Oxycodone Withdrawal

Generic Name or Active Ingridient: Oxycodone.

Definition

Rehabilitation specialists define oxycodone withdrawal as a normal, predictable consequence of a sudden drop in the level of this opioid in the body of a person who is physically dependent upon it. Physical withdrawal symptoms associated with oxycodone can last five or more days; psychological symptoms of withdrawal often last much longer, especially when left untreated.

Causes

The human body adapts to the presence of certain chemicals in the body, including opioids such as oxycodone. The body can become tolerant of these substances, which means it takes an ever-increasing amount of oxycodone to cause the intended euphoric or pain-relieving effect. With continuous use, a person may become physically dependent on that chemical; this means the individual must maintain a certain level of opioids for her body to feel normal. If the level of opioids drops rapidly, her system struggles to maintain chemical balance; this struggle manifests itself through withdrawal symptoms.

Oxycodone dependence may come about through illicit drug abuse, using very high doses or by continuing oxycodone use after the prescription runs out. Oxycodone abuse greatly increases the risk for developing physical dependence and suffering withdrawal symptoms when trying to quit oxycodone.

Facts

Oxycodone abuse means to use this opioid for non-medical purposes either to get high or to treat a condition without a doctor's prescription. The National Institute on Drug Abuse, or 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," filing phony prescriptions or from a friend or family member. Law enforcement calls this process "diversion."

There is plenty of opportunity for diversion - oxycodone is one of the most widely prescribed medications in the United States. The Drug Enforcement Agency, or DEA, notes that U.S. 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.

Symptoms

Withdrawal from opioids such as oxycodone causes physical symptoms similar to the flu. Withdrawal also causes psychological symptoms whose demoralizing affects can be just as overpowering as the physical symptoms of withdrawal. Physical and psychological symptoms of oxycodone withdrawal frequently prevent people from quitting drug abuse, especially when they try to overcome drug dependence without the help of qualified rehabilitation professionals.

Physical

The physical symptoms of oxycodone can last for five days to two weeks, with the worst symptoms appearing on or about the fourth day. While physical withdrawal from oxycodone is not fatal, the symptoms are extremely uncomfortable. Many are unable to overcome these physical symptoms and return to oxycodone abuse simply to stop the agony.

Physical symptoms of withdrawal include:

  • Abdominal Cramping
  • Diarrhea
  • Fever, Runny Nose or Sneezing
  • Goose Bumps and Abnormal Skin Sensations
  • Hot Sweats and Cold Sweats
  • Insomnia
  • Low Energy Level
  • Muscle Aches or Pains
  • Nausea or Vomiting
  • Pain
  • Rapid Heartbeat
  • Rigid Muscles
  • Runny Nose
  • Shivering, Tremors
  • Teary Eyes
  • Yawning

Psychological

The psychological symptoms of oxycodone withdrawal are as devastating as the physical symptoms. Psychological symptoms can last significantly longer than the physical manifestations of withdrawal and present an equal challenge to a successful recovery, especially without expert assistance. Psychological symptoms of withdrawal include:

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

Possible Complications

Withdrawal from oxycodone is associated with complications, which include vomiting and then breathing the stomach contents into the lungs, which may result in infection. Extreme vomiting and diarrhea may cause dangerous dehydration. One benefit of medically assisted withdrawal is the presence of professionals who are attentive and expert at addressing complications as they arise.

Treatment options

Opioid abuse and subsequent physical dependence is a growing epidemic among American adults and youth. More people need help overcoming oxycodone withdrawal and rehabilitative professionals are investigating new and innovative ways to help individuals stop using oxycodone.

More than 23 million adults and teenagers in the United States needed treatment for alcohol or substance abuse in 2010; of these, only about 11 percent received treatment at a specialty facility. Just over 5 percent of admissions to publicly funded substance abuse programs were for treatment of opioid abuse. These treatment facilities assist individuals in overcoming dependence and the ensuing psychological and physical withdrawal symptoms during detoxification and rehabilitation.

Some people try to quit opioids alone, without the help of medicine to reduce withdrawal symptoms or someone to monitor and address complications. Doctors call this self-detoxification but the average person may call it "going cold turkey," referring to the cold, clammy, pale and bumpy appearance the skin takes on during the withdrawal process. Unpleasant withdrawal symptoms, such as diarrhea, abdominal pain, cold sweats and muscle pain can last for several days to two weeks. Complications and overpowering symptoms of withdrawal cause many people who attempt self-detox to go back to opioid abuse.

