Oxycodone Addiction

The National Institute on Drug Abuse, or NIDA, estimates there were 1.9 million adults in the United States addicted to prescription opioid pain relievers such as oxycodone in 2010, as compared to 329,000 Americans who are addicted to heroin.

Abuse

Abuse means to use a drug for non-medical purposes either to get high or to treat a condition without a doctor's prescription. NIDA estimates between 12 and 21 million people worldwide abuse opioids such as oxycodone. These individuals divert oxycodone from its prescribed use through "doctor shopping," phony prescriptions or getting it from a friend or family member. Law enforcement calls this process "diversion."

There is plenty of opportunity for diversion, as oxycodone is one of the most widely prescribed medications in the United States. According to the Drug Enforcement Agency, or DEA, pharmacies filled more than 50 million prescriptions for oxycodone in 2008. By then, almost 14 million Americans used oxycodone for non-medical purposes at least once in their lifetime.

The Definition of Dependence

Oxycodone abuse may lead to physical dependence or addition, two independent medical conditions.

Physical dependence on hydrocodone means the body needs opioids to feel normal. If the level of opioids drops below a certain level, the body struggles to regain chemical balance. The individual experiences this battle for chemical stability through unpleasant, flu-like withdrawal symptoms.

Medical professionals say a patient is physically dependent on oxycodone if he suffers symptoms once levels of this opioid decline in his system. An individual can cause a rapid decrease in oxycodone by suddenly quitting opioid use or through the administration of certain drugs, such as naloxone.

The Definition of Addiction

Oxycodone addiction is a primary condition. This means other illnesses do not cause addiction; it is an independent illness not related to other conditions. Addiction is a chronic condition - the individual must participate in long-term treatment to overcome addiction.

Many issues influence the development of addiction, including genetic, psychological, social, and environmental factors. These factors affect the ways addiction affects each person.

Addiction is a neurobiological disorder, directly affecting the cells of the central nervous system.

Addiction presents itself in a variety of ways, including being unable to control hydrocodone use, compulsive use of hydrocodone, continued use despite harm, and craving for opioids.

Addiction is closely associated with dependence on a substance such as hydrocodone, but there are distinct differences between being addicted to hydrocodone and being dependent upon it.

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Addiction versus Dependency

Addiction and dependence on drugs are separate and independent from one another: you can be addicted to something without being physically dependent on it and vice versa. When a person is dependent on hydrocodone, he must continue to take in order to maintain chemical balance. In contrast, addiction is the compulsive use of a drug.

For example, a person may need an anti-hypertensive drug to keep her blood pressure at a healthy level; if she were to stop taking the drug, her body would struggle to maintain a safe blood pressure but she would not feel cravings for the medicine.

Conversely, an individual can be addicted to cocaine without being physical dependent upon it. A person addicted to cocaine will crave more once he runs out, but the drop in cocaine levels will not disrupt his body chemistry.

Both addiction and dependence to oxycodone cause actual changes in the brain and body but addiction and dependence show themselves in different ways.

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Addiction: What Family Members Should Know

Addiction affects the entire family. Addiction is the result of nature and nurture combined; addiction passes from one generation to the next, through both heredity and environment.

A family history of substance abuse or mental illness increases the risk for addiction to alcohol or drugs such as Oxycodone. While no one yet knows exactly what causes addiction, scientists agree that heredity plays a major role. Other environmental factors, such as emotional distress, anxiety, depression or peer pressure, contribute to dependence and addiction. These environmental factors can cause, as well as be the result of, addiction to opioids.

Because researchers think that addiction is hereditary, passed from one generation to the next, young family members should recognize an increased risk for addiction if one or both parents suffer from addiction.

Scientists have found that people who are hypersensitive to stress are more likely to suffer an addiction. Environmental household stresses, like relationship or financial troubles, increase the risk for addiction in hypersensitive individuals.

Family members should know that children learn how to deal with stress by watching their parents. A parent addicted to oxycodone passes poor stress management skills to the child, especially if both the parent and child suffer hypersensitivity to stress.

