Roxicet Detox

Roxicet detoxification helps a drug-dependent person reach a drug-free state. This process cleanses the body of the toxic effects of chronic Roxicet use.

Roxicet is a brand name pain reliever that contains 5 mg oxycodone and 500 mg of acetaminophen. Oxycodone is a semi-synthetic opioid analgesic that drug makers create from derivatives of the opium poppy plant.

Pain control is an important feature in proper medical care, especially after a significant injury, invasive surgical or dental procedure, or to treat acute or chronic pain associated with a serious medical condition. In 2010, U.S. pharmacists dispensed 58.2 million prescriptions for drugs containing oxycodone. Currently, about three percent of American adults are on long-term opioid therapy for chronic pain, and this statistic does not include patients who take opioids like Roxicet for cancer pain.

Oxycodone

Roxicet and other opioids work with the central nervous system, or CNS, to change the brain’s perception of pain. Roxicet causes many other CNS reactions, the most notable being sedation, relaxation, and a pleasant euphoric feeling.

With continued use, some of these neurological effects become more permanent and alter the individual’s thought patterns, emotional state, and behaviors in a way that can have a negative effect on the person’s ability to work, take care of family, and interact with others. This can lead the individual to job loss, financial hardship including homelessness, separation or divorce, loss of child custody, and other difficult and demoralizing social consequences.

Most people use Roxicet as directed and stop using this drug when they no longer need it to control pain, but many people use Roxicet for non-medical reasons. To use Roxicet non-medically means to consume it to get high or to treat a different condition than the one the prescribing physician had intended to treat. About 5 million Americans use painkillers for non-medical reasons each year.

Opioid Dependence

Anyone who uses Roxicet regularly for more than a few weeks can become physically dependent on oxycodone, whether he uses it for therapeutic or non-medical purposes. The body acclimates to the presence of some toxic substances, including the oxycodone in Roxicet. With continuous use, the body even begins to depend on a certain level of Roxicet to feel normal - when oxycodone levels fall, the opioid-dependent body struggles to regain chemical stability and detoxify itself from the effects of Roxicet. Medical specialists refer to this as Roxicet detoxification. The opioid-dependent person experiences Roxicet detoxification through unpleasant withdrawal symptoms.

Opioid dependence is a growing problem in the United States. According to results from a 2011 National Survey on Drug Use and Health, about 1.9 million Americans are dependent on prescription painkillers including the oxycodone in Roxicet. The number of opioid-dependent Americans has grown slightly since 2004, when there were 1.4 million opioid-dependent people in the United States.

An opioid-dependent person experiences unpleasant, flu-like withdrawal symptoms. These withdrawal symptoms tend to appear in two waves, with the first set of symptoms beginning a few hours after a missed dose or inadequate dose of Roxicet.

Initially, the patient may feel:

  • Agitation
  • Anxiety
  • Excessive Yawning
  • Insomnia
  • Muscle aches
  • Runny nose
  • Sweating
  • Watery eyes

Later, the individual may suffer:

  • Abdominal cramps
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea and vomiting

These symptoms may persist for five or more days before disappearing as the body completes the Roxicet detoxification process and achieves an opioid-free state. Withdrawal symptoms do not come back unless the individual returns to an opioid-free state.

Someone can ease the severity of withdrawal symptoms by taking a variety of anti-withdrawal medications. He can stop withdrawal symptoms completely by relapsing to Roxicet but this halts the detoxification process and returns the individual to an opioid-dependent state.

Acetaminophen

Acetaminophen is a common non-opioid pain reliever found in many prescription and over-the-counter medications. In 2005, Americans purchased more than 28 billion doses of products containing acetaminophen. Acetaminophen does not produce euphoria and is therefore not associated with recreational drug abuse, but long-term acetaminophen abuse associated with Roxicet dependence can cause serious health hazards and complications during detoxification.

Someone who is dependent on Roxicet must take this drug frequently to keep opioid levels high enough to avert withdrawal symptoms. Continuous Roxicet use causes acetaminophen to build to toxic levels, potentially leading to liver damage or fatal overdose. Toxic levels acetaminophen is the leading cause of liver failure in the United States. It may take from 12 hours to several days for symptoms of acetaminophen overdose to appear.

