Search Results for: oxycodon

Oxycodone Overdose

Oxycodone is a semi-synthetic opioid painkiller that is available in a range of doses and formulations (brand names include OxyContin, Percocet, Percodan, and Roxicet). Individuals who abuse oxycodone are at high risk of experiencing an overdose, which can prove fatal. In 2015 alone, almost 18,000 people died due to an overdose on opioid medications like oxycodone

Individuals who abuse oxycodone are at high risk of experiencing an overdose, which can prove fatal. In 2015 alone, almost 18,000 people died due to an overdose on opioid medications like oxycodone 1. If signs of an overdose are caught and treated quickly, however, there is a much better chance of recovery.


Signs and Symptoms

When a person ingests a dose of oxycodone that overwhelms the body—and, in doing so, brings imbalance to certain brain-controlled, life-preserving physiological processes such as breathing—they may experience an overdose. Oxycodone overdose can be a terrifying experience that manifests with numerous life-threatening symptoms. The sooner these symptoms are recognized and treated, the better the person’s odds of surviving.

Oxycodone overdose symptoms include 2, 3, 4:

  • Vomiting.
  • Lightheadedness.
  • Tiny, unreactive pupils.
  • Low blood pressure.
  • Pale skin.
  • Blue-like color to lips and nails.
  • Limp body.
  • Cold, clammy skin.
  • Non-responsiveness.
  • Unconsciousness.
  • Extremely slow or stopped breathing.
  • Seizures.
  • Profoundly slowed heart rate.

In addition to opioid overdose, many oxycodone products contain other drugs like acetaminophen (Percocet, Roxicet) or aspirin (Percodan), which have their own overdose dangers. Overdose on products containing acetaminophen or aspirin may cause extensive damage to the user, and require additional treatment precautions in an emergency setting.

If any of these symptoms present in a user after ingesting the drug, call 911 for emergency medical help right away.


Afraid of opioid withdrawal? Learn how detox can help.

Risk Factors

Choosing not to use oxycodone products is the only way to altogether avoid an overdose. However, for those who use the medication, sticking closely to prescription guidelines—including dose and frequency of dosing—can help you minimize the risk of overdose.

Abusing the drug puts the user at a much higher risk of experiencing a fatal overdose. Abuse entails taking oxycodone in a way other than intended (snorting or injecting), taking it without a prescription, or taking it in higher doses than prescribed. All of these factors increase an individual’s risk of overdose.

As oxycodone abuse escalates, a user may begin to need higher doses to get the same desired effects. This is known as building a tolerance to oxycodone’s effects, and it often leads to dose levels that are much higher than prescription standards. These high doses increase the user’s risk of overdosing.

Relapsing back into use can also put the user at high risk because after an extended period of abstinence, tolerance resets. This means your body can no longer tolerate the high levels it had once become accustomed to. If the recovering person then returns to the same high dose that they were taking when they had a higher tolerance, it may be overwhelm their body and result in an overdose.

Some users take oxycodone products in combination with other substances, such as alcohol or benzodiazepines. Combining oxycodone with other drugs, especially other depressants, can lead to negative interacting effects. Whether additive or opposing in nature, these interacting effects can lead to even more serious, life-threatening symptoms and thereby increase the user’s risk of overdosing. On top of the opioid risks, combining oxycodone medications containing acetaminophen with alcohol can severely compound the risk of liver or other organ damage 5.


What to Do If You Overdose on Oxycodone

Calling 911 is the first and most important step to take if an overdose is suspected.

Oxycodone overdose can result in lasting injury, severe medical issues, or even death if not treated right away. Calling 911 is the first and most important step to take if an overdose is suspected. While waiting for medical professionals to arrive, it is imperative that the overdosing individual is kept conscious and upright, if possible. If they are not conscious, closely monitor their condition—especially breathing and heart rate—and report all observations to the emergency crew when they arrive. CPR may be performed by a trained professional if breathing stops.

When emergency medical personnel arrive, report all observations and be prepared to answer any questions they may have. It is important to let the emergency responders know which formulation of oxycodone was consumed, since those with acetaminophen or aspirin can result in even more complicated overdose scenarios that require additional interventions to minimize the chances of lasting health consequences.

The suffering individual will be closely monitored and treated to maintain vitals like breathing, heart rate, and body temperature. If breathing has stopped, a drug called naloxone may be administered 6. Naloxone blocks opioid receptors to instantly stop opioid effects, which may save the person’s life.

Getting professional medical help is the best way to help an overdosing individual. Never wait to call 911 if an oxycodone overdose is suspected—the sooner a person gets help, the better their chances of recovery.


Preventing Oxycodone Overdose

Inpatient Treatment to Avoid Oxycodone Overdose

Getting help for an oxycodone abuse problem can be the vital first step toward preventing an overdose. Formal treatment can help struggling individuals step out from a cycle of compulsive abuse and start working toward a healthier, drug-free life. Through therapy, counseling, education, and skill development, a recovering person learns how to break free from oxycodone abuse and stop potential overdoses before they happen.

Treatment options include inpatient treatment, which is when the patient stays at a treatment center for a predetermined amount of time. This allows an escape from many stressors, temptations, and other triggers of everyday life and provides a sober haven for focusing solely on recovery. Treatment in an inpatient or residential setting is frequently sought by those with relatively more severe abuse or addiction problems.

Outpatient treatment is another great option for individuals who cannot take any time away from their day-to-day life. These programs allow the person to continue to live at home while checking in on a regular basis with the program for various treatment sessions.

Getting help for an oxycodone abuse problem can be the vital first step toward preventing an overdose.

Self-help groups, such as 12-step groups, are great supplements to a formal treatment program. They can provide much-needed social support and community reinforcement to maintain sobriety, even in the face of use temptations. Narcotics Anonymous is a great self-help group for a person recovering from oxycodone abuse.

Oxycodone overdose is a potentially life-threatening situation that can be avoided with the help of substance abuse recovery efforts. Call us at 1-888-744-0069Who Answers? to find a treatment center and get started on your recovery journey today.


References:

  1. National Institute on Drug Abuse. (2017). Overdose Death Rates.
  2. U.S. National Library of Medicine. (2015). Hydrocodone/oxycodone overdose. MedlinePlus.
  3. Drug Enforcement Administration. Drug Fact Sheet: Oxycodone.
  4. Berling, I., Whyte, I. M., & Isbister, G. K. (2012). Oxycodone overdose causes naloxone responsive coma and QT prolongation. QJM, 106(1). 35–41.
  5. U.S. National Library of Medicine. (2015). Acetaminophen overdose. MedlinePlus.
  6. Substance Abuse and Mental Health Services Administration. (2016). Naloxone.

Snorting Oxycodone

Oxycodone is a prescription opioid pain reliever often sold under the brand names OxyContin, Percodan, and Percocet 1. Oxycodone—often called “oxy”—causes users to experience a pleasurable euphoria. In seeking Oxycodone’s pleasurable effects, users may misuse the drug by taking it without a prescription, taking it in larger amounts than prescribed, or tampering with it by snorting, smoking, or injecting it.

While any recreational use of oxycodone is dangerous due to the myriad of possible side effects, snorting may be even more dangerous as it can lead to additional serious medical complications as well as an increased risk of overdose

Oxycodone is one of the most frequently misused prescription drugs in the United States 2. In its various pharmaceutical formulations, it is available as an instant-release pill, where the drug is immediately released into the bloodstream, and as an extended-release version, where it is released slowly over a longer period of time. Some users may tamper with the extended-release pill by crushing it up and snorting it in order to release the effects all at once and experience an intense high 2. While any recreational use of oxycodone is dangerous due to the myriad of possible side effects, snorting may be even more dangerous as it can lead to additional serious medical complications as well as an increased risk of overdose 3.

While snorting oxycodone is not unique to any one demographic, certain groups may be at higher risk, including adolescents, women, and older adults 3. Surveys indicate that adolescents—especially young men—may be at higher risk of snorting oxycodone than other age groups 3,4. Adolescent abuse of oxycodone is a significant concern because it can lead to future opioid addiction 3. While men tend to misuse prescription drugs at higher rates than women, the rates of overdose among women is increasing at a significant rate 3. Older adults are also more likely to experience chronic health issues that require taking multiple drugs at once. This can lead to unintentional misuse and dangerous drug interactions 3. Understanding the dangers of snorting oxycodone, who is at risk, and the treatment options available can help people struggling with oxycodone addiction get the necessary help.


Is Snorting Oxycodone Dangerous?

Yes, snorting oxycodone is dangerous and can have serious and even deadly consequences. Snorting oxys not only quickens and intensifies the euphoric high from the drug 5, but it also increases the likelihood a user will experience significant medical or psychological problems, such as an overdose and nasal damage 3,6.

Along with the risk of medical complications, the likelihood of developing an addiction to oxycodone is significantly increased when a user administers the drug in ways other than prescribed 7.

Extended-Release Versions Increase Dangers

Extended-release was developed to minimize the drug’s addictive potential by slowly and steadily releasing the drug into the bloodstream, therefore reducing its euphoric effects. However, crushing up and snorting extended-release oxycodone can intensify its effects because the drug is released all at once, resulting in a maximum dose in a short period of time in the brain 5,7. This can increase the risk of breathing difficulties, coma, and addiction 7.

From Oxy to Heroin

Some oxy users may transition from prescription drugs to heroin 7. This can occur in users who develop a tolerance to oxycodone and eventually turn to heroin for a stronger high.

The transition may also be the result of affordability in many cases. Heroin is significantly cheaper than painkillers on the street. Painkiller addiction has been labeled a contributing factor to the increasing numbers of heroin users, new populations of heroin users, and overdoses from heroin. In fact, as opioid prescriptions rose, numbers of people trying and getting hooked on heroin did as well—the amount of heroin abusers doubled between 2005 and 2012 7.

While both oxycodone and heroin pose a significant risk of overdose, heroin is even more dangerous because it is almost impossible to know the purity of heroin sold on the street, as well as whether it has been contaminated with (or even replaced by) other drugs, such asfentanyl (an opioid much more potent than heroin) 7.


Side Effects

Users may abuse the drug because of its pleasurable effects. However, oxy can also cause unpleasantside effects such as 8:

  • Mood swings.
  • Dry mouth.
  • Headaches.
  • Stomach pain.
  • Constipation.
  • Nausea and vomiting.
  • Dizziness.
  • Sweating.
  • Reddening of the skin.