Opioid addiction increases household stress as the addicted individual shifts his attention from family responsibilities increasingly towards oxycodone. This person spends more of her time looking for, using and recovering from oxycodone and less time working, going to school or raising children.

Addiction imposes financial hardship onto family unit through lost wages and misdirected funds. Family members should know the average cost for oxycodone on the streets is $1 per milligram. The most popular form of oxycodone is the 40mg Oxycontin formula.

Having this drug or other opioids in the house, whether illegally or by prescription, increases the risk for drug abuse by another member of the family simply because the drug is easily available. Keeping opioids in the house also makes the household a target for drug trafficking or theft.

Family members should know that using oxycodone without a prescription is illegal. The addicted individual may go to jail, lose time from work and incur fines and legal fees. Having a parent or other family member in prison on a drug charge is very difficult for the family financially, psychologically and socially.

Caring for a Family Member with an Addiction

Caring for someone who has an addiction is extremely difficult for every member of the family but it is important to remember that the individual needs compassion now more than ever if recovery is going to take place. The family works as a safety net for the addicted individual, with every member of the family participating in the recovery effort.

The family should meet frequently to help one another deal with the stress and emotional drain of addiction to oxycodone. These meetings can take place with or without the knowledge and consent of the addicted individual. Family members should invite the addicted person to participate, but the family should continue with the meeting without the individual if he decides against attending.

During these meetings, every member of the household can make a commitment to take good care of the addicted individual, himself and the rest of the family. Work as a group to accomplish household chores, childcare and financial responsibilities so that no single individual carries the burden of opioid addiction.

It is okay to learn more about a family member's addiction by visiting websites, asking questions and seeking referrals from other people who have supported a loved one battling addiction. Addiction to oxycodone and other opioids is a growing problem in the United States; there are countless, caring individuals willing to share their experiences in helping a loved one overcome addiction.

Addiction alters pathways in the brain in a way that causes an individual to become protective and secretive about his condition. The addicted person will likely be very resistant to talk about oxycodone abuse. He may communicate feelings of anger and betrayal at first, and will probably refuse to talk about his addiction or treatment for that disease. Despite passionate protests from the addicted individual, it is important that family members continue to urge professional treatment.

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Signs of addiction: For those around

Oxycodone addiction changes in a person's behavior, thinking patterns, emotions and relationships with others. Addiction changes an individual's executive functioning, or the way a person thinks in a way that causes the person to have trouble perceiving, learning, controlling impulses and making sound decisions. Family members, co-workers, friends and members of the community might notice an abrupt or slow, subtle change in the individual as his addiction to oxycodone progresses.

A friend or co-worker may notice changes in a person addicted to oxycodone or other opioids, including:

  • Excessive Painkiller Prescriptions for Self and/or Family
  • Frequent Emotional Crisis
  • Prioritizing Activities Involving Opioids
  • Arguments or Violent Outbursts
  • Withdrawal from Relationships, Family or Friends
  • Child Neglect
  • Abnormal, Illegal or Anti-Social Actions
  • Separation or Divorce
  • Unexplained Absences from Home
  • Legal Trouble
  • Neglect of Social Commitments
  • Unpredictable Behavior such as Inappropriate Spending

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Addiction Symptoms: Physical and Psychological

Physicians should assess a patient's risk for oxycodone abuse or addiction before prescribing an opioid painkiller. Physicians should then monitor for signs and symptoms of physical or psychological abuse.

The disease of addiction makes changes to the brain and body in a way that causes specific physical and psychological symptoms. Physical symptoms may include unexplained changes in weight or sleep patterns, slurred speech, shakiness, a nagging cough and bloodshot eyes. Addiction causes an individual to care less about hygiene and physical appearance; she begins to look sickly, wears shabby clothing or stops bathing.

An individual who is addicted to oxycodone begins to display some telltale psychological symptoms, including an inability to stop using opioids despite multiple promises to do so. The individual may seem to have trouble controlling his behavior in other ways: he may participate in criminal or antisocial activities even when he is not abusing oxycodone. He might crave drugs other than oxycodone or seek intense reward experiences, like stealing cars or committing other crimes.