Each Roxicet tablet contains 500 mg of acetaminophen. For some people, taking any more than the recommended total daily dose of 4,000 mg of acetaminophen can lead to serious liver injury. Doses exceeding 7,000 mg may result in death.

Additionally, the symptoms of acetaminophen overdose are flu-like, similar to opioid withdrawal symptoms, especially the abdominal cramps, nausea and vomiting, diarrhea, and excessive sweating. Someone may be tempted to take even more acetaminophen to relieve withdrawal symptoms or even to ease the symptoms of acetaminophen overdose itself.

Symptoms of acetaminophen overdose include:

  • Abdominal cramps
  • Loss of appetite
  • Coma
  • Seizures
  • Diarrhea
  • Irritability
  • Yellowing of the skin or eyes
  • Nausea and vomiting
  • Sweating
  • Upset stomach

Benefits of Roxicet Detoxification

Roxicet detoxification is only one part of the recovery process and, by itself, does little to change the behaviors that may lead to relapse. Most opioid-dependent people benefit from rehabilitation to learn how to live without drugs. Rehabilitation usually includes counseling and behavior modification that gives participants the tools they need to recognize situations that could potentially lead to drug abuse and to refuse Roxicet when offered. Rehabilitation reduces the risk for relapse and decreases the likelihood the individual will have to repeat Roxicet detoxification.

Roxicet detoxification stops withdrawal symptoms, thereby facilitating the individual’s entry into rehabilitation. Detoxification helps the patient remain in rehabilitation long enough to reverse the neurological changes and restore his thought patterns, emotional well-being, and healthy behaviors. Detoxification and rehabilitation help the patient return to as much of his normal life as possible, including going back to work, reuniting with family, and enjoying intimate relationships with others.

Roxicet detoxification promotes abstinence by removing the toxins that make an opioid-dependent person feel unhealthy; many people enjoy the extra energy and clarity in thinking they feel after achieving an opioid-free state and are reluctant to return to drug abuse. Detoxification reduces the frequency of relapses, and decreases the severity of these drug use episodes when they do occur.

Types of Detox

Detoxification can also refer to the medical process of lowering opioids and addressing withdrawal symptoms. Roxicet detoxification can occur at home, through an outpatient clinic, hospital, or special detoxification facility.

In 2011, more than 21 million people in the United States needed treatment in for substance abuse problems, including dependence on Roxicet. Of these that needed help, only about 10 percent got it in a specialty facility, such as a hospital, inpatient detoxification center, outpatient clinic, or mental health institution. Everyone else tried to quit Roxicet at home alone, enlisted the help of a family physician, went to an emergency room, quit while in jail or prison, or did not try to quit at all.

The National Institute on Drug Abuse, or NIDA, says that U.S. treatment centers saw 1.8 million admissions for help with drug and alcohol abuse during 2008. While alcohol abuse made up for most of these admissions, opiates like the oxycodone in Roxicet accounted for about 20 percent of drug-related admissions.

Dependence on Roxicet affects each person in a slightly different way and every individual experiences Roxicet detoxification uniquely. This makes Roxicet detoxification a highly personal process - some people are able to complete the detoxification process at home without medical assistance with others might need a great deal of professional guidance and the help of potent anti-withdrawal medications available only in an inpatient facility. To reflect this wide variety of needs, there are several viable approaches to Roxicet detoxification.

Self Detox

Someone may perform Roxicet detoxification at home, without professional guidance or the help of anti-withdrawal medications, in a process known as self-detoxification. Sometimes a doctor will suggest a patient wean himself from Roxicet at home by taking smaller doses each day until he completes the detoxification process. This tapering process may work for someone who became dependent on opioids after using Roxicet for non-medical reasons.

Self-detoxification is most appropriate for individuals without any underlying illnesses and who have been dependent on Roxicet for only a short time or otherwise experiences only modest withdrawal symptoms.

Cold turkey

Lingering withdrawal symptoms prevent some people from tapering Roxicet; these individuals may try quitting cold turkey by quitting Roxicet abruptly.

Quitting cold turkey does bring someone to an opioid-free state but the sudden drop in opioid levels causes severe withdrawal symptoms. The phrase “cold turkey” refers to the skin’s appearance during detoxification: pale, cold, and clammy with goose bumps, resembling a plucked and frozen bird. Left unaddressed, these withdrawal symptoms increase the risk for relapse.

