Oxycodone Withdrawal Symptoms | The Comedown from Oxycodone

One of the hardest things about recovery from oxycodone (OxyContin, Percocet) is the first step: stopping. What makes it so hard is the comedown that comes with withdrawal.

It’s easier to become hooked on drugs than to get off them. That’s because the game is rigged in addiction’s favor.

Addiction is both psychological and physiological. It rewires the brain so that drug use is the new normal. Most people use opioids medically to ease their pain or recreationally to feel euphoria or pleasure.

The body tends towards equilibrium, so it adjusts to the drug’s effects. If the body is continually receiving infusions of feel-good chemicals, it reduces the production of or access to the body’s natural feel-good chemicals. The opioid’s effects are, in effect, canceled. This is called tolerance.

At that point, users could conclude they might as well stop since the opioid use no longer gives them any pleasure, but that’s not what addiction wants to happen. Neither do most people with substance use disorders such as oxycodone addiction. They want to feel better, they crave it, so instead, they increase the amount and frequency of their drug use.

Withdrawing from oxycodone scares people, and this fear persuades them to continue.

Still, withdrawal is a transition that must be endured. It is the body’s natural way to detox and though painful, it’s not usually life-threatening.

Oxycodone use is dangerous, even as prescribed, and far too often deadly. You can overdose even if you are not dependent or addicted and only if you use opioids occasionally.

What Are the Symptoms of Withdrawal from Oxycodone?

Oxycodone withdrawal symptoms or the side effects of withdrawal typically begin about 12 hours after drug usage stops, and may include:

• Anxiety or restlessness
• Depression
• Muscle or body aches
• Yawning, fatigue, or insomnia
• Teary eyes or runny nose
• Excessive sweating

Additional symptoms that may begin after 24 hours include:

• Diarrhea
• Abdominal cramping, nausea, and vomiting
• Fever
• Chills or goosebumps
• Dilated pupils or blurry vision
• High blood pressure, rapid heartbeat, or seizures
• Rapid breathing
• Hallucinations (hearing and seeing things that aren’t there)

Symptoms usually peak from about three days to one week, but they may continue in some intensity for a month or longer.

Oxycodone Withdrawal Help

Withdrawal from oxycodone or other opioids by itself usually will not kill you, but there may be contributing factors, such polydrug use (alcohol and benzodiazepines are much more likely to result in death if use is stopped suddenly) or certain side effects of withdrawal (vomiting can cause asphyxia due to aspiration pneumonia).

For this reason, quitting cold turkey (immediately) on your own is not recommended. It makes achieving withdrawal or detox more difficult and dangerous than it has to be. Abstinence is the goal, but it isn’t always doable in one go.

One alternative is to gradually wean oneself off oxycodone with medication-assisted treatments (MATs).

What Is Medication-Assisted Treatment?

Medication-assisted treatment is the use of drugs to relieve the symptoms of withdrawal or block the effects of opioids.

There are only three drugs approved for oxycodone or other opioid MAT:

• Methadone
• Buprenorphine (Suboxone)
• Naltrexone (Vivitrol)

Both methadone and buprenorphine are themselves opioids, but much less potent ones than oxycodone. For someone who has an addiction or dependence on oxycodone, they will usually only control the withdrawal symptoms, not produce euphoria.

Methadone must be taken once a day at a recognized clinic or doctor’s office to discourage abuse. Methadone clients don’t go home with a 30-day supply.

Buprenorphine is most often prescribed as an under-the-tongue (sublingual) dissolvable film called Suboxone, which also contains naloxone (Narcan), an anti-overdose drug that discourages abuse.

Suboxone tablets can be crushed and snorted (insufflated) or dissolved and injected. If people tamper with Suboxone, the naloxone is activated, canceling out buprenorphine’s effects.

There is also a six-month subcutaneous (under-the-skin) implant and a 30-day injectable form that is undergoing trials.

Medication for Maintenance

Sometimes the weaning process becomes maintenance. Methadone is intended to

last at least one year, and buprenorphine use can extend for years.

Such long-term control of opioid use disorder is sometimes derisively called “trading one addiction for another,” but it allows the individuals to function, meet their obligations, and gradually learn to cope with their OUD. It is preferable to drug use without recovery.

Medication for Prevention

Naltrexone is different. It is an opioid antagonist, a drug that prevents opioids from taking effect. If people who are still experiencing a high from an opioid take naltrexone, they will almost instantly go into withdrawal. That is not recommended. Before people begin using naltrexone, they should already have gone through withdrawal. Naltrexone only stops them from relapsing.

Naltrexone is available in a once-monthly injectable form called Vivitrol.

How Effective Is MAT?

MAT is not widely used, according to a 2016 report. Private programs offer this treatment less than half the time, and publicly funded programs less than a quarter. Insurance doesn’t always cover MAT, and politicians, judges, and law enforcement often don’t trust them.

Despite this, MAT is probably the most effective treatment for OUD. Compared to the previous seven years, heroin overdose deaths dropped more than one-third (37%) in Baltimore after people had access to buprenorphine from 2003 to 2009.

The problem with MAT is that it only works for OUD (though some other MATs help with alcohol used disorder). While these three drugs can help control opioid abuse, they don’t seem to affect stimulants (cocaine, methamphetamine) or benzodiazepines (Xanax, Valium). Some opioid users might try another type of drug abuse.

MAT may be helpful with withdrawal, but for long-term recovery, remember that it is medication-assisted treatment, not treatment with medication alone. Behavioral therapy, psychotherapy, or peer support are needed to teach new, non-drug coping skills and to check for dual diagnosis, which is a condition that includes an addiction and a mental illness.

Besides pain relief or pleasure, oxycodone and other opioid use disorders sometimes begin for a third reason. Some people start using opioids to cope with a co-occurring mental health disorder. It begins as an attempt to self-medicate.

Depression, trauma, stress, and anxiety may be the cause of substance use disorder, not a side effect. Without treatment for the mental health disorder, a relapse of the opioid disorder is more likely. Therapy can detect this.

Other medications may help treat individual symptoms of withdrawal symptoms: vomiting, diarrhea, upset stomach, dehydration, high blood pressure, fever, headaches, or joint pain can be treated with ordinary over-the-counter (OTC) drugs such as ibuprofen.

Better yet, some non-medication practices and activities are helpful to many people, not just those going through withdrawal, such as:

• Walking or other moderate exercises
• Eating healthy meals and small meals and snacks, and lots of them
• Drinking plenty of water and other fluids
• Meditating, journaling, and practicing mindfulness
• Talking with a friend or engaging in other activities, hobbies, or distractions.

Getting sober is only part of the battle. As smokers can attest, quitting isn’t that hard; they do it all the time. Much harder is staying sober.

Sources

• healthline.com – Withdrawing from Opiates and Opioids
• healthline.com – Opiate Withdrawal: What It Is and How to Cope with It
• samhsa.gov – Medication and Counseling Treatment
• drugabuse.gov – How Long Does Drug Addiction Treatment Usually Last?
• pewtrusts.org – Medication-Assisted Treatment Improves Outcomes for Patients with Opioid Use Disorder
• ncbi.nlm.nih.gov – Opioid Agonist Treatments and Heroin Overdose Deaths in Baltimore, Maryland, 1995–2009