinks and feels. These changes serve to cause the progression addiction and interfere with intervention efforts. Left untreated, addicted is self-perpetuating.
An addicted person will use Endocet to excess, taking stronger doses or using this drug more frequently than she intends. She may express a desire to quit or cut down, even as she consumes more Endocet. It may seem she is ultimately unwilling or unable to control her behavior.
She will lose an excessive amount of time looking for Endocet, getting high or recovering from drug abuse. Her behavioral repertoire will narrow, so that soon she only participates in activities that result in getting high. This has a significantly negative impact on her daily life, impairing her ability to participate in school, go to work or take care of personal responsibilities.
The addicted individual will continue to use Endocet, despite the negative effect it has on her life. She may blame other people or events for her problems, rather than recognizing them as predictable consequences of drug abuse.
Endocet addiction changes the way a person thinks. She becomes preoccupied with substance abuse so that, eventually, doing drugs is all she thinks about. Addiction alters her view of the relative benefits and risks of drug abuse; she believes all of the positive attributes of Endocet and none of the negative.
Many people take Endocet to relieve stress and emotional pain but Endocet addiction can actually increase anxiety and emotional pain. Addiction can even cause the emotional opposite of euphoria, dysphoria.
Opioid addiction actually recruits the brain's stress system to increase the person's perception of stress; addiction makes things seem more stressful than they really are.
Addiction may make it difficult for some people to identify their feelings or describe emotions to others. Addiction may even make it hard to distinguish between feelings and bodily sensations.
Symptoms of Addiction
The neurological changes associated with addiction causes physical and psychological symptoms that doctors look for when considering a diagnosis of addiction.
Physical symptoms of drug addiction include an unexplained change in weight or sleep patterns. The addicted patient will have a deteriorating physical appearance and may even look sickly with a nagging cough, bloodshot eyes with unusually large or small pupils, tremors and slurred speech. The patient's body or clothing may have an unusual odor and he may have poor hygiene.
Physicians will also look for psychological symptoms of addiction, such as an inability to abstain from Endocet consistently, impairment in behavior control or intense cravings for drugs or other rewarding experiencing. The drug addict presents a diminished capacity to recognize significant personal or relationship problems. This individual may display a dysfunctional emotional response, becoming upset at trivial matters or seem unmoved by major catastrophe.
Men are twice as likely to abuse illegal substances such as heroin, cocaine or marijuana. In 2010, 5.9 percent of females admitted to using illicit drugs, as compared to 11.6 percent of males.
Men are also more likely to become addicted to drugs such as Endocet. Men die from overdoses of prescription painkillers more often than women do.
While men are at more risk for developing substance abuse problems, women have a more difficult time overcoming Endocet addiction. Women tend to progress more quickly from prescription drug abuse to addiction. Females tend to develop more physical problems associated with substance abuse - women get sicker quicker. Women also suffer more relapses than men do.
Men and women begin drug abuse in different ways. Men start out using drugs recreationally, to get high with friends. Women frequently arrive at drug abuse after using painkillers as part of a prescribed treatment for a medical condition.
Physicians tend to prescribe pain relievers more frequently to women than men. This could be because some chronic conditions, like fibromyalgia, affect women more often than men. Women are also more likely go to the emergency room for treatment for drug-related problems.
Women with addictions are frequently in relationships with a partner who also has a substance abuse problem; a woman in this situation may feel she is "abandoning" her partner when she stops using drugs.
A woman may face special obstacles when it comes to treatment for Endocet addiction, such as being able to afford quality treatment or finding childcare while she participates in treatment. Social stigmas may prevent a woman from seeking help. For these reasons and many more, women are less likely to complete treatment.
When left untreated or undertreated, addiction to Endocet can cause disability or premature death. In 2010, an estimated 17.9 million Americans needed treatment for substance abuse problems like Endocet addiction but only about 2.6 million received the therapy they needed that year.
There are two phases of treatment: detoxification and rehabilitation. Detoxification is the physiological process of lowering oxycodone levels. Rehabilitation addresses the behavioral aspects of Endocet addiction, giving the addicted person the tools he needs to live without drugs.
Skipping a dose, taking an inadequate dose or using a drug that lowers opioid levels will initiate the detoxification process. Without intervention, withdrawal symptoms will last five or more days, with the worst symptoms occurring on or about the fourth day. A person can halt the detoxification process by taking a medication that mimics opioids or by taking more Endocet.
Many people try to overcome dependence on Endocet by themselves, without medicine to ease withdrawal symptoms or the advice of rehabilitation specialists. Doctors call this self-detoxification, but this is commonly known as "going cold turkey." Cold turkey refers to the way the skin looks during detoxification - pale, cold, clammy with goose bumps, resembling a plucked turkey.
Without anti-withdrawal medications or help with the psychological symptoms of withdrawal, the individual is vulnerable to complications. Vomiting and then inhaling stomach contents, known as aspiration, may lead to fluid in the lungs and lung infection. Severe or prolonged vomiting, diarrhea and sweating may result in dehydration.
