Endocet Withdrawal

Endocet withdrawal is the normal, predictable consequence of using this drug continually for a long time.

Endo Pharmaceuticals manufacture Endocet in three strengths. Each Endocet tablet contains 5 mg, 7.5 mg or 10 mg of oxycodone. Each tablet also contains 325 mg, 500 mg or 650 mg of acetaminophen.

A person may become dependent upon the oxycodone component of Endocet and experience withdrawal symptoms when he stops using this drug. Withdrawal produces flu-like symptoms lasting several days. The withdrawal process also causes demoralizing psychological symptoms that can worsen dependence or interfere with recovery efforts, especially when the psychological aspects of withdrawal are left untreated or undertreated.


The human body adapts to the continual presence of some foreign substances, including Endocet, by altering its own chemical makeup. Long-term use causes some of these adaptations to become more permanent; the body begins to rely on a steady supply of oxycodone to feel "normal." When oxycodone levels drop suddenly, the body struggles to maintain chemical stability. Doctors refer to this as detoxification. The individual experiences this battle for chemical balance through withdrawal symptoms.

Detoxification causes withdrawal symptoms in an opioid-dependent person; a doctor will diagnose an individual as being opioid-dependent if the patient experiences flu-like symptoms after he stops using Endocet. The detoxification process is initiated by missing a dose, taking an insufficient dose or by using a drug to rapidly lower opioid levels.


Taking Endocet for a long time may increase tolerance to opioids. Someone with a high tolerance must take stronger doses of Endocet more frequently to relieve pain or to get high. A person with a low tolerance is more sensitive to the effects of Endocet.

Facts about this drug

Physicians prescribe Endocet to relieve moderate to moderately severe pain. Recreational users target Endocet because of the euphoric feeling oxycodone provides.

Non-medical use increases risk for opioid dependence and subsequent Endocet withdrawal. Non-medical use includes using Endocet to get high or to treat a condition other than the one it was prescribed for.

Oxycodone is a semi-synthetic drug. Pharmacologists create oxycodone from thebaine, extracted from the opium poppy plant, Papaver somniferum.

Opioids such as oxycodone work on the central nervous system, or CNS, to relieve pain, calm anxiety and cause euphoria. Oxycodone and other opioids act on the respiratory centers in the brain to reduce cough. Opioids also work on smooth muscle groups, like those in the digestive tract, to curb diarrhea. As a result, Endocet withdrawal symptoms will greatly affect the CNS, respiratory and digestive systems.

Potential for Abuse

Abuse and non-medical use increases the risk for opioid dependence and subsequent withdrawal from Endocet. The U.S. Drug Enforcement Agency, or DEA, classifies drugs according to their relative risk for abuse. The DEA classifies all oxycodone products as schedule II narcotics, which means Endocet poses the same relative risk for abuse as OxyContin and raw opium. To minimize this risk, Endocet is available only by prescription.

Abuse and Addiction Rates

About 12 million people in the United States used a prescription opioid for non-medical reasons in 2010. As a result, more people are now addicted to prescription analgesics including Endocet than to heroin. In 2010, about 1.9 million Americans were addicted to prescription painkillers like Endocet, while there were only 329,000 reported heroin addicts that year.

Widespread availability is adding fuel to the substance abuse fire. People in the United States use more painkillers than anywhere on earth. Even though Americans make up only about 5 percent of global population, they use 80 percent of the world's opioid pain medicine.

Facts about Withdrawal

Anyone can become opioid-dependent and suffer Endocet withdrawal when he stops using this drug. Withdrawal symptoms often begin several hours after the last dose of oxycodone and last for five or more days. The worst symptoms usually start around the fourth day. Left untreated, withdrawal symptoms disappear in time.

A person can ease withdrawal by taking medications to address individual symptoms. She may also take a drug that mimics the effects of oxycodone. The detoxification process can be halted at any time by taking more Endocet. Without medical assistance, overpowering withdrawal symptoms prevent many people from quitting Endocet.


The physical and psychological symptoms associated with Endocet withdrawal may interfere with recovery, especially without medicine to ease symptoms or professional guidance. While the symptoms of Endocet withdrawal are uncomfortable and discouraging, the detoxification process is not usually life threatening.

Withdrawal symptoms appear in two waves, and last five or more days with the worst symptoms appearing on or about the fourth day.

Early symptoms of withdrawal include:

  • Agitation
  • Anxiety
  • Muscle aches
  • Increased tearing
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Late symptoms of withdrawal include:

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea
  • Vomiting

Possible Complications

The detoxification process is not life threatening but Endocet withdrawal symptoms can cause dangerous complications. The individual may vomit and inhale the stomach contents, a complication known as aspiration. Aspiration may cause fluid in the lung and lung infection. Excessive vomiting, diarrhea and perspiration may result in dehydration.

Relapse is the primary complication associated with detoxification and Endocet withdrawal. Without treatment, individuals succumb to overwhelming physical and psychological Endocet withdrawal symptoms and return to Endocet.

Treatment options

Treatment for Endocet withdrawal focuses on lowering oxycodone levels, reducing withdrawal symptoms and avoiding complications including relapse. Treatment also reduces the risk for side effects, overdose and contracting or spreading infectious diseases such as HIV/AIDS, tuberculosis, and hepatitis B and C.

More than 23 million people in the United States needed treatment for substance abuse problems including Endocet withdrawal in 2010. Of those who needed help, only about 11 percent got it in a specialty facility staffed with professionals who received special training in drug detoxification and rehabilitation. The other 89 percent received help at a general hospital or psychiatric unit without the benefits of trained staff.

Treatment for opioid dependence involves two phases: detoxification and rehabilitation. The detoxification process focuses on lowering oxycodone levels and easing withdrawal symptoms. Rehabilitation includes behavioral modification to change the behaviors associated with drug abuse. Both detoxification and rehabilitation aim to reduce relapse and decrease the negative impact of drug abuse.