Oxycodone is not meant to be snorted. In fact, the pills that contain oxycodone frequently include other ingredients such as talc, lactose, and stearyl alcohol, which may cause serious damage when insufflated 6.Snorting drugs like oxy may result in problems like 6:

  • Nasal infections.
  • Damage to the septum and roof of the mouth.
  • Erosion of parts of the nasal passages.


Can Snorting Oxycodone Cause an Overdose?

Dangers of Oxycodone

Taking oxycodone as prescribed by a doctor is unlikely to lead to serious problems or overdose. However, overdose is an immediate risk for anyone snorting the drug and/or taking excessive amounts. Taking more than the intended dose of oxycodone even once can result in severe respiratory depression, where breathing slows down or stops completely 3.

You are more likely to overdose on oxycodone if you 3:

  • Take more of the drug than prescribed.
  • Snort the drug or take it in other ways different from that which is prescribed.
  • Mix the drug with alcohol or other sedatives.

Symptoms of an oxy overdose include 9:

  • Markedly constricted pupils.
  • Bluish tint to the fingernails and lips.
  • Stomach spasms.
  • Uncontrollable vomiting.
  • Dangerously low blood pressure and decreased pulse rate.
  • Severe respiratory depression or complete inability to breathe.
  • Seizure.
  • Extreme drowsiness and/or loss of consciousness.
  • Coma.

With proper treatment, people may recover from an overdose. However, if left untreated, an overdose can result in permanent brain damage or death 9.

Numbers of opioid overdoses have risen to epidemic proportions, nearly quadrupling since 1999 4.


Signs That Someone is Addicted to Oxycodone

Snorting oxycodone increases the risk of addiction, since crushing and snorting elicits more heightened effects and an intensely rewarding sensation that reinforces continued use 7. Signs that a person is addicted to oxycodone may include 10:

  • Taking larger amounts of oxy over time.
  • Unsuccessfully trying to cut down.
  • Spending a long time acquiring, taking, or recovering from oxycodone.
  • Craving oxycodone.
  • Inability to carry out obligations at home, work, or school.
  • Continuing to use oxy despite relationship problems.
  • Giving up activities that were once important in favor of obtaining and using oxy.
  • Using oxy in hazardous situations.
  • Continuing to use in spite of physical or psychological problems.
  • Needing larger amounts of oxy to achieve the desired effects.
  • Suffering from withdrawal symptoms in the absence of oxy.

Other signs you may have noticed in a loved one who is snorting oxycodone include:

  • Frequent sniffling.
  • Nasal problems or damage.
  • Possession of drug paraphernalia like straws and empty prescription bottles.

Admitting that you or a loved one is suffering from oxycodone addiction can be difficult. Fortunately, treatment programs and recovery groups are available to help.


Don’t let Ritalin addiction steal your health.
Find treatment today.

Getting Help

According to the National Institute on Drug Abuse, successful addiction treatment involves detox, medication, and therapy 3. There are several different options for getting help for oxycodone addiction:

  • Detox is often the first step in recovery and focuses on safely removing drugs from the body. Withdrawing from painkillers like oxycodone can be unpleasant and risky, since withdrawal symptoms are often extremely uncomfortable and increase the risk of a relapse. Detox programs can help by monitoring withdrawal symptoms, administering medications to reduce discomfort, and providing support during the early part of the recovery process.
  • Inpatient treatment is an intensive form of care that allows people in recovery to stay for a designated period of time in a sober facility during which the complete focus is on learning to live a sober life. Therapy sessions are offered daily, along with other amenities such as recovery meetings and exercise programs. Some inpatient programs are short-term while others are designed around longer-term residential stays which may last for up to 90 days or more, if needed.
  • Outpatient treatment offers therapy sessions without housing services. The number of therapy sessions may vary depending on the type of program and how far along a person is in the recovery process.

Behavioral therapies are recommended for treating oxy addiction and may be incorporated into group, individual, or family therapy. Behavioral therapies have been proven to help reduce drug use and improve relationships and overall well-being 3:

  • Cognitive behavioral therapy (CBT) helps people identify and change unhealthy thinking patterns that lead to detrimental behaviors like drug use. CBT also teaches coping skills for managing urges and high-risk situations that could lead to a relapse.
  • Contingency management assumes that people will continue to engage in behaviors that are rewarded. Drug addiction is often rewarded with immediate pleasure and then followed by long-term pain, such as health, relationship, and financial problems. Contingency management seeks to immediately reinforce recovery by providing rewards for abstinence.

Medication-assisted treatment is also helpful for treating oxy addiction. Medications can be used to reduce withdrawal symptoms, decrease cravings, and counter the effects of opioids if a relapse occurs 3. Medications are most effective when combined with behavioral therapy and sober support 3. Medications used to treat oxy addiction include 3,11:

  • Naltrexone, an opioid antagonist that prevents opioids from binding to their receptors and creating a high.
  • Vivitrol, an injectable form of naltrexone.
  • Buprenorphine, a partial opioid agonist that partially binds to opioid receptors to allay cravings.
  • Methadone, an opioid agonist that decreases cravings and withdrawal symptoms in opioid-addicted individuals.
  • Probuphine, a form of buprenorphine that is implanted under the skin and slowly releases the drug into the body over a span of 6 months.

Recovery support groups are free resources for people struggling with addiction. They can be a helpful addition to treatment because many people with addiction require continued support past the initial treatment phase. Some popular recovery support groups are:

  • Narcotics Anonymous (NA) — a 12-step group that is similar to Alcoholics Anonymous. NA encourages members to admit their powerlessness over their addiction and put their faith in a higher power.
  • SMART Recovery — another support group that provides support and tools based on the latest scientific research. It is based on a four-point system that includes increasing motivation for recovery, coping with cravings, managing thoughts, feelings, and behaviors, and living a balanced life. SMART Recovery helps to empower members to feel more in control of their addiction and recovery.

Committing to treatment is an important first step in recovering from oxycodone addiction. Call today for help finding an addiction treatment program.


References:

  1. National Institute on Drug Abuse. (2016). Commonly abused drugs chart.
  2. Omidian, A., Mastropietro, D. J., & Omidian, H. (2015). Routes of opioid abuse and its novel deterrent formulations. Journal of Developing Drugs4(5), 1-7.
  3. National Institute on Drug Abuse. (2016). Research report series: Misuse of prescription drugs.
  4. Cicero, T. J., Ellis, M. S., Surratt, H. L., & Kurtz, S. P. (2013). Factors influencing the selection of hydrocodone and oxycodone as primary opioids in substance abusers seeking treatment in the United States. PAIN®154(12), 2639-2648.
  5. Gasior, M., Bond, M., & Malamut, R. (2016). Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations. Postgraduate Medicine128(1), 85-96.
  6. Lofwall, M. R., Moody, D. E., Fang, W. B., Nuzzo, P. A., & Walsh, S. L. (2012). Pharmacokinetics of intranasal crushed OxyContin and intravenous oxycodone in nondependent prescription opioid abusers. The Journal of Clinical Pharmacology52(4), 600-606.
  7. Volkow, N. (2014). America’s addiction to opioids: Heroin and prescription drug abuse.
  8. U.S. National Library of Medicine. (2016). MedlinePlus, Oxycodone.
  9. U.S. National Library of Medicine. (2015). MedlinePlus, Hydrocodone/oxycodone overdose.
  10. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  11. National Institute on Drug Abuse. (2016). Probuphine: A game-changer in fighting opioid dependence.

Oxycodone History and Statistics

Oxycodone in man's hand

Oxycodone is an opioid analgesic, or ‘painkiller’ drug that is most often prescribed to control moderate to severe pain that cannot be treated with other medications. It is a semi-synthetic opiate that was first created in 1916 from thebaine, a chemical found in poppy plants and related to other narcotic drugs, such as morphine and heroin.

History

Oxycodone was first developed as part of an effort to find non-addictive alternatives to these drugs, which were commonly used in medicine before and during World War I.

Unfortunately, oxycodone also has significant potential for abuse and addiction. Like all opiates, it works by binding to opioid receptors in the brain and spinal cord, and these receptors are responsible for both:

Although the US only accounts for approximately 5% of the world’s population, the National Institute on Drug Abuse (NIDA) estimates that 81% of the world’s supply of oxycodone is now consumed here.

  • The pain-relieving effects that patients need.
  • AND
  • At higher doses, the euphoric effects that abusers seek.

Individuals who take oxycodone without a prescription, or take more than prescribed by their doctor, are at high risk of developing dependence and addiction.

Oxycodone is most often prescribed in formulations combined with other pain-relieving drugs like acetaminophen (Percocet) or as extended release tablets (OxyContin). In the past, oxycodone and other opiate drugs were prescribed sparingly, and mainly for short-term pain. However, changes to government recommendations and aggressive marketing by pharmaceutical companies have led to a dramatic increase in the last 25 years in prescriptions of oxycodone for long-term use in patients with chronic pain.

This growth in legal prescriptions of oxycodone has increased its availability in the US, and a greater amount of the drug is now being diverted to street users. Major sources of oxycodone for sale on the black market include:

  • Forged prescriptions.
  • ‘Doctor-shopping’ to obtain prescriptions.
  • Pharmacy break-ins and robberies.
  • Diversion by unethical doctors and dentists (pill-mills).

The widespread availability both in prescriptions and on the black market lead to the significantly increased risk of medical complications and overdoses from the drug.

If you are abusing oxycodone, you are putting your health at extreme risk. You don’t have to continue to suffer. Call 1-888-744-0069Who Answers? to find out how to begin your journey towards recovery today.

Treatment facility admissions for oxycodone vs. all opiates

United States, admissions for treatment, age 12+

Who’s Abusing Oxycodone?

Current statistics about oxycodone abuse present a mixed picture of the problem and suggest that although oxycodone abuse may no longer be increasing in the US, neither is it decreasing.

Consider the following statistics:

  • The 2013 National Survey on Drug Use and Health showed that people aged 18-25 were the most likely to report ever having abused oxycodone (9.9%) compared to 6% of people 26 and older.
  • The Monitoring the Future Survey, funded by NIDA, found that about 1 in 30 high school seniors has abused OxyContin at least once.

How many youth use OxyContin non-medically?