Natural remedies

Some natural remedies ease the severity of withdrawal symptoms during self-detoxification. Ginger and peppermint, for example, are natural remedies for nausea; people have used cayenne and chamomile to ease diarrhea for centuries. Some believe a diet filled with vegetables, fruits, soups, and juices help the body withstand the detoxification process. Others use acupuncture, meditation, yoga or massage to enhance Roxicet detoxification.

Some people take a scientific approach, developing homemade treatment plans that combine prescription and non-prescription drugs to ease withdrawal symptoms. One well-known treatment plan is The Thomas Recipe. It calls for a benzodiazepine like Xanax or Librium to calm the patient’s nerves and help with sleep, vitamin B6 and hot baths for muscle aches, and Imodium for diarrhea.

Medical Detox

Medical detoxification, sometimes called medication-assisted detoxification, incorporates clinically proven medications that control the onset of the detoxification process and reduce withdrawal symptoms.

Outpatient
Outpatient clinics offer opioid replacement drugs, such as methadone and buprenorphine, to manage the onset of detoxification and control withdrawal symptoms. Methadone and buprenorphine are widely known for their use as part of a maintenance program, where patients come to an outpatient clinic to receive a dose of these replacement drugs. Methadone and buprenorphine are opioids so, when taken as directed, they stop the detoxification process and its associated withdrawal symptoms but dosages are so weak that these drugs do not cause euphoria. Patients remain on methadone or buprenorphine maintenance programs while engaging in rehabilitation then taper from the replacement drug after learning how to lead a drug-free life. Some participants remain on buprenorphine or methadone maintenance programs for months or years.

An outpatient clinician may prescribe methadone or buprenorphine to control withdrawal symptoms during Roxicet detoxification. The patient starts out on a high dose of the opioid replacement drug during the induction phase - just enough to control withdrawal symptoms - then takes successively smaller doses during tapering.

Outpatient detoxification is suitable for individuals who have been opioid-dependent for longer than a year, need little supervision, and require a great deal of flexibility during the detoxification process. Medication-assisted detoxification may take days or weeks to complete.

Methadone

A previously unknown chemist first synthesized methadone in a German laboratory in 1939. This scientist developed methadone for use as a pain reliever. Doctors around the world still prescribe methadone as an analgesic but physicians in the United States usually prescribe methadone as part of a drug maintenance program. In 1964, officials used methadone to stop a heroin epidemic that swept across New York City. The FDA approved methadone for use in the treatment of opioid dependence in 1972.

Today, about 100,000 Americans use a methadone maintenance program but many now use this replacement drug to “step down” from Roxicet dependence. To as an aid to tapering, outpatient clinicians will typically start patients on an induction dose of 10 to 15 mg of methadone, increasing dosages by 10 mg each day until the patient no longer experiences withdrawal symptoms. The patient will remain on this induction dose for a few days to allow his condition to stabilize. The patient then reduces dosages by 10 mg each day until the patient is no longer opioid-dependent.

Buprenorphine

Buprenorphine is another opioid replacement drug outpatient doctors prescribe as part of a maintenance program or as part of medication-assisted Roxicet detoxification. As with methadone, a patient starts on a high induction dose and gradually lowers daily dosages until she is no longer opioid-dependent.

Drug manufacturers offer buprenorphine under the brand name, Subutex. The patient places the buprenorphine or Subutex tablet under his tongue, where it dissolves before entering the bloodstream.

Suboxone

Someone could abuse buprenorphine or Subutex to get high by dissolving the tablet before injecting the solution into a vein. Drug makers discourage this intravenous abuse by adding naloxone to the brand name preparation, Suboxone. When taken as directed under the tongue, naloxone has no effect on the consumer. However, intravenous administration causes naloxone to interfere with buprenorphine to prevent the consumer from getting high. Additionally, intravenous naloxone use causes withdrawal symptoms in opioid-dependent consumers.

Inpatient
Many opioid-dependent people benefit from inpatient Roxicet detoxification. Inpatient care usually includes screening for the presence of underlying conditions that could complicate treatment, a professional treatment plan including drugs to lower opioid levels and multiple medications to ease the variety of withdrawal symptoms, and close patient supervision to address any complications that may arise and reduce the risk for relapse.