Self Detoxification

A large number of people attempt to overcome opioid dependence alone, without the help of medicine to ease withdrawal symptoms or the guidance of a rehabilitative professional. Doctors call this self-detoxification; it is commonly called "going cold turkey." Cold turkey refers to the skin's appearance during the detoxification process: pale, cold, clammy with goose bumps, much like a plucked bird.

Self-detoxification is prolonged process, marked with uncomfortable and demoralizing withdrawal symptoms. Without medical help, those who attempt self-detoxification may suffer complications including aspiration, dehydration and relapse.

The Thomas Recipe

Some people create a treatment plan including a variety of medications to address individual symptoms of withdrawal. One remedy is The Thomas Plan, which calls for a benzodiazepine such as Valium, Librium, Ativan or Xanax to calm anxiety and help with sleep. The Thomas Plan calls for Imodium to curb diarrhea. L-Tyrosine helps with malaise, while Vitamin B6, supplements and hot baths soothe muscle aches and restless leg syndrome.

The Thomas Recipe eases the symptoms of Endocet withdrawal somewhat but this homemade remedy does not shorten detoxification or reduce the risk for complications, including relapse that may result in overdose.


Detoxification increases risk for overdose if the patient relapses. Any amount of detoxification reduces tolerance to oxycodone; this means someone can potentially overdose on a smaller dose of Endocet than he used to take before experiencing even moderate withdrawal symptoms.

It is possible to overdose on either the oxycodone or the acetaminophen components of Endocet. Acetaminophen overdoses is frequently the result of taking multiple products containing this common analgesic.

Oxycodone acts on the respiratory centers in the brain; taking too much Endocet may cause the brain to "forget" how to breathe. Oxycodone overdose causes respiratory depression, a serious and potentially fatal breathing problem. Respiratory depression is characterized by 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 and cold or clammy skin. The victim may sometimes have a very low blood pressure and slow pulse.

Acetaminophen overdose can damage the kidneys and liver. Symptoms of acetaminophen overdose include nausea, vomiting, excessive sweating and general malaise. The clinical signs of acetaminophen overdose may not appear for 48 to 72 hours after consumption.

Endocet overdose is a serious, potentially fatal medical emergency. Prescription painkiller overdose kill nearly 15,000 people every year in the United States. In cases of suspected overdose, take the victim to the nearest hospital or urgent care facility.

Emergency department doctors will administer 0.4 mg to 2 mg of naloxone to bring oxycodone to safe levels. She may also administer antidote to acetaminophen, N-acetylcysteine. Nurses will establish an airway to help the patient breathe. Nurses will also pump the patient's stomach or administer charcoal to remove excess Endocet. Once the patient is in stable condition and detoxified from the effects of Endocet, she may participate in rehabilitation.

Drug Replacement Therapy

Those who are not in immediate danger of overdose may participate in DRT, or drug replacement therapy. DRT drugs include methadone, Suboxone and buprenorphine.

DRT medications mimic the effects of oxycodone but do not cause euphoria, so the DRT patient does not feel withdrawal symptoms but does not get high either. This allows the DRT patient to skip the detoxification process temporarily while she participates in behavior modification. Once she learns how to live without Endocet, she weans herself from the DRT drug by taking successively smaller doses further apart.

Standard detox

Many facilities now offer detoxification services. During standard detoxification, doctors administer naloxone to bring down oxycodone levels. Nurses monitor the patient for complications. While standard detoxification eases withdrawal symptoms greatly, it does not shorten the detoxification process or address the psychological problems associated with withdrawal.

Rapid Detox

Rapid detox is the most humane form of detoxification available today. During rapid detox, board-certified anesthesiologists administer the standard detoxification and anti-withdrawal drugs along with sedatives and anesthesia. During rapid detox, the patient dozes in a pleasant "twilight sleep," unaware of the grueling detoxification process. Rapid detox shortens the detoxification process and puts the patient in a receptive state of mind for meaningful rehabilitation.


The detoxification process alone does little to change the behaviors associated with drug abuse. Without meaningful rehabilitation and behavioral modification, the individual is likely to return to drug abuse.

Rehabilitation can take place at an outpatient clinic or in a residential setting. Outpatient treatment may include DRT and weekly or monthly meetings with a counselor. Outpatient rehabilitation is appropriate for patients who need to work or take care of children during the rehabilitative process.

Inpatient care may be short-term or long-term, lasting from six months to a year. Inpatient treatment is appropriate for those whose condition is resistant to treatment; inpatient treatment provides care that is more comprehensive.

Opioid dependence is a complex but treatable disease that affects everyone a little differently, therefore no one treatment is right for everyone. Treatment addresses the multiple needs of the individual and not just her drug abuse.

No matter which treatment the individual chooses, it needs to be readily available to promote participation and completion. It is critical that the individual remains in treatment long enough to detoxify her body and change behaviors associated with drug abuse.

Counselors will assess the patient and create a treatment plan based on her needs. The counselor may suggest individual, group or family counseling along with behavior modification. Medications are an important part of treatment, especially during the detoxification phase. Some patients have other medical or mental problems that could benefit from medication.

The counselor will continually assess the patient's condition and modify the treatment plan as necessary to ensure treatment fits the patient's changing needs. Drug use will be monitored, as relapses do occur.
The treatment program may assess the individual for the presence of infectious diseases commonly associated with drug use, including HIV/AIDS, tuberculosis and hepatitis B and C. The counselor may provide educational resources to reduce the patient's risk for contracting or spreading these diseases.

Treatment does not need to be voluntary to be effective; many individuals do better when under legal coercion to quit Endocet use.