United States

Overall, the number of people who reported abusing OxyContin in the previous 12 months declined from 2012 to 2013, but the number of people who have ever used this drug for non-medical purposes increased between 2012 and 2013.

This suggests that while there are fewer current abusers than in the past, more people are now trying the drug for the first time.

How many people used OxyContin non-medically in the last month?

United States, aged 12+

How many people used OxyContin non-medically in the last year?

United States, aged 12+

How many people have used OxyContin non-medically in their lifetime?

United States, aged 12+

Likewise, NIDA reports that despite a modest decline in OxyContin abuse since 2010, the rate of oxycodone abuse overall has remained steady.

This suggests that changes to the formulation of OxyContin that make it harder to abuse have merely caused users to switch to other forms of the drug rather than quit altogether.

Oxycodone abuse is particularly frightening because it can easily lead to heroin abuse, as addicts may switch to heroin use when oxycodone pills become either too difficult to obtain or prohibitively expensive.

Oxycodone’s Addictive Power

Did you know that it is one of the 12 most addictive drugs? Read more here.

The Oxycodone Market

There were 53 million oxycodone prescriptions filled in 2013 by US pharmacies, according to NIDA. This translates to approximately one bottle of this addictive drug for every 6 people in the country.

Prescriptions of oxycodone/acetaminophen by year

United States

When obtained legally through a pharmacy, the average cost for 30 tablets of 40mg of OxyContin is $240, or about $0.20 per milligram. However, because of the potency of oxycodone and the intense dependence that abusers develop, the black market value of this drug is much higher.

Spending on OxyContin

United States

A 2013 study estimated the street value of oxycodone to be approximately $1 per milligram in all regions of the US (about $40 for a 40 mg tablet of OxyContin), a 5-fold increase over legal prices.

This high markup creates a strong incentive for patients with legal oxycodone prescriptions, and even doctors and pharmacists with access to such medications, to sell their pills on the black market, which increases the supply available to recreational users.

United States DEA annual production quotas for oxycodone (for sale)

Interest in Oxycodone on the Internet

Google Trends: Searches for oxycodone

Is Oxycodone Illegal?

Legal Penalties of Using Oxycodone

Doctors and pharmacists must follow strict record-keeping requirements when dispensing Schedule II drugs such as oxycodone, and there are stiff criminal penalties for illegally possessing and distributing such drugs.

Under federal drug laws, sentences of up to 20 years in prison and $1 million fines can be levied for trafficking oxycodone. Moreover, if a death results from the sale of the drug (overdose or otherwise), a life sentence can be imposed.

When used on a legitimate prescription basis, it is not illegal. However, it’s worth nothing that it was classified as a Schedule II drug by the Drug Enforcement Agency (DEA) in the early 1960s, which means it has both:

  • Recognized medical uses.
  • AND
  • A high potential for abuse.

Other drugs that are also classified as Schedule II include:

  • Hydromorphone (Dilaudid).
  • Adderall.
  • Ritalin.

Although it has been in clinical use for nearly a century, the current epidemic of abuse did not begin until the 1990s. In 1995, the Food and Drug Administration (FDA) approved OxyContin, the extended-release form of the drug, subject to the same restrictions as other forms of oxycodone; however, high levels of OxyContin abuse were reported in the eastern US almost immediately after its introduction and soon spread throughout the entire country.

Because of their extended-release formulation, tablets of OxyContin can contain a very high amount of oxycodone, up to 80mg per pill, allowing patients with severe pain to take fewer pills per day. This high potency is attractive to drug seekers and dealers for 2 main reasons:

  • Fewer tablets must be obtained.
  • By crushing and injecting or snorting the tablets, abusers with high tolerance levels can more easily achieve a high.

Efforts have been made to reduce the appeal of OxyContin to abusers including:

  • Discontinuation of the most potent 160mg tablets.
  • The introduction of a new formulation in 2010 that made it more difficult to crush or dissolve the tablet in order to release the full dose all at once.

These changes may be responsible for the recent decrease in OxyContin abuse that has been observed. However, since oxycodone abuse overall has not changed, many users may not have stopped taking oxycodone, but simply switched to other forms of the drug.

How Dangerous Is Oxycodone?

Oxycodone, like all other narcotic painkillers, can cause addiction and dangerous, life-threatening effects when abused.

Furthermore, methods frequently employed by users to increase the euphoric high of this drug—including taking large quantities at once and crushing pills to inject or snort—increase the chances of developing a dependence or a experiencing an adverse reaction or overdose.

Effects of Oxycodone Use

Oxy side effects

Emergency room visits due to adverse reactions to Oxycodone

United States

Oxycodone Withdrawal

Individuals who develop dependence on oxycodone and suddenly stop taking it may experience withdrawal symptoms including:

  • Panic attacks.
  • Anxiety.
  • Gastrointestinal distress.
  • Muscle weakness.
  • Fever.
  • Flu-like symptoms.

Withdrawal is extremely unpleasant and can cause users to persist in taking the drug despite negative effects on their life and finances. This addictive spiral can cause users to become depressed and, in extreme cases, even attempt suicide.

Oxycodone-related emergency room visits by people seeking detox services

United States

Emergency room visits due to suicide attempts involving oxycodone

United States

Another danger of oxycodone abuse lies in the fact that many formulations, such as Percocet, also contain other types of analgesic drugs like acetaminophen (Tylenol). Ingesting large amounts of these combinations can cause irreversible liver damage, and possibly death.

Oxycodone Overdose

Overdose is the most serious danger of oxycodone abuse because large doses are needed to achieve a euphoric high, and the development of tolerance means the amount of drug required to achieve the same effect increases over time.

As the abuse of opiates has increased in recent years, so have emergency room visits due to overdose.

An individual who overdoses on oxycodone may experience:

  • Extreme sleepiness.
  • Unconsciousness.
  • Constricted pupils.
  • Uncontrolled vomiting.
  • Slowed or shallow breathing.
  • Cessation of breathing.
  • Death.

An oxycodone overdose can be fatal unless the user receives medical attention immediately. It should only be taken as prescribed and should be monitored with caution to avoid the development of dependence. If you notice the signs of overdose, do something immediately. Learn how in our blog, Taking Action: How to Intervene During an Overdose.

Sources:

Concurrent Alcohol and Oxycodone Abuse

prescription bottle warning

If you are concerned about yourself or someone else who has been combining alcohol and oxycodone, it is no surprise. These two substances should never be combined, as doing so heightens the dangers inherent to each individual substance.

Alcohol and Oxycodone Facts

Here are some alcohol and oxycodone facts to be aware of:

  • Each substance leads to abuse and addiction. You can have separate addictions to each, as well as an addiction of using the substances together for the desired effect.
  • There are dangerous consequences of concurrent alcohol and oxycodone use, including potential overdose or death.
  • Using both of these substances alters your mental capacity for making decisions, your alertness and your reaction time.
  • Operating machinery while using these substances, including a vehicle, is extremely dangerous.
  • You may experience short-term and long-term effects of combining these substances.
Alcohol and Oxycodone Abuse question 1

Signs and Symptoms

The signs and symptoms of someone using alcohol and oxycodone are similar to using these substances alone. Common symptoms of being under the influence of oxycodone and alcohol include:

Physical Signs and Symptoms

  • Nausea/vomiting.
  • Lightheadedness.
  • Drowsiness and sedation.
  • Itching.
  • Headache.
  • Sweating.
  • Dry mouth.
  • Constipation.
  • Low blood pressure.
  • Euphoria.
  • Pinpoint pupils.
  • Restlessness.

Other Signs of Abuse and Addiction

  • Thinking about nothing but the drug and alcohol.
  • Getting multiple prescriptions for oxycodone.
  • Taking more than prescribed doses of prescriptions (if you have a prescription).
  • Taking increasing amounts due to development of tolerance.
  • Using the substances in secret.
  • Experiencing financial difficulty due to use.
  • Hiding alcohol or pills throughout the house.
  • Lying, stealing or cheating to gain more of the oxycodone.
  • Having increased conflicts with loved ones due to substance use.


Alcohol and Oxycodone Abuse question 2


Combined Effects of Oxycodone and Alcohol

The main concurrent alcohol and oxycodone problem is that it is extremely dangerous to combine these substances. Not just due to the risk of abuse and addiction, but because of what it does to your body and your mind. Your tolerance and sensitivity to alcohol is lower when you are taking oxycodone, but you might not realize it, so you may drink more than your body can handle. In combination with oxycodone, another depressant, you can do serious harm to your body and may experience:woman-feeling-depressed-from-oxy-and-alcohol-abuse

  • Respiratory depression.
  • Loss of consciousness.
  • Confusion.
  • Impaired motor control.
  • Dizziness.
  • Overdose.
  • Death.

Find out more about the harmful effects of Oxycodone use and how to help an Oxycodone addict by calling our helpline.

Alcohol and Oxycodone Abuse question 3

Treatment for Co-occurring Alcohol and Oxycodone Addiction

When you are ready to overcome your addiction to alcohol and oxycodone, you should find a rehab program that deals with both conditions concurrently. Both substances are highly addictive and hard to quit without help, so care in a specialized rehab facility that can deal with co-occuring addictions is essential.

You will also want to make sure you enter a facility where you can undergo supervised medical detox, as withdrawal from alcohol can be dangerous and induce life-threatening symptoms such as seizures. Oxycodone withdrawal is not usually dangerous but can be so uncomfortable that it sends many running back to the drug and into a relapse.

Rehab facilities are varied, allowing you to choose the one that fits you best. You may wish to choose to attend a private or luxury treatment center, an executive treatment center where you can continue working as you get care, or even a center that provides holistic treatment.

Outpatient care is also an option and benefits those who need treatment but are unable to attend a residential rehab facility due to cost, time constraints, or other responsibilities. These programs are best suited to those who have a supportive home environment which will foster recovery efforts. Many people struggling from co-occurring addictions will prefer to get treatment in an inpatient facility for focused care and minimized exposure to triggers during treatment.

Call 1-888-744-0069Who Answers? to learn more about your treatment options.

Alcohol and Oxycodone Abuse question 4

Statistics for Alcohol and Oxycodone

According to the National Institute on Drug Abuse:

teen-with-oxy-abuse-alcohol

  • Prescriptions for opioid pain relievers like OxyContin has risen from approximately 76 million in the US in 2007 to almost 207 million in 2013.
  • The US is the word’s biggest consumer of hydrocodone and oxycodone.
  • Opioids are to blame for the biggest proportion of the prescription drug problem in the US.
  • More than 2 million people in the US have a substance use disorder involving prescription opioids.