He may also have an inappropriate emotional response to everyday situations. For example, he may have an explosive outburst during a child's birthday party or laugh inappropriately during a serious conversation. He will also demonstrate a diminished capacity to recognize significant problems in his personal life or in relationships.

Addiction causes changes in brain structure and function, especially in the amygdala, the area of the brain associated with reward. Addiction changes the way the brain remembers rewards, causing an individual to incorrectly associated opioids with a rewarding experience. This incorrect reward pattern alters an individual's behavior, shifting away from activities previously viewed as pleasurable and towards behaviors that result in opioid abuse.

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Behavioral, Cognitive and Emotional Changes

Addiction to opioids causes physical changes that affects the way a person behaves, thinks and feels. These changes may come about abruptly or slowly and may last long after the individual has stopped using oxycodone, increasing the risk for relapse long after completing treatment.

A person with an addiction may take higher doses of oxycodone more frequently than he intends, even as he promises to control his behavior in the future. He spends the bulk of his time pursuing, using or recovering from opioid use. Increasingly, interest fades in things he used to be passionate about; eventually, he only cares about oxycodone. He continues to abuse this drug, even though he says he understands the harm oxycodone inflicts. To observers, it might seem he lacks the will or ability to quit using opioids.

Changes in the reward center of the brain cause the individual to become preoccupied with opioids. Her views of the benefits and dangers of opioids shift, so that she eventually ignores the risk of opioid abuse. She may blame all her troubles on other people or events rather than as a predictable consequence of opioid abuse.

Oxycodone addiction challenges emotional well-being. An individual addicted to opioids feels more anxiety, sadness and emotional pain than do others. Addiction to hydrocodone increases sensitivity to stress, especially in those individuals who are hypersensitive to stress.

Addiction and gender: how women and men are affected differently

Both men and women are at risk for developing an addiction to oxycodone but addiction affects men and women differently. According to Psychiatric Times, women start abusing drugs such as oxycodone in small doses as compared to men, but women become addicted more quickly and face a greater risk for relapse after treatment.

Women tend to enter treatment sooner than men, but females start treatment with more psychological distress and mood disorders than males. There are gender differences in treatment plans, but the differences usually relate to organization rather than pharmacology. In other words, treatment plans for women need to include childcare and job training on top in addition to drug rehabilitation.

More males over the age of 12 use illicit drugs than females over 12 years, according to the 2010 National Survey on Drug Use and Health. Females between the ages of 12 and 17 years, however, were more likely to abuse pain relievers such as oxycodone than males of the same age.

Females are more likely to abuse prescription drugs such as oxydocone and are more likely to abuse multiple substances than are males. Women who abuse drugs frequently come from homes where illicit drug use was acceptable. Addicted women are more likely to have a partner or spouse with an addiction, whereas men suffer addiction regardless of their partner's drug use.

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Treatment options

According to the American Society of Addictive Medicine, addiction can cause "disability or premature death, especially when left untreated or treated inadequately." Nearly 15,000 people die in the United States each year from overdoses on prescription painkillers including oxycodone.

According to statistics gathered by the National Institute on Drug Abuse, more than 23 million people in the United States over the age of 12-years needed treatment for alcohol or substance abuse in 2010. Of these, only about 11 percent received treatment at a specialty facility with just over 5 percent of admissions to publicly funded substance abuse programs were for treatment of opioid abuse.

Many individuals try to quit this opioid "cold turkey," without the help of medicine to reduce withdrawal symptoms. During self-detoxification, uncomfortable withdrawal symptoms, such as diarrhea, abdominal pain, cold sweats and muscle pain can last for a week or more.

Without proper medical assistance, the addicted individual attempting self-detoxification may face serious complications. For example, he may vomit and inhale stomach contents, a complication known as aspiration. Dangerous dehydration may result from excessive vomiting and diarrhea. Complications and unpleasant withdrawal symptoms force many people who attempt self-detox to return to opioid abuse.

Other people ease the overpowering symptoms during self-detoxification with a treatment plan including a variety of products. Once such program is The Thomas Recipe, in which a person takes Xanax or some other medication to calm his anxiety and help him sleep. The individual will also take drugs to stop diarrhea plus vitamins and supplements to ease muscle aches and fatigue.