Other people address withdrawal symptoms associated with oxycodone self-detoxification by concocting a treatment plan including variety of products. Once such remedy is The Thomas Recipe, in which a person takes Xanax or some other medication to alleviate anxiety and induce sleep, anti-diarrhea medication, plus vitamins and supplements to ease muscle aches and fatigue

While The Thomas Recipe reduces withdrawal symptoms with some measure of success, the individual may suffer dangerous complications that can thwart recovery efforts. Furthermore, self-detoxification addresses only the physical aspects of oxycodone abuse; self-detox does not address the behavioral effects of oxycodone addiction in a way that increases the risk for returning to oxycodone abuse.

The greatest complication associated with withdrawal from oxycodone is the return to opioid abuse. There is a greater potential for overdose in individuals who have recently attempted detoxification because detox reduces tolerance to opioids; after detox, a person can overdose on a much smaller dose of oxycodone than he used to take.

Oxycodone overdose requires emergency, sometimes lifesaving treatment. In the emergency department, doctors administer naloxone and other medications to reduce opioids to safe levels quickly. Nurses observe the patient for dangerous complications and take appropriate action. Once the patient has completed the withdrawal process, she may participate in behavioral therapy as an inpatient or outpatient to learn how to live without oxycodone.

Some individuals avoid the detoxification process by participating in outpatient drug replacement therapy, or DRT. During DRT, physicians prescribe drugs such as methadone, Suboxone or buprenorphine to reduce physical symptoms of withdrawal. DRT medications bind to the same opioid receptors within the body as oxycodone does so that the individual's body does not battle to regain chemical stability.

The replacement drugs are longer lasting than opioids and do not produce the euphoric effects. DRT allows the individual to skip the hospital stay and go directly to behavioral therapy. After counselors help the individual change the behaviors associated with oxycodone abuse, they help the patient wean himself from the replacement drug. Supporters of DRT recognize the flexibility of outpatient treatment while opponents say it is merely trading one drug addiction for another.

Medication-Assisted Treatment, or MAT, refers to any substance abuse treatment plan that includes medicines clinically proven to reduce the severity and duration of withdrawal symptoms. DRT is one type of MAT. According to the Substance Abuse and Mental Health Services Administration, or SAMSA, this medical intervention:

  • Improves Survival
  • Increase Retention in Treatment
  • Decreases Illicit Opiate Use
  • Decreases The Risk for Hepatitis and HIV
  • Decreases Criminal Activities
  • Increases Employment
  • Improves Birth Outcomes for Pregnant Women Battling Addiction

Many rehabilitation specialists suggest inpatient MAT programs to help a patient complete detoxification before moving on to behavioral modification. During inpatient detoxification, physicians administer some medications to decrease the level of opioids and other drugs to address the resulting symptoms of withdrawal. Nurses observe the patient for dangerous complications, such as dehydration or aspiration, and respond appropriately. While detox eases the physical aspects of addiction, it does not reduce the demoralizing and debilitating psychological symptoms of oxycodone withdrawal.

The most humane method of detoxification is rapid detox, in which board-certified anesthesiologists administer standard detoxification and anti-withdrawal medications alongside anesthesia and sedatives so that the patient rests in a comfortable "twilight sleep." When the patient awakens revitalized and refreshed, he will have no recollection of the grueling and demoralizing detoxification and withdrawal period. He can now move onto the rehabilitation process without the additional emotional baggage oxycodone withdrawal imposes. While medical treatment and behavioral modification are each independently useful in the treatment of opioid withdrawal, an individual must address both the physical and behavioral aspects of physical dependence to oxycodone.

Rehabilitation

Physical dependence to oxycodone causes changes in the brain that affects brain function and behavior. Both pharmacological and behavioral treatments work to restore normalcy to those brain function and behavior related to oxycodone dependence and subsequent withdrawal.

Rehabilitation includes behavior modification that helps the individual learn to live without oxycodone. Behavioral therapy may take place at an inpatient or outpatient facility. Matching the type of facility to an individual's personal needs offers the best chance of success. These treatments focus on improving employment rates, reducing the risk for relapse and lessening side effects associated with physical dependence to opioids.

Rehabilitation may be inpatient or outpatient, and programs can be as short as 28 days or as long as 6 months or a year. New behavioral therapies show particular promise in the treatment of dependence on and addiction to oxycodone. One type of therapy is the contingency management therapy, which is a voucher system where a patient earns points for negative drug tests. He may redeem these points for items that enhance a healthy lifestyle. Contingency management therapy helps correct the brain's reward system damaged by oxycodone abuse.

Cognitive-behavioral intervention, another type of therapy, modifies the patient's expectations and behaviors related to oxycodone addiction and give him new tools to deal with stresses that may cause relapse.

Long-term recovery from oxycodone withdrawal relies heavily on success during both the detoxification and rehabilitation phases. A significant number of individuals suffer relapse, especially those who engage in self-detoxification or do not participate in rehabilitation.

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