According to the National Institute on Alcohol Abuse and Alcoholism:

  • In 2013, more than 16 million adults age 18 years old and older had an alcohol use disorder.
  • Nearly 700,000 adolescents (12-17 years) had an alcohol use disorder in 2013.
Alcohol and Oxycodone Abuse question 5

Concurrent Use Among Teens

Oxycodone is highly addictive and abused frequently by teens between the age of 12 and 18. This is a scary fact, since they are starting so young. Prescription medications are all too easy for teens to obtain, as pills are given to them by friends, taken from relatives or friends with prescriptions, or bought with little effort.

It is important that you become familiar with the common signs and symptoms of not just oxycodone abuse, but when combined with drinking, so you know the warning signs to look for in your own teen.

Alcohol and Oxycodone Abuse question 6

Resources, Articles and More Information

The following articles can provide you more information about Oxycodone, alcohol, abuse and the dangers of combining these substances.

Find support and offer your support to others today by visiting our community forum.

Am I Addicted to Oxycodone? How Can I Quit Safely?

Opiates are one of the best inventions of mankind for so many reasons. They formed the basis of modern medicine and inspired a huge range for pharmaceuticals. Plenty of drug companies started off by manufacturing painkillers that were based on opium, and the main focus of the research was to find a drug that was as effective as morphine but as addictive as codeine. Plenty of drugs have been made, but only one or two are routinely used as painkillers. Oxycodone was one of these.

Now, oxycodone was first synthesized in 1916 by two chemists working at the University of Frankfurt. There’s a chemical in opium called thebaine, and it’s not as addictive as morphine or heroin. They figured they could create a chemical that wasn’t as addictive as morphine but still retain morphine’s painkilling properties. And in a way, they were right, although it’s not quite as powerful. Alas, they were not wholly successful, because their drug was still addictive, although mercifully not as addictive as heroin.

The most recognized formulation is probably Purdue Pharma’s OxyContin, although other brands are available. The reason it’s popular is because it is an extended dose, meaning that it comes out very gradually, providing pain relief over a longer period of time.

The problem with extended release versions is that you get a lot of oxycodone in your pill than in immediate release ones. People would therefore crush them up to inject or, more commonly, snort them, as well as take them orally. There have even been reports of people taking them as suppositories, which sounds messy.

If any of this seems familiar-particularly the rectal insertions-you might want to read on.

Modifying a prescribed dosing regimen or modifying the pills to take them in a different way is a prime example of abuse. To modify one of Yoda’s sayings (green dude in Star Wars):

“Excess pills are the path to addiction. Excess leads to abuse. Abuse leads to tolerance. Tolerance leads to suffering.”

It’s a fairly clear-cut route to addiction, really. Once you start modifying your prescription, doctor shopping (i.e., seeing multiple doctors for the same conditions without their knowledge), and taking more than is stated-or even taking it without medical supervision-you’re heading down that rather oil-slicked slope.

Of course, it’s possible to be addicted to oxycodone and take it legitimately. That’s the peril of any medication, really. If you find that you need more pills to get through the pain at a fairly regular rate, you’ve likely developed tolerance. The main way to test is to try to give up.

This leads to the world of withdrawal. Unlike the World of Warcraft (yes, I am getting in all of the random references in), it doesn’t have Night Elves, Paladins, and Pandaren. Instead you get night sweats, pain, and paranoia. Along with a host of other symptoms.

Naturally these aren’t nice in the way that sunshine, lollipops, and rainbows are nice. If you do suffer from these symptoms, though, you’ve developed a tolerance and likely an addiction. At some point, you’re going to have to face some of these symptoms.

Generally, if you find yourself lying about your consumption and if it’s affecting your life worse than stairs affect a Dalek (they have wheels and shouldn’t be able to go up them), you might want consider seeking help. Fortunately, there are a few places that can help you boldly go into sobriety.

These places are drug abuse treatment centers, and they can help you get through withdrawal. They have qualified medical staff who can prescribe medication to make your journey through the badlands much more comfortable. In addition, they can really guide you to making the right choices.

Quitting isn’t just about stopping the use of oxycodone, though. When addictions are caused partially by circumstance-it’s rare that anyone is born with an addiction. Instead you need to look at what caused the addiction in the first place. This means taking the dreaded therapy, although it’s nothing to what therapy sessions with River Tam would be like (I might be getting a little too obscure here).

Ultimately, you need to unlearn, unlearn, and wipe away your old thoughts and fears that lead partially to the addiction. Consider attending regular group meetings, preferably Narcotics Anon, not your local D&D. There you can find the solace and the understanding that you need to enjoy and maintain sobriety.

How to Help an Oxycodone Addict

oxy-on-young-womans-tongue-pill-addict

Oxycodone is an opioid pain reliever prescribed to people experiencing moderate or severe pain. Due to the drug’s ability to act on the opioid receptors in the body (and for extended periods, with some formulations) oxycodone is a highly useful medication in the realm of pain management. The substance is available as several name brand medications, including:

  • OxyContin, OxyIR, OxyFast – Oxycodone only.
  • Percocet – Oxycodone combined with acetaminophen.
  • Percodan – Oxycodone combined with aspirin.

Oxycodone is a very desirable drug of abuse due its ability to relieve pain while providing a euphoric high similar to other opioids like heroin. In fact, the Drug Enforcement Administration reports that more than 16 million people abused oxycodone in 2012.

Help for Oxycodone Addicts

With the relatively high availability of the substance and the large number of people abusing it, oxycodone addiction has become quite common. Fortunately, there are a number of effective treatment options for someone abusing oxycodone. The options include treatments like:

  • Medication interventions including detoxification and maintenance treatment.
  • Behavioral therapies with motivational incentives.
  • Family therapy and education.
  • 12-step support.

How to Approach an Oxycodone-Addicted Loved One

Oxycodone can have powerful effects on the user. A person abusing oxycodone may be feeling dizziness, weakness, and uncomfortable digestion problems. When they are high they are not in a receptive or particularly coherent state, so it is much better to wait until they are sober to discuss treatment.

Those who are caught up in addiction to Oxycodone may be experiencing psychological and physical dependence, so educate yourself on the effects of Oxycodone so that you can talk with them from a place of improved understanding about the drug and its effects. When you finally decide to bring up the topic, make sure to use compassionate language that does not throw blame around. If you approach the person who is suffering from oxycodone addiction with aggression or frustration, the user may retreat even further.

In some cases, professional help can make a big difference. Community Reinforcement and Family Training (CRAFT) is a proven program that teaches friends and family members of addicted individuals how to best approach the topic of treatment. A therapist will teach you and other people that care about the oxycodone abuser about the most effective communication strategies that are more likely to get that person to agree to enter treatment- it works in seven out of ten cases (Meyers, Smith, & Lash, 2005).

All in all, you want to come to an oxycodone user with empathy and sobriety support. Make sure that they understand that you care about them and are bringing this up because you want to help them in their recovery journey. The support of friends and family can help encourage an oxycodone user to stay abstinent and work toward long-term recovery both during and following treatment.


Video: Dying By Prescription

Watch the 3-min clip from the video below for the story of one man who was prescribed Percocet in the hospital and quickly developed an addiction.

Credit: 16x9onglobal


Oxycodone Addiction Treatment

The appropriate treatment for you will depend on factors, including:

  • The amount of the substance used.
  • The duration of use.
  • The frequency of use.

Ending use of oxycodone is best done under the care of a substance abuse professional. By completing an assessment, the professional can recommend the safest course of treatment with the best prognosis.

For many people ending oxycodone use, treatment begins with detoxification. This process involves monitoring and reducing the amount of oxycodone in your system under close, medical supervision to ensure your comfort. At this point, some will be transitioned onto another “stabilizing” or “maintenance” medication like buprenorphine (Suboxone, Subutex) or methadone. These substances can be controlled in a way to help prevent full withdrawal symptoms, reduce cravings and reduce the risks of continued substance use.

Following detox, people will likely transition to a residential rehab or outpatient setting. Most treatments will share similarities including:

  • Medication management to reduce cravings and address mental health issues underlying addiction.
  • Behavioral therapy to identify the triggers of use and the mechanisms in place that maintained these patterns. Many behavioral programs employ ‘token economies’, or provide rewards for periods of abstinence.
  • Family therapy and education to provide loved ones with information to better aid recovery and to address their own needs related to addiction.
  • 12-step programs to build a sense of community and fellowship with others in recovery.

Emergency room visits due to adverse reactions to Oxycodone

United States


Emergency room visits due to suicide attempts involving oxycodone

United States


Is Oxycodone Addictive?

All opioids have some level of addiction. Oxycodone is no different. The substance attaches to tiny molecular structures throughout the brain and the body called opioid receptors. Once in place, the drug triggers a cascade of molecular events—including the release of a substance called dopamine. Ultimately, opioid receptor activation culminates in:

  • Decreased pain perception.
  • Decreased physical tension.
  • Increased sense of relaxation.
  • Euphoria.

When someone experiences these effects, the brain’s reward system reinforces the behavior. Users will want to replicate the drug taking behavior with increased frequency and intensity. Over time, however, the body will become tolerant to the effects of the drug and require more and more to experience the same feelings.


What Are the Signs of Oxycodone Addiction?

People often begin abusing a substance to experience the pleasurable effects. Others may become addicted despite taking the medication as prescribed. Regardless of the path of the addiction, indicators will be the same. Signs of oxycodone addiction include:

  • Slowed or labored breathing.
  • Appearing more lethargic and lacking energy or motivation.
  • Pinpoint pupils.
  • Alternating between being alert and asleep.
  • Confusion.
  • Problems with motor coordination.

In the long-term or at higher doses, these signs will appear more often or with increased severity

Oxycodone Help Quiz question 3

Yearly deaths linked to oxycodone and other opioid use

United States

Deaths involving oxycodone and other opioids (CDC WONDER query, ICD-10 code T40.2, ???Poisoning by, adverse effect of and underdosing of other opioids???)


Am I Addicted to Oxycodone?