The primary complication of detoxification is relapse to Endocet use. Any amount of detoxification reduces the individual's tolerance to oxycodone. As the result of this lowered tolerance, a person can potentially overdose on a smaller dose than he used to take before experiencing even moderate withdrawal symptoms.
The Thomas Recipe
Some people develop a treatment plan that includes anti-withdrawal medicine. One such remedy is The Thomas Recipe, which calls for valium or another drug to calm anxiety and help the individual sleep. He takes Imodium to ease diarrhea, plus vitamins and supplements along with hot baths to soothe muscle aches. L-Tyrosine with B6 provides a burst of energy to combat fatigue and malaise.
While The Thomas Recipe reduces the severity of withdrawal symptoms, it does not shorten the duration nor decrease the risk for complications such as aspiration, dehydration and overdose.
Overdose of prescription painkillers such as Endocet claimed the lives of nearly 15,000 people in 2008. Someone can overdose on the oxycodone component, the acetaminophen in Endocet, or both.
Oxycodone overdose causes respiratory depression, a serious and potentially fatal breathing problem. Symptoms of respiratory depression include slow or shallow breathing, irregular breathing problems and a blue tint around the eyes, mouth and fingertips. Symptoms of oxycodone overdose include respiratory depression, flaccid muscles, excessive sleepiness, cold or clammy skin and sometimes very low blood pressure and slow pulse.
Acetaminophen overdose typically occurs after the individual consumes multiple products containing this common analgesic. Acetaminophen can cause liver and kidney damage. Symptoms of acetaminophen overdose include nausea, vomiting, excessive sweating and general malaise; clinical signs of acetaminophen overdose may not appear for 48 to 72 hours after ingestion.
In cases of suspected overdose, transport the victim to the nearest hospital or fire department. While at the hospital, emergency department doctors will administer 0.4 mg to 2 mg of naloxone to reduce opioid levels, or the antidote to acetaminophen, N-acetylcysteine. Nurses will establish an airway to help the patient breath. They may rid the stomach of excess medication by inducing vomiting, pumping the patient's stomach or introducing charcoal, which absorbs the drug.
Drug Replacement Therapy
Those who are not in immediate danger of overdose can participate in DRT, or drug replacement therapy. DRT uses drugs that mimic the opioids in Endocet but do not produce euphoria. This means the patient does not experience withdrawal symptoms but he does not get high.
DRT drugs include methadone, Suboxone and buprenorphine. DRT allows the patient to skip the detoxification process temporarily while he engages in behavior modification. Once the patient learns the skills he needs to live without Endocet, he weans himself from the replacement drug by taking successively smaller doses further apart.
Supporters of DRT say it allows patients to continue working and living at home while participating in behavior modification. Opponents think it is merely replacing one drug addiction for another.
Many institutions now offer inpatient detoxification services, where doctors administer naloxone to lower oxycodone levels along with multiple medications to ease the subsequent withdrawal symptoms. Nurses monitor the patient for complications.
While standard detoxification reduces the severity of withdrawal symptoms, it does little to address the demoralizing psychological effects of Endocet addiction, which can leave a patient feeling unworthy or incapable of recovery.
Most rehabilitation professionals think that rapid detox is the most humane form of detoxification. During rapid detox, board-certified anesthesiologists administer the standard detoxification and anti-withdrawal drugs plus sedatives and anesthesia. This allows the patient to doze in a pleasant "twilight sleep" during detoxification. When she awakens, she will have no memory of the grueling withdrawal process.
Detoxification is only the first step towards recovery and, by itself, does little to change the behaviors associated with Endocet addiction. Recovery from Endocet addiction requires behavior modification along with individual, family and group counseling; medications may be an important part of rehabilitation for many people.
Endocet addiction is a complex but treatable condition. Treatment requires a multi-faceted approach, addressing the individual's physical, psychological and social needs. Many people who suffer with addiction also have other mental health disorders, such as depression; medications are an important part of treatment for these individuals. Others need intense behavior modification or help with social problems. Each person experiences Endocet addiction in a slightly different way, so no single treatment is right for everyone.
Some people may choose outpatient treatment with weekly or monthly visits to a counselor. Others may prefer an in-patient residential setting for long-term care lasting six months to a year.
No matter which form of treatment the individual chooses, it is important that treatment is readily available to encourage maximum participation and completion. Endocet addiction is neurological disease that affects brain function and behavior; it is critical the individual remains in treatment long enough to restore brain function and behavior enough to prevent relapse.
The rehabilitation professional is an important part of recovery. The counselor will develop a treatment strategy based on the multiple needs of the individual, and not just her Endocet addiction. The counselor will continually assess the patient's changing needs and adjust the care plan accordingly.
The counselor will likely require drug testing, as relapses do occur. The treatment plan may assess the patient for the presence of infectious diseases and provide risk-reducing education to patients whose behaviors place them at risk for contracting or spreading these diseases.