Inpatient Roxicet detoxification is necessary for anyone recovering from acute liver failure caused by toxic acetaminophen levels associated with Roxicet abuse. Inpatient care is mandatory for anyone recovering from an overdose. Anyone with acute psychosis, depression with suicidal thoughts, or who exhibits behaviors that pose a danger to his own safety or to the safety of others must participate in inpatient Roxicet detoxification.

Inpatient Roxicet detoxification is appropriate for anyone whose withdrawal symptoms prevent him from completing the detoxification process at home or through an outpatient clinic. This intensive care is also right for those who are at special risk for severe withdrawal symptoms or complications, or who have not responded well to other, less restrictive approaches.

Rapid Opiate Detox

Most patients benefit from rapid detox. Rapid detox is a cutting-edge, safe procedure that brings the patient to an opioid-free state in a matter of hours instead of days. The rapid detox patient receives anesthesia and sedatives prior to the standard detoxification and anti-withdrawal drugs so he rests in a comfortable “twilight sleep” during Roxicet detoxification.

Our detox center: Who we are and what we do

We are a group of board-certified anesthesiologists and other highly trained medical professionals who are dedicated to helping people reach an opioid-free state in the safest, most effective manner possible. Since opening the doors of our fully accredited hospital longer than a decade ago, we have helped thousands of people complete the detoxification process.

We treat our patients as individuals. We prescreen patients in our high-tech facility to uncover any medical conditions that may interfere with the detoxification process. We create an individualized treatment plan that sometimes includes rapid detox. After reaching an opioid-free state, patients may continue the recovery process in our qualified aftercare facility.

Detox Comparisons

Choosing the right forms of treatment can be a daunting task, so it is sometimes helpful to compare the various approaches to Roxicet detoxification to highlight the advantages and disadvantages of each.

Without the cost of anti-withdrawal drugs, prescreening and professional guidance, self-detoxification is the least expensive treatment for opioid dependence. Self-detoxification does bring the patient to an opioid-free state in a relatively short time - about five days - but the lack of anti-withdrawal drugs makes self-detoxification the most uncomfortable approach. Without professional guidance, anti-withdrawal drugs, and prescreening for the presence of underlying conditions such as acute liver failure, self-detoxification is also the most likely to produce complications.

Outpatient care provides replacement drugs to control the detoxification process and reduce withdrawal symptoms to make the Roxicet detoxification process tolerable. Outpatient clinics provide professional treatment plans, some prescreening, and counselors adept at identifying and correcting complications including relapse. Outpatient care can bring the patient to an opioid-free state but some patients become dependent on the replacement drugs and remain on methadone or buprenorphine for months or years.

As compared with self-detoxification and outpatient care, inpatient Roxicet detoxification provides the greatest protection from withdrawal symptoms and complications because inpatient facilities have adequate screening equipment, clinically proven treatment plans including potent detoxification and anti-withdrawal drugs, and close patient supervision to reduce complications. Inpatient care brings patients in about 4 days, as compared with 197 days for medication-assisted therapy.

Rapid detox provides the most efficient and humane approach to Roxicet detoxification. Rapid detox spares patients from days of uncomfortable and demoralizing withdrawal symptoms that can interfere with recovery. Rapid detox offers fast and complete detoxification in a matter of hours, rather than days, weeks, months or even years.

Detox Possible Complications

Roxicet detoxification is not usually a life-threatening procedure but underlying medical conditions, toxic acetaminophen levels, acute liver failure, co-existing substance abuse issues, pregnancy, and uncontrolled withdrawal symptoms can cause dangerous complications. The accumulation of acetaminophen during the course of opioid dependence may cause significant complications, including liver damage. These complications not only interfere with the detoxification process, some can be serious or even fatal.

The primary complication associated with any approach to Roxicet detoxification is relapse. The promise of relief from withdrawal symptoms tempts many people to take Roxicet during the detoxification process. Others relapse after completing the detoxification process, some because they have not participated in rehabilitation to learn how to lead a drug-free life.

Relapse can result in overdose, especially during detoxification or soon after the individual completes Roxicet detoxification. The detoxification process reduces the body’s tolerance of oxycodone, making the individual more sensitive to the effects of Roxicet. Detoxification makes it possible for someone to overdose on a smaller dose than she used to take before experiencing even modest withdrawal symptoms.

Overdose from Roxicet and other prescription pain relievers claimed the lives of 14,800 Americans in 2008 - killing more than cocaine and heroin overdoses combined.