While the signs of use can be quite distinct, and easy to recognize, knowing definitively that you are addicted to oxycodone may require further introspection. Addiction is the continued use of a substance even when it has caused negative life events in the past or you know it will lead to problems in the future. Consider the following indications that you might be addicted to oxycodone:

  • You have been placing less value on the relationships in your life, or you have been fighting more with those close to you.
  • You have not been devoting the needed time or attention to the responsibilities in your life like attending work and paying bills.
  • You are not caring for yourself physically or mentally.
  • More of your time is spent thinking about the substance and trying to acquire more of it.
  • If you are prescribed oxycodone, you find yourself using more than indicated by the prescribing doctor, trying to receive multiple prescriptions from various doctors, or trying to trade or buy medication.
  • You have made previous attempts to limit or stop use of the medication with poor success.
  • When you attempt to stop, you experience unwanted mental and physical health symptoms including flu-like symptoms, agitation, and depression.

Call Our Hotline Today

Just because a substance is legal and prescribed does not mean that it is always safe. Call 1-888-744-0069Who Answers? to gain more information about oxycodone abuse and possible treatment options.


Sources:

What Are the Side Effects of Oxycodone?

drugabuse_shutterstock-291277055-oxy-FI

Is Oxycodone Dangerous?

Oxycodone is a prescription opioid analgesic that is used to manage moderate to severe pain by changing the way that the brain responds to pain.1 It is the primary active component in the commonly prescribed pharmaceutical formulations OxyContin and Percocet.1,2 Oxycodone is classified as a Schedule II drug by the Controlled Substances Act, meaning that it has a currently accepted medical use, but also has a high potential for abuse, and may lead to severe psychological or physical dependence.3

In its various formulations, oxycodone is available as an oral tablet (with immediate and controlled-release variations) as well as a liquid solution. It is commonly prescribed as a combination product with other drugs such as acetaminophen, aspirin, and ibuprofen, with each combination having a different brand name.1 Brand names include OxyContin, Roxicodone, Percocet, and Percodan. Street names for oxycodone include “oxy,” “kickers,” “blue,” and “hillybilly heroin.”4

At certain doses, oxycodone may elicit an intensely rewarding, positive experience for the user.2,4 As such, it has a high potential for abuse. When misused, there is a high risk for overdose, as recreational methods of ingesting certain formulations may accelerate the absorption of large, dangerous amounts of the drug.

In less than five minutes, see if your loved one—or you—could be addicted to oxycodone. Take our online confidential survey.


Short-Term Effects

When taken as prescribed, oxycodone can be a very effective painkiller. However, for some people, even at prescribed doses its use may be associated with other desirable effects, such as:

  • Mild euphoria.
  • Relaxation.
  • Sedation.
  • Reduced anxiety.

Side Effects

Oxycodone is a powerful opioid painkiller. Its therapeutic effects may also be accompanied by a number of unwanted side effects:1,2,4

Did You Know?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2017, approximately 1.7 million people were found to be prescription opioid-dependent, based on the DSM-5 criteria for substance use disorder.5

  • Mood changes
  • Drowsiness
  • Headache
  • Dizziness
  • Dry mouth
  • Flushing
  • Sweating
  • Itching
  • Stomach pain
  • Nausea
  • Vomiting
  • Constipation
  • Loss of appetite
  • Weakness

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2017, approximately 1.7 million people were found to be prescription opioid-dependent, based on the DSM-5 criteria for substance use disorder.5

Rapid effects of oxycodone use are particularly dangerous when combined with alcohol or other respiratory depressing drugs.

These side effects can make the user uncomfortable, and tend to get worse as the dose increases. Other side effects can be much more serious and may require immediate medical help:1,2,4

  • Postural hypotension
  • Lightheadedness
  • Extreme drowsiness
  • Irregular heart rate and/or rhythm
  • Chest painDifficulty breathing or swallowing
  • Seizures

Some of the most dangerous side effects of oxycodone use are associated with the breathing problems that it may create. A markedly slowed respiratory rate can quickly turn life-threatening, especially in overdose situations.1

Rapid effects of oxycodone use are particularly dangerous when combined with alcohol or other respiratory depressing drugs. The combined effects of such drugs could result in much higher risk of harm or death, particularly from severe respiratory slowing and overdose.1

Oxycodone Overdose

Signs and symptoms of an oxycodone overdose include:1,2,4

White pill overdose

  • Abnormally constricted or dilated pupils.
  • Limp or weak muscles.
  • Difficulty breathing.
  • Slowed or stopped breathing.
  • Slow or stopped heartbeat.
  • Cyanosis (blue color of skin, fingernails, lips, or mouth area).
  • Cold, clammy skin.
  • Extreme drowsiness.
  • Dizziness.
  • Fainting.
  • Loss of consciousness or coma.

It’s important to take action immediately should you suspect an overdose. Learn how at Taking Action: How to Intervene During an Overdose.


Long-Term Dangers

Over time, oxycodone can have many different effects—both good and bad. For some, oxycodone is very effective at managing their pain, especially for those suffering from chronic pain.

On the other hand, oxycodone can have detrimental impact on both mental and physical health and, especially when misused, can increase one’s risk of developing significant physiological dependence and addiction.

Oxycodone can have detrimental impact on both mental and physical health and, especially when misused, can increase one’s risk of developing significant physiological dependence and addiction.

Some combination products present even further risk. Chronic or extended use of any medication combining oxycodone and acetaminophen in doses that exceed recommendations could increase the risk of severe liver damage. This risk is profoundly increased when an oxycodone/acetaminophen combination drug is abused simultaneously with alcohol.

Long-term prescription use presents risks that you should discuss with a doctor. Long-term recreational use often involves larger, more frequent doses that can lead to life-changing damage.


Development of Dependence

Oxycodone is classified as a Schedule II drug, meaning that it has been determined to have a high potential for abuse and dependence.

Physiological dependence on oxycodone involves adaptation to a persistently heightened presence of drug in one’s system. After some duration, certain physiologic processes are impeded when the drug isn’t available, and this can lead to tolerance. Tolerance, which can quickly develop with drugs like oxycodone, is a phenomenon that results in your requiring more and more of the drug to achieve desired effects, and this ramping up in drug use behavior can further drive the development of physiological dependence.


Withdrawal Treatment

Opioid detox ideally should be managed with the help of a medical team, as withdrawal symptoms can be extremely uncomfortable and may send the user back to using in avoidance of the symptoms.

There are several options for treating oxycodone dependence. The first phase of treatment will often involve medical detoxification. Opioid detox ideally should be managed with the help of a medical team, as withdrawal symptoms can be extremely uncomfortable and may send the user back to using in avoidance of the symptoms.

Oxycodone withdrawal symptoms may include:1,2,4

  • Irritability, anxiety, and depression.
  • Difficulty falling asleep or staying asleep.
  • Restlessness.
  • Muscle or joint aches and pains.
  • Muscle weakness.
  • Stomach cramps.
  • Nausea/vomiting.
  • Loss of appetite.
  • Diarrhea.
  • Increased heart and breathing rate.
  • Flu-like symptoms (sneezing, runny nose, watering eyes, sweating, chills).

Treatment following detox will usually involve behavioral counseling and, in some cases, medications. The combination of therapy and medications is referred to medication-assisted treatment (MAT). The combination of MAT with counseling and behavioral therapies provides an approach that treats the whole person.6 While there is a concern by some that MAT is simply replacing one drug with another, MAT is intended to help relieve the potentially-severe symptoms of acute opioid withdrawal with a carefully metered dose of treatment drug to allow focus on recovery and reduce the risk of relapse with the previously-misused drug.6

Opioid detox ideally should be managed with the help of a medical team, as withdrawal symptoms can be extremely uncomfortable and may send the user back to using in avoidance of the symptoms.

There are several FDA-approved drugs commonly used in treating opioid use disorders. These medications may include:6

  • Naltrexone: Blocks the activation of opioid receptors to decreases the likelihood of continued opioid misuse.
  • Methadone: A long-acting synthetic opioid that helps with withdrawal symptoms and relieves drug cravings.
  • Buprenorphine: A partial opioid agonist drug, buprenorphine can also stabilize someone in opioid withdrawal and decrease cravings.

Non-pharmacologic therapeutic approaches will serve as the basis for treating oxycodone addiction. One of the most common approaches is cognitive behavioral therapy, which aims to address issues that may have contributed to the development of or otherwise support an ongoing addiction, change maladaptive patterns of behavior, and help people develop coping and relapse prevention skills.


Sources

  1. U.S. National Library of Medicine. (2019). MedlinePlus: Oxycodone.
  2. National Institute on Drug Abuse. (2018). DrugFacts: Prescription Opioids.
  3. United States Drug Enforcement Administration. (n.d.). Drug Scheduling.
  4. Center for Substance Abuse Research (CESAR). (n.d.). Profile: Oxycodone.
  5. National Institute on Drug Abuse. (2019). Opioid Overdose Crisis.
  6. Substance Abuse and Mental Health Services Administration. (2019). Medication and Counseling Treatment.

Oxycodone Abuse

drugabuse_shutterstock-249289327-oxy-addict-FI

What Is Oxycodone?

Those addicted to prescription opiates like oxycodone are 40 times more likely to develop a heroin abuse problem.


?Oxycodone is a pain-relieving drug that is prescribed frequently to address moderate to severe pain. The substance is found alone and in combination with other pain relievers in a tablet form under several brand names including:

  • OxyContin – oxycodone; both immediate and controlled release formulations.
  • OxyIR and OxyFast – oxycodone immediate release.
  • Percodan – oxycodone and aspirin.
  • Percocet – oxycodone and acetaminophen.

Oxycodone is synthesized, in part, by chemical modification of opioid precursor molecules which are obtained from the opium poppy. Despite being manufactured in a lab, oxycodone impacts the user in ways similar to other legal and illegal opioids. Also, like other opiate and opioid drugs, oxycodone is capable of delivering a powerful high—rendering it a potential drug of abuse for an alarming number of individuals.
?
Additionally, oxycodone use will put someone at risk for developing tolerance and dependence. People are at risk of these phenomena even when the medication is taken as prescribed and, over time, addiction may be the end result. Those addicted to prescription opiates like oxycodone are 40 times more likely to develop a heroin abuse problem.