While the Thomas Recipe may reduce withdrawal symptoms, the individual can still suffer complications that could become dangerous if left untreated. Furthermore, self-detoxification addresses only the physical aspects of opioid dependency; self-detox does not address the behavioral and cognitive aspects of opioid addiction, increasing the risk for relapse.

Relapse is the most common complication associated with quitting oxycodone; relapse may be life threatening. Someone who has recently gone through detoxification is at a greater risk for overdose, as detoxification lowers the body's tolerance to this drug. He can accidently overdose on a lower dose of oxycodone than he used to take before he went through the detoxification process.

Oxycodone overdose requires emergency, sometimes lifesaving treatment. Emergency Department doctors administer naloxone to reduce oxycodone to safe levels quickly. Once the patient has safely avoided overdose, she may participate in behavioral therapy as an inpatient or outpatient.

Outpatient drug replacement therapy, or DRT, is a good solution for a few individuals. During DRT, physicians prescribe drugs such as methadone, Suboxone or buprenorphine, which bind to the same opioid receptors within the body as oxycodone does in a way that reduces withdrawal symptoms. DRT drugs last longer than oxycodone and do not produce the euphoric effects, which allow the individual to participate in treatment without a hospital stay. After the individual changes the behaviors associated with addiction, he weans himself from the replacement drug by taking increasingly smaller doses.

DRT allows some patients to participate in rehabilitation without a lengthy hospital stay; opponents worry that DRT merely trades one addiction for another. Despite this difference in professional opinion, most experts prefer treatments including prescription medications that address withdrawal symptoms are better than self-detox or using home remedies.

Medication-Assisted Treatment, or MAT, is a substance abuse treatment plan that includes pharmacological intervention. According to the Substance Abuse and Mental Health Services Administration, or SAMSA, this intervention:

  • Improves Survival Rates
  • Increases Retention in Treatment
  • Decreases Oxycodone Use
  • Decreases the Risk for Hepatitis and HIV, Especially Among IV Users
  • Decreases Criminal Activities
  • Increases Employment
  • Improves Birth Outcomes for Pregnant Women Battling Addiction

Inpatient MAT programs use medicine to ease withdrawal and facilitate the detoxification process. During detox, physicians administer certain medications to decrease oxycodone levels and other drugs to address the ensuing withdrawal symptoms. Specially trained medical personnel watch for and respond appropriately to dangerous complications, such as dehydration or aspiration.

While standard inpatient detoxification procedures ease the physical aspects of addiction, individuals must still endure the demoralizing and lengthy process of detoxification.

Rapid detox is the most humane method of detoxification for oxycodone addiction. During rapid detox, board-certified anesthesiologists administer the standard detoxification and anti-withdrawal medications along with anesthesia and sedatives so that the patient rests in a comfortable "twilight sleep." When the patient awakens alert and refreshed, he will have no memory of the difficult and demoralizing detoxification and withdrawal period and can move onto the rehabilitation process.

Rehabilitation

Although medical treatment and behavioral modification are independently helpful, addressing both the physical and behavioral aspects of opioid addiction offer the best hope for recovery from oxycodone addiction. After successful detoxification or drug replacement therapy, patients may participate in drug rehabilitation treatments designed to change the behaviors that caused physical dependence or improve the environmental factors that led to the initial oxycodone addiction and reduce the risk for relapse.

Both pharmacological and behavioral treatments work to restore normalcy to those brain function and behavior. These treatments also aim at improving employment rates, reducing relapse and lessening side effects associated with opioid addiction.

Behavioral rehabilitation can occur at an inpatient or outpatient facility. To offer the best chance of success, it is important to match the type of facility to the individual's personal needs. Rehabilitation may be inpatient or outpatient with many programs lasting as short as 28 days or as long as 6 months or a year.

The American Society of Addictive Medicine states that recovery from addiction to oxycodone or other drugs is "best achieved through a combination of self-management, mutual support, and professional care provided by trained and certified professionals." Professional treatment programs include personal, family and group counseling; each addresses a specific aspect of opioid addiction. These programs include behavior modification programs and provide peer support.