Acetaminophen overdose is one of the most common poisonings worldwide and is the leading cause of acute liver failure in the United States.

Self Detox Possible Complications

Patients typically experience intense withdrawal symptoms during Roxicet detoxification and these withdrawal symptoms may cause complications. Prolonged or severe vomiting or diarrhea, for example, can cause dehydration and imbalances in potassium and other electrolytes.

Roxicet withdrawal symptoms can worsen underlying health problems. For example, the individual may experience slowed heartbeat, perspiration, and increased blood pressure that can aggravate an underlying heart condition. Detoxification can cause the return of pain in patients who take Roxicet to reduce discomfort associated with chronic conditions.

Outpatient Care Possible Complications

The professional guidance and opioid replacement drugs provided by outpatient clinics reduce the complications associated with self-detoxification but outpatients may still suffer obstacles to recovery. For example, some patients become dependent on the replacement drugs and remain on methadone or buprenorphine for months or even years. Harvard Medical School Publications estimate about a quarter of all methadone users eventually abstain from drug abuse, another 25 percent continue to take the drug while 50 percent go on and off methadone forever.

Methadone is not entire safe; the number of deaths associated with methadone overdoses has increased in recent years. Even though methadone represents only about 2 percent of sales on the prescription painkiller market, methadone overdoses are associated with about a third of all prescription opioid overdose deaths. The number of 2009 deaths associated with methadone overdose was about 5.5 times higher than in 1999.

While experts consider buprenorphine safer than methadone, intravenous buprenorphine abuse increases the risk for death. The likelihood for death increases when the consumer injects buprenorphine while consuming benzodiazepines such as the Xanax or Librium recommended in The Thomas Recipe.

Inpatient Detox Possible Complications

Inpatient detoxification reduces the risk for complications associated with withdrawal symptoms but patients may still face problems during inpatient care. Chronic acetaminophen use may cause acute liver failure that can greatly complicate the Roxicet detoxification procedure. Withdrawal from multiple substances can cause complications, especially alcohol, benzodiazepines such as those used in The Thomas Recipe, sedatives, and anti-anxiety drugs.

Rapid Detox Possible Complications

Rarely, a patient will have an allergic reaction to the drugs used in rapid detox procedures. Strong sedatives may cause difficulties with breathing, blood pressure, and heart rate. Infection, bruising, or swelling may occur at the anesthesia injection site.

Detox Myths

Countless doctors, researchers, and actual patients have contributed to a vast wealth of information about opioid-dependence and detoxification, yet widespread myths about detoxification prevent an untold number of people from getting the help they need. Patient education promotes detoxification and improves the participant’s chances of completing Roxicet detoxification.

Self Detox Myths

Myth: Successful self-detoxification is just mind over matter - anyone can do it with enough willpower.
Fact: While self-control helps someone abstain from relapsing, Roxicet detoxification is an intense physiological process that occurs regardless of the individual’s state of mind. Severe withdrawal symptoms and complications can prevent even the most dedicated participant from completing Roxicet detoxification.

Myth: Take-home detoxification kits or homemade treatment plans like The Thomas Recipe make self-detoxification safe because they include prescription and non-prescription anti-withdrawal drugs.
Fact: Combining certain medications may result in dangerous drug interactions, especially in individuals with already high levels of oxycodone and acetaminophen, making The Thomas Recipe and other home brews dangerous for some people.

Outpatient Detox Myths

Myth: It is cheaper to throw drug addicts in prison than to provide treatment.
Fact: One year of methadone costs an average of $4,700 per patient while that same year of imprisonment runs approximately $24,000 per inmate.

Myth: Methadone causes tooth and bone rot.
Fact: Methadone can cause a dry mouth, which promotes plaque and leads to tooth decay and gum disease. Methadone consumers should drink more water, and brush and floss daily.

Inadequate doses causes methadone withdrawal symptoms, which includes bone ache. Patients should consult with the prescribing physician to discuss a dosage increase.

Inpatient Detox Myths

Fact: Relapse rates for drug addiction are similar to those of other chronic diseases, such as high blood pressure, diabetes or asthma. Even with treatment, relapse rates for drug addiction are 40 to 60 percent.