Signs and Symptoms

When someone uses oxycodone they will experience a range of signs and symptoms related to its activity at opioid receptors throughout the body—essentially depressing multiple functions throughout the body in a manner consistent with other opioid substances.
?
The signs will vary somewhat depending on the specific formulation of oxycodone. Controlled release OxyContin will provide signs that may be of lower intensity that last for an extended period – as long as 12 hours – whereas drugs like OxyIR and other immediate release variants can trigger stronger symptoms for a shorter duration. The specific dose and the method used to consume the substance will additionally influence the impact on an individual as well. Some of the ill-advised alternate routes of administration of oxycodone include crushing the tablets and either snorting them, or dissolving them in aqueous solution to be injected.
?

?

Desirable Effects

  • Perceptions of less physical pain.
  • Feelings of joy and happiness referred to as euphoria.
  • Release of muscular tension.
  • Mental calm or relaxation.

Unwanted Signs and Symptoms

  • Slowed or difficult breathing.
  • Constipation.
  • Nausea and vomiting.
  • Confusion.
  • Alternating periods of sleep and consciousness.

Potential Signs of Overdose

  • Constricted pupils, non-reactive to light.
  • Periods of extreme sedation; difficult to wake.
  • Lack of responsiveness (even to painful stimuli).
  • Respiratory arrest.
  • Cyanotic, or bluish appearance to lips, fingernails.

?

?


?


Video

The following video shows interviews with several people struggling with oxycodone addiction. The video illustrates the powerfully addictive nature of this drug.
?
Warning: this video contains some explicit language.
?



Credit: Vocativ

Effects of Oxycodone Abuse

Oxycodone is considered an opioid receptor agonist. One of the effects of this molecular interaction between the drug and receptor is in increasing dopamine activity in key brain regions.
?
Dopamine is an important neurotransmitter, in part responsible for the effects of the drug. Also, dopamine is associated with the brain’s reward system—meaning that people experiencing this type of dopaminergic activity will value the sensation and try to repeat it in the future. This leads to abuse of the drug and, as previously mentioned, some of the effects of abuse include tolerance, physiological dependence and, ultimately, addiction.
?

Tolerance

As the body continues to experience the effects of oxycodone, it begins to adjust to the levels so that the same amount will have a decreased effect.
?
This process is called tolerance.
?
With tolerance in place, the user will seek out more of the substance to achieve the desired effects of the drug.
?
People that begin using the drug in excess of prescribed amounts, using it for reasons other than prescribed, and using oxycodone that is not prescribed to them are displaying indicators of addiction.
?


?

Addiction

An addiction is likely to have taken hold at the point that a person continues to use a substance that they know is having an unwanted influence in their life. People addicted to oxycodone may:

  • Lie and steal to obtain more of the drug.
  • Display changed interests and personality characteristics.
  • Neglect other aspects of life while devoting more attention to obtaining and using oxycodone.
  • Try to acquire more of the substance by providing false medical histories to medical professionals, forging prescriptions or visiting multiple doctors to receive multiple prescriptions.
  • Continue use even when confronted by medical, interpersonal, legal or financial hardships.

?

Dependence and Withdrawal

Oxycodone addiction is related to dependence. Dependence is when the brain becomes so accustomed to the presence of – as well as physical and mental effects of a drug – that it cannot function normally without it. Once dependence is established, the user will need to maintain a supply of “oxy” or face withdrawal symptoms like:

  • Rebound pain, or increased pain sensitivity.
  • Restlessness and agitation.
  • Inability to sleep.
  • Gastrointestinal problems including appetite changes, diarrhea, nausea and vomiting.
  • Diaphoresis or excessive sweating.
  • Feeling cold and shivering.

Interestingly, people using other opiate or opioid substances – such as heroin – will sometimes use drugs containing oxycodone to reduce or eliminate their own withdrawal symptoms.
?


Oxycodone Abuse Treatment

The withdrawal symptoms of oxycodone can be quite uncomfortable and long lasting. Because of this, individuals attempting to quit oxycodone often benefit from seeking professional treatment.
?
Depending on the amount, frequency, and duration of time using oxycodone, a supervised detox may be recommended. Detoxification is the purposeful reduction of oxycodone in the body. This is often completed in an inpatient setting so that medical professionals can tend to the patient—ensuring safety and comfort.

drugabuse_shutterstock-292627211-therapist-welcoming-concurrent-ultram-350During this process, other medications may be prescribed to reduce cravings and other unpleasant symptoms.
?
When detox is complete, patients can be referred to a number of treatment options such as:

Residential rehab programs have the patient in recovery living at the treatment center for a period of time. Treatment program lengths vary, but tend to ranging from several weeks to several months—a period throughout which there is intensive focus on recovery throughout each day. Addiction therapy can be administered via outpatient programs as well. Outpatient addiction treatment is less time intensive than inpatient or residential programs, but typically involves daily or weekly (depending on level of need) counseling and education sessions to discuss recovery and learn methods to maintain abstinence.


Statistics on Oxycodone Abuse

Oxycodone has been a dangerous substance growing in popularity over the last 20 years. Consider these statistics from the Drug Enforcement Administration:

  • Nearly 60 million prescriptions for oxycodone-containing drugs were written in 2013.
  • In 2012, 16 million people reported abusing oxycodone in their lifetime, which is an increase of more than a million individuals compared with the previous year.
  • In 2011, oxycodone was responsible for more than 150,000 ER visits.
  • In 2009, law enforcement documented more oxycodone-related infractions than any other prescription drug.
Opioid Use Graph

To learn more, visit our page Oxycodone History and Statistics.


Teen Oxycodone Abuse

Because it is a legal prescription drug, many teens may view oxycodone as a harmless high.

Adults are not the only ones abusing forms of oxycodone like OxyContin. Since the prescription drug is found in many home medicine cabinets, it is easily accessible for teens. Frequently, teens are introduced to the drug by friends at school.
?
Because it is a legal prescription drug, many teens may view oxycodone as a harmless high. As mentioned above, however, many abusers – including teens – end up becoming addicted. As a crackdown on overprescribing practices and heightened attention to a growing prescription drug abuse issue continues to upregulate the price and decrease availability of drugs like oxycodone, young people are switching to illicit street drugs such as heroin at alarming rates.
?
It’s extremely important to talk to your teen about the dangers of prescription opiate abuse before it’s too late.


Resources, Articles and More Information

For more information, please see the following articles:

You can also hear from others by visiting our Forum today.


Sources:

Dark Web Oxy Dealer Could Get 20 Years in Prison

Frenchman Guy Vallerius – aka the “OxyMonster”- is accused of selling the illicit drugs oxycodone, cocaine, and methamphetamine over the dark web.

In May, Vallerius plead guilty to charges of conspiracy and money laundering; he’s facing at least 20 years in prison.

Finding the OxyMonster

Vallerius earned the nickname “OxyMonster” for his role as a moderator on Dream Market and TradeRoute, underground sites used in Europe and the United States for online transactions between buyers and sellers of illicit drugs. And these transactions are done without revealing either party’s real identities.

Authorities found Vallerius also had accounts on the notorious marketplaces Silk Road, Pandora, and Alpha Bay. Similar in nature to eBay, these sites can be used to sell products through a digital black market. Users can request technical assistance, resolve disputes, post reviews of vendors, and even take commissions from sales.

In January 2017, the US Drug Enforcement Agency (DEA) logged onto the Dream Market, where they were able to identify Vallerius’ true identity through his official capacity on the site. In a multi-agency approach involving the FBI, IRS, DEA, Homeland Security Investigations, and the U.S. Postal Inspection Service, they managed to track him down when he traveled from his home in France to Austin, Texas…where he was set to compete in the world beard-growing championship. (Can’t make this stuff up!)

He was arrested by U.S. authorities when he flew into Atlanta, Georgia. Special Agent Lilita Infante asked security officials from the Atlanta airport to detain Vallerius for questioning immediately upon arrival.

Security asked Vallerius for the passwords to his devices – cell phone, iPad, and laptop – as part of a routine inspection at the border. It was there that officials were able to search his devices and ultimately confirm his identify as the “OxyMonster.”

What Role Did Bitcoin Play?

The DEA also found evidence supporting his online drug business, including the Tor browser that allowed Vallerius to conceal his identity, as well as $500,000 in Bitcoin and profiles/ login details for these websites.

The OxyMonster initially hit the authorities’ radar thanks to Bitcoin. Agents were able to use Bitcoin to ascertain his true identity, track several incoming payments, and monitor outgoing deposits from accounts controlled by Vallerius.

Facing life in prison on an indictment, Vallerius and his attorney tried to keep his laptop out of evidence. When that failed, he entered a plea agreement.

 

 

Image Source: iStock

This Is Your Brain on Drugs

Read Time: 20 minutes

Readers of a certain age might remember the public service announcements from the late 1980s showing a frying egg with the tagline: “This is your brain on drugs.” Although these commercials were effective at delivering the message that drugs are harmful to the brain, the comparison is very simplistic, and some consider it no more than a “scare tactic”.1

For many people, addiction can be difficult to understand. After all, why do people risk so much, perhaps even their own lives, just to get high? Understanding how drugs affect the brain can help shed some light on this mystifying behavior.

Rather than “frying” all of the brain’s circuits at once, most drugs have very specific effects on the way the brain functions. This article is a brief survey of how various drugs affect the chemistry of the brain. This will help reveal why even though someone who is high on cocaine acts very differently than someone who is abusing heroin, both individuals may find it close to impossible to give up their drug habit, even if they desperately want to.
To understand how different drugs—with their diverse mechanisms of action and varied effects—can all lead to addiction in those who abuse them, it helps to know a little bit about how the brain works.

Neurotransmitters: the Messengers of the Brain

The brain is the most complex organ in the human body2 and has even been called “the most complex object in the known universe”.3 Around 100 billion individual nerve cells, or neurons, form a complex network that has over 100 trillion (100,000,000,000,000) connections, or synapses.
Information travels around this network 24 hours a day, allowing the brain to direct all the conscious and unconscious activities in the body. Everything from composing a symphony to deciding what to eat for dinner requires complex calculations carried out in the brain.

The brain uses chemicals called neurotransmitters to carry information from one neuron to another at junction points known as synapses. Neurotransmitter signaling is a crucial part of all the brain’s functions, and changes in neurotransmitter signaling can alter the way people think, feel, or perceive the world around them.

Important neurotransmitters in the human brain include:

  • Endorphins.
  • GABA.
  • Glutamate.
  • Norepinephrine.
  • Dopamine.
  • Serotonin.

Messages in the brain usually travel from the presynaptic neuron to the postsynaptic neuron. This occurs when the presynaptic neuron releases neurotransmitters into the synapse, which then attach to special proteins on the surface of the postsynaptic neuron called receptors.

 Neurotransmitters and receptors fit together in specific combinations like a lock and key. Other specialized proteins, called transporters, move neurotransmitters from the synapse back inside the neuron to turn off signaling.

Medications and illicit drugs that affect the brain alter neurotransmitter signaling in several different ways:

  • Imitating neurotransmitters—Drugs like opiates and marijuana have chemical structures that are similar to natural neurotransmitters. Because they fit into the receptors, these drugs act like neurotransmitter “imposters”.
  • Causing neurotransmitter release—Drugs like methamphetamine cause neurons to release neurotransmitters into synapses when they would normally be inactive.
  • Preventing neurotransmitter signals from switching off—Certain drugs, like cocaine and many antidepressants block transporters so that neurotransmitters stay in the synapse and continue to activate receptors longer than normal.

All of the different ways drugs affect neurotransmitters have the effect of changing the information being processed by the brain. Drugs prescribed by a doctor, such as painkillers or antidepressants, can be used to “correct” imbalances in brain chemistry that may contribute to an individual experiencing physical or emotional distress. On the other hand, those who abuse drugs are altering the way their brains work in ways that may be temporarily pleasurable, but potentially dangerous in both the short- and long-term.

Drugs Hijack Communication in the Brain

The brain is a finely tuned machine, and individuals who abuse drugs upset its delicate balance. These outside chemicals can flood or supplant the brain’s natural circuitry, resulting in effects ranging from confusion to death. Several classes of drugs and the neurotransmitter systems they affect are described below.

Stimulants

Stimulant use between 2015 &2016

Stimulants are drugs that increase the activity of a few specific neurotransmitters in the brain. Prescription stimulant medications are mainly used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. They function similarly to the illicitly abused stimulants like methamphetamine and cocaine, though, and all ultimately result in increased levels of the neurotransmitter dopamine in the brain. Stimulants are also sometimes referred to as “speed,” “uppers,” or “study drugs”. Well-known prescription stimulants include:

  • Methylphenidate (Ritalin).
  • Amphetamine + Dextroamphetamine (Adderall).
  • Lisdexamfetamine (Vyvanse).

Common illicitly abused stimulants include:
  • Methamphetamine (crystal meth).
  • Cocaine.

In the brain, dopamine is involved in several important behaviors including:
  • Arousal (the state of being awake or alert)—Boosting dopamine levels increases energy, wakefulness, and attention while decreasing dopamine causes fatigue and drowsiness.
  • Motor (movement) control—The death of dopamine-producing neurons in patients with Parkinson’s disease causes symptoms such as shaking, stiffness, and difficulty walking.
  • Reward and motivation—Activities that promote survival including eating food, having sex, socializing with friends, or hugging a puppy, all increase dopamine levels in the brain’s reward circuitry.

Dopamine is an important neurotransmitter for keeping people awake, focused, motivated, and coordinated. However, when someone abuses stimulants, the unnaturally elevated levels of dopamine in their brain can cause hyperactivity, insomnia, anxiety, increased risk taking, and euphoria.

Also, because these drugs unnaturally stimulate the brain’s reward and motivation circuitry, they are often abused in a “binge” pattern. In a binge, individuals will consume all of the available stimulants in one sitting, often neglecting eating or sleeping. Because the brain’s reward center is more strongly activated by stimulants than normal, healthy activities, the brain prioritizes drug use over almost any other behavior.

Opioids

Graphic of opioid use between 2013&2016Opioids are a group of natural and synthetic drugs that activate opioid receptors in the brain, spinal cord, and digestive tract. Opioid medications are also known as opiates or narcotics and are used as painkillers, cough suppressants, and anti-diarrhea medications. Well known opioids include:

  • Heroin.
  • Morphine.
  • Oxycodone (OxyContin).
  • Percocet.
  • Hydrocodone.

Normally, opioid receptors are activated by chemicals called endorphins. Endorphins are produced naturally in the brain and pituitary gland when the body is exposed to pain or other stressors such as an injury, childbirth, or intense exercise (runner’s high). In the brain, endorphin signaling has several roles, including:

  • Altering pain perception—Opioid signaling reduces pain sensations centrally – mitigating pain signaling within the brain without affecting the injury itself. This is different from many over-the-counter pain relievers such as aspirin or ibuprofen, which reduce swelling and inflammation at the site of the injury to achieve their analgesic effects.
  • Producing feelings of wellbeing—Endorphins cause more dopamine to be released in the reward and motivation circuits of the brain, which produces positive feelings. Opioid drugs mimic these endorphins but cause much more dopamine release in the reward pathways, creating a strong euphoric high.
  • Decreasing respiration—There are many opioid receptors in the areas of the brain stem that unconsciously control breathing. Endorphin signaling in these neurons helps to slow breathing in situations that might otherwise lead to hyperventilation – such as feeling pain or being under stress. Because opioids can activate these receptors more strongly than endorphins, individuals who overdose on these drugs could stop breathing and die.

The brain’s system of endorphins and opiate receptors is a survival tool that helps people in dangerous situations from being overcome by pain or fatigue. Medically, opioids are an important treatment for people who have severe pain that cannot be controlled with other medications.

Individuals who abuse illicit or prescription opioids do so because these drugs have unnaturally large effects on the opioid system, including the reward pathway. Because opioid use can initiate much higher dopamine release in the nucleus accumbens rather than endorphins, they produce a euphoric high that is difficult to achieve through natural means.
Brain reward pathways

By simply swallowing, snorting, or injecting these drugs, abusers can get all the feel-good effects of endorphins without having to break a bone or run a marathon. Also, because opioid users can control how much and how often they take the drug, they can get a more intense, longer-lasting high than is possible with natural endorphins.

Depressants

Depressent use comparison between 2015&2016

Many different types of legal and illegal drugs are classified as depressants. Dependent on the specific type of depressant medication, the prescription pharmaceuticals in this broad class may also be referred to as sedatives, tranquilizers, and hypnotics.

Substances classified as depressants include:

  • Phenobarbital (Luminal, goof balls).
  • Amobarbital (blue devils).
  • Secobarbital (Seconal, red devils).
  • Tuinal (Secobarbital + Amobarbital, rainbows)

Benzodiazepines—Also known as benzos, these drugs are used to treat anxiety and panic attacks, as well as to manage acute seizures in emergency situations. Examples include:

  • Diazepam (Valium).
  • Alprazolam (Xanax).
  • Lorazepam (Ativan).

Non-benzodiazepine sedatives—Often referred to as “z-drugs” because many of the drug names begin with the letter “z,” these medications are considered to be safer (milder effects and lower addictive potential) than benzodiazepines and are used to treat insomnia. Examples include:

  • Zolpidem (Ambien).
  • Eszopiclone (Lunesta).
  • Zaleplon (Sonata).

Although these different drugs are very different chemically, all of them ultimately increase the activity of a neurotransmitter known as gamma-aminobutyric acid (GABA). Alcohol, barbiturates, and benzodiazepines all bind at different sites on the surface of the GABA receptor to activate this type of inhibitory signaling.

Activated GABA receptors inhibit, or decrease, the firing of individual neurons, and GABA signaling is critical to maintaining a healthy level of brain activity. Insufficient levels of GABA can cause restlessness, insomnia, anxiety, and seizures due to abnormally high levels of neural overactivity.

Many people abuse sedatives because they reduce anxiety, help them to relax and, in some cases, to help them sleep. These drugs can also indirectly affect the reward pathway and cause a euphoric high, especially when taken in high doses.

However, excessive GABA signaling from depressant abuse can cause problems if brain activity is reduced too much. These negative side effects include:

  • Difficulty breathing
  • Slurred speech.
  • Memory loss.

In extreme cases, critical functions such as breathing might stop, causing death.

Cannabinoids

Marijuana use between to15&2016Cannabinoids are chemicals that bind with cannabinoid receptors in the brain. They are found naturally (in marijuana or cannabis), but may also be laboratory-made (synthetic cannabinoids, Spice/K2).

Although illegal in many parts of the country under federal law, cannabinoids are very popular recreational drugs that produce effects such as:

  • A euphoric high.
  • Distortion of perception.
  • Memory impairment.

Cannabinoid receptors were first discovered in the 1980s using tetrahydrocannabinol (THC) and other cannabinoids found in the marijuana plant. It took another decade of research before scientists discovered the natural brain chemical counterparts – called endocannabinoids – that naturally bind to these receptors. In 1992, researchers discovered the first endocannabinoid in the brains of pigs, which they called “anandamide” from the Sanskrit word for bliss.5

Endocannabinoid signaling is complex and slightly unusual because these are retrograde neurotransmitters. That means endocannabinoids are released by the postsynaptic neuron and their receptors are on the presynaptic neuron, so they send information in the reverse direction of most neurotransmitters.

Although scientists are still learning precisely what these chemicals do, they are involved in many brain processes including:6

  • Energy balance—Endocannabinoid signaling is important in brain pathways controlling hunger and energy metabolism in the body.
  • Sensory perception—Many brain cells in the areas of the cortex that process sight, sound, hearing, and touch have cannabinoid receptors.
  • Learning and memory—The hippocampus, an area involved in learning and forming short-term memories, is rich in cannabinoid receptors.
  • Coordination—Endocannabinoids are important for the function of the cerebellum and basal ganglia, areas of the brain involved in balance and motor control.

In the brain, endocannabinoids are created only in specific neurons where they are needed and only for the amount of time they are needed, which can be as short as a few minutes.7 In contrast, THC and other cannabinoid drugs are ingested in relatively large amounts and indiscriminately activate receptors all over the brain.

This is why natural endocannabinoids are essential for forming clear memories and maintaining a normal appetite, while cannabis abusers often find themselves craving junk food and forgetting mundane things like where they parked.

Why Do Drugs Feel Good?

Brain reward pathways

Dopamine levels increase in response to survival-related things like food. Drugs manipulate this function to cause increased dopamine signaling.

Most addictive drugs produce an intense euphoric high that abusers seek. This is because these drugs either directly or indirectly increase dopamine signaling in the limbic system, which includes a part of the brain that is involved with reward and motivation—the nucleus accumbens.