Myth: Communities cannot afford to waste money on drug treatment in this bad economy.
Fact: A community cannot afford to ignore the financial benefits of investing in drug treatment. Experts estimate that for every dollar spent on drug treatment programs, a community can enjoy a return of $4 to $7 in reduced drug-related crime rates, prosecution and criminal justice costs, and theft. Add in savings to the local healthcare system and the savings rise to $12 gained for every dollar spent.

Rapid Detox Myths

Myth: Pain and humiliation are important features of Roxicet detoxification as they serve as punishment for drug abuse.
Fact: Human suffering is never an appropriate part of any treatment plan. In fact, the debilitating and demoralizing aspects of Roxicet detoxification prevent many people from reaching an opioid-free state. Rapid detox spares patients the discomfort of withdrawal, thusly improving the chances for completing the detoxification process.

Myth: It takes a week or longer to complete Roxicet detoxification.
Fact: Rapid detox brings the patient to an opioid-free state in one to two hours.

Detox and Pregnancy
Opioid dependence substantially complicates pregnancy, and places both the mother and unborn baby in peril. Opioid-dependent women are more vulnerable to the development of certain medical disorders than are women who are not dependent on opioids. An opioid-dependent woman is at a high risk for anemia, heart problems, mood disorders, pneumonia, blood infections, and hepatitis. Drug abuse increases the possibility a woman will contract an infectious disease, such as a sexually transmitted disease, tuberculosis, or HIV/AIDS. Opioid-dependence increases the risk for gestational diabetes, or wildly fluctuating blood sugar levels during pregnancy.

These conditions may cause complications during pregnancy, including hemorrhage, separation or inflammation of the tissues shared by the mother and unborn baby, slowed fetal growth, spontaneous abortion, premature labor and delivery, and fetal death.

Methadone reduces complications that can make Roxicet detoxification unsafe for pregnant women. Currently, methadone maintenance is the only approved treatment plan for pregnant women but researchers who published a study in the New England Journal of Medicine suggests buprenorphine is “an acceptable treatment for opioid dependence in pregnant women.”

A baby born to a mother that uses opioids such as Roxicet, methadone, and buprenorphine, may be born with neonatal abstinence syndrome, or NAS. Newborns with NAS suffer withdrawal symptoms for the first weeks of life, and are at high risk for suffering low birth weight, seizures, problems breathing and feeding, and even death.

Self Detox and Pregnancy

Roxicet detoxification may be unsafe for pregnant women. A pregnant woman should consult with a physician before attempting even tapering to be sure it is safe for herself and for her unborn baby.

Inpatient and Pregnancy

A physician will likely admit a pregnant patient to an inpatient facility to begin a methadone maintenance program to reduce complications and control withdrawal symptoms. The facility will screen the patient for any underlying conditions that could complicate treatment and monitor the unborn baby’s response to treatment with fetal movement monitoring equipment. The physician will start the mother on a moderate induction dose of 10 to 20 mg of methadone daily. The doctor will adjust dosage based on the woman’s response to treatment, often increasing daily dosages by 5 to 10 mg each day until establishing a safe dose that adequately controls withdrawal symptoms. The maximum daily dose for a pregnant woman is 60 mg of methadone.

The inpatient stay typically lasts about three days. After discharge from the hospital, the pregnant woman will continue treatment through an outpatient clinic. Many women will require larger doses to cover breakthrough withdrawal symptoms towards the end of pregnancy; outpatient clinicians will manage dosage increases safely.

After delivery, the mother may continue methadone maintenance or participate in methadone detoxification. Babies born to women taking methadone during pregnancy will remain under close observation in the hospital for 72 hours after delivery. Many of these babies will suffer NAS and require advanced care.

Outpatient and Pregnancy

Some women are unable to begin methadone maintenance as inpatients, choosing instead to initiate treatment through an outpatient clinic. These pregnant women come to the methadone clinic twice a day during the induction phase, once in the morning to consume the daily dose and again in the evening for evaluation. Once the doctor has established a safe maintenance dose, the mother reduces her visits to once daily.

What is the best method to detox from Roxicet?
Opioid dependence affects each person differently, and every individual experiences Roxicet in a slightly different way. The best Roxicet detoxification method depends largely on the severity of the patient’s withdrawal symptoms, his potential for complications, and his need for structure and support. The individual should assess his ability to refrain from drug use and choose the least restrictive approach to Roxicet detoxification that is still likely to bring him to an opioid-free state in a safe and effective manner.