Behaviors that improve the chances of survival, like eating, having sex, and socializing with friends cause an increase in dopamine levels in this area. This increase in dopamine feels good and motivates people to repeat those actions.

Stimulants flood the whole brain with dopamine, including the nucleus accumbens, which causes intense pleasure in abusers and motivates them to repeat this behavior. Likewise, studies have shown that drugs that affect other neurotransmitter systems, such as alcohol,8 opioids,9 and cannabinoids,10 also cause dopamine levels to rise in regions of the brain involved in pleasure, especially the nucleus accumbens.

Experiments in animals have shown that drugs such as alcohol, amphetamine, cocaine, and morphine cause 2 to 10 times more dopamine to be released in the nucleus accumbens than natural rewards.11 This means that the motivation to use these drugs repeatedly is very strong, even if an individual knows that drug use is unhealthy and causes other problems such as losing a job or getting arrested. It also means that drug use takes priority over the desire for other healthy activities that originally provided a feeling of satisfaction or happiness.

Brain chemistry in the nucleus accumbens also shows the link between addictions to drugs and behavioral addictions. Research has shown, for example, that dopamine levels rise in the reward center when individuals with gambling addictions make bets, and that drugs that restore the normal neurotransmitter balance in the nucleus accumbens reduce both cocaine cravings in drug addicts and gambling urges in compulsive gamblers.12

How Drugs Change the Brain

Check out this awesome podcast all about how drugs work. What really happens when someone takes a drug? What’s going on in their brain to produce such wild effects? And what’s so weird about hallucinogens? Can your brain ever recover from the damage? Tune in to find out!

The brain and its networks have the ability to change and adapt, a property called plasticity. Plasticity is important for normal brain development and learning, as well as recovering from brain injuries and strokes. Plasticity is also the reason that long-term exposure to drugs produces abnormal changes in the brain.

The brain will attempt to correct network activity that is much higher or much lower than normal levels. If an individual is regularly flooding their brain with opioid or endocannabinoid signaling by abusing drugs, the brain makes attempts to counteract these changes and bring them back to natural levels. Like a thermostat in a house, which works to keep the temperature from getting too hot or cold, plasticity allows the brain to keep neurotransmitter signaling from getting far from normal levels.

This adaptation by the brain leads to 2 important consequences of drug abuse: tolerance and withdrawal.13

Tolerance

Individuals who abuse drugs often find that they need to take larger and larger doses of a drug over time to feel the same high. This is known as tolerance, and it is the result of the brain adapting to counteract the effects of abnormal neurotransmitter signaling caused by the drug.

One example of this is seen with long-term opioid abuse, which results in abnormally high opioid receptor signaling. The brain attempts to compensate for this imbalance by reducing the number of opioid receptors on the surface of neurons.14 Over time, this “pruning back” of receptors results in a reduced potential to experience the full spectrum of pain relief and euphoria that these drugs produce in a more “drug naïve” individual. Interestingly, circuits that control some of the more negative effects of opioids—including respiratory depression—do not develop tolerance as quickly. This phenomenon is known as asymmetric tolerance.15

An opioid abuser who develops asymmetric tolerance is at great risk for overdose. Why? When an individual has become tolerant to the effects on the reward pathways, it will take a lot to feel high. Meanwhile, the area of the brainstem that controls breathing has yet to develop an equal tolerance level, so there is a high risk of overdose and respiratory arrest.

Withdrawal

People who regularly abuse a drug may find that they feel sick or experience other negative symptoms when they stop using the drug suddenly. This phenomenon is referred to as a withdrawal syndrome. Many of the symptoms of withdrawal are caused by the same brain adaptations that lead to tolerance.

The brain of a person who abuses sedatives such as alcohol for months or years has an imbalance caused by too much GABA receptor activation. GABA signaling reduces overall neuron firing and slows down many networks in the brain. The brain tries to counteract this imbalance by decreasing the baseline amount of GABA being released as well as by increasing glutamate signaling to boost overall neuron activity.16 This adaptation works well as long as the person keeps using alcohol or sedatives. Logistically, this cannot occur indefinitely. Inevitably, the onset of withdrawal arrives at the point which the abuser stops taking these drugs for a certain amount of time. Without them, the brain will be over-stimulated – potentially resulting in anxiety, delirium, and even seizures. (This is the main reason that attempts to detox from alcohol and sedatives should take place under close medical supervision).

The Addiction Trap

Graphic of people suffering from substance use disorderThese drug-induced changes in the brain eventually lead to addiction. Individuals who have a drug addiction may have a variety of symptoms, but they all share the key feature of this condition, which is that they use their drug of choice compulsively despite experiencing serious negative consequences from their drug use such as being arrested, being fired from a job, or losing important relationships.

Avoidance of withdrawal symptoms can partially explain why it can be especially difficult for addicted individuals to stop taking drugs on their own.

However, it is adaptations in the nucleus accumbens and the motivation circuits of the brain that are thought to play the biggest part in the development of addiction. Every time an abuser gets high, they bombard the neurons in the reward pathway with unnaturally high levels of dopamine. Just as in other brain regions, these neurons adapt to counteract the repeated overstimulation.

Eventually, the brain adjusts to the intense rewards of drugs, and natural rewards such as food and friends no longer produce a pleasurable response in a drug abuser’s brain (a phenomenon referred to as “anhedonia”). The anticipation of obtaining and using drugs (wanting and craving) becomes the main source of excitement and produces a flow of dopamine that narrows that individual’s focus and excitement to drug use and little else.

This is why many people with addictions often feel life is pointless and empty. Individuals who have reached this stage may also stop feeling good at all when taking drugs; instead, they need the substance in order to feel “normal”.

Once this level of brain adaptation has been reached, taking drugs is no longer truly a choice. The addicted person will be driven to continue their habit as if it is necessary for survival, and drugs will seem more important than almost anything else. The effects of pleasure and motivation, powerful tools to help human survival, have been hijacked for a destructive and unhealthy purpose.

These physical changes in the brain support the idea that addiction is, in fact, a disease and not simply a moral failing. What is known today about the way drugs affect the brain also suggests why the 1980s “Just Say No” anti-drug campaign was not especially successful in preventing drug abuse.17

While using drugs may start out as a choice, physiologic changes in the brain caused by the drug use makes it difficult, if not impossible, for someone who is addicted to make rational decisions about their drug use. Also, individuals decide to first use drugs for many reasons; some want to get high, but others give in to social pressures or are prescribed opioid painkillers by their doctors and begin to misuse them.

By presenting addiction as an issue of morals or willpower, the “Just Say No” campaign did not offer practical tools for people who had already started down the path of drug dependency. It also created a stigma around addiction by sending the message that people could simply stop taking drugs if they wanted to. It is difficult to imagine that anyone really wants to ruin their lives with their drug use, and understanding how drugs affect the reward and motivation circuits of the brain shows us how an individual can lose the power to say “just say no”.

Instead of stigmatizing addiction, we can move forward by increasing the understanding of drug use on the brain and highlighting the ways that someone battling addiction can find recovery and sobriety in the long term.

Recovery

People who have received addiction treatment

Addiction does not have to be the end of the road for anyone. There are many drug detoxification and rehabilitation programs available all over the country to help people break out of the addiction trap.

Knowing how drugs affect the brain has provided healthcare professionals with tools that help break the hold of addiction. Benzodiazepines are used therapeutically to prevent life-threatening seizures in people who are addicted to alcohol, while medications like methadone and buprenorphine soothe intense withdrawal symptoms and block the high that comes from abusing opiates, serving as effective tools in recovery maintenance.

Although a happy, productive, drug-free life is possible for those who have become addicted to drugs, the brain adaptations caused by drug and alcohol abuse can be especially persistent.

Most symptoms of withdrawal last only a few days or weeks, but some effects including anxiety, fatigue, insomnia, and anhedonia (absence of pleasure) may last for months or even years. These symptoms are known as post-acute withdrawal syndrome (PAWS) and are thought to be caused by the slow process of the brain undoing drug-induced adaptations.

Some brain changes in the reward and motivation circuitry seem to be permanently affected by addiction.18 Though the vast majority of people recovering from addiction will soon be able to feel pleasure and enjoy life as much as ever, they may always be at risk for relapsing. It seems the brain never completely unlearns the rewarding aspects of drug abuse, so lifelong vigilance is important to prevent relapse.

References

  1. Alexander, E. (2000). Famous fried eggs: Students debate effectiveness, accuracy of well-known anti-drug commercial. CNNfyi.com.
  2. National Institute on Drug Abuse. (2007, July 2014). Drugs, Brains, and Behavior: The Science of Addiction. NIDA Notes.
  3. Kock, C., & Kuhl, P. (2013). Decoding ‘the Most Complex Object in the Universe’/Interviewer: I. Flatow. Science Friday, National Public Radio.
  4. Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health.
  5. Devane, W. A., Hanus, L., Breuer, A., Pertwee, R. G., Stevenson, L. A., Griffin, G., . . . Mechoulam, R. (1992). Isolation and structure of a brain constituent that binds to the cannabinoid receptor. Science, 258(5090), 1946-1949.
  6. Griffing, G. T., & Thai, A. (2015). Endocannabinoids.
  7. Cravatt, B. F., Demarest, K., Patricelli, M. P., Bracey, M. H., Giang, D. K., Martin, B. R., & Lichtman, A. H. (2001). Supersensitivity to anandamide and enhanced endogenous cannabinoid signaling in mice lacking fatty acid amide hydrolase. Proc Natl Acad Sci U S A, 98(16), 9371-9376.
  8. Boileau, I., Assaad, J. M., Pihl, R. O., Benkelfat, C., Leyton, M., Diksic, M., . . . Dagher, A. (2003). Alcohol promotes dopamine release in the human nucleus accumbens. Synapse, 49(4), 226-231.
  9. Gratton, A. (1996). In vivo analysis of the role of dopamine in stimulant and opiate self-administration. J Psychiatry Neurosci, 21(4), 264-279.
  10. Gilman, J. M., Kuster, J. K., Lee, S., Lee, M. J., Kim, B. W., Makris, N., . . . Breiter, H. C. (2014). Cannabis use is quantitatively associated with nucleus accumbens and amygdala abnormalities in young adult recreational users. J Neurosci, 34(16), 5529-5538.
  11. Di Chiara, G., & Imperato, A. (1988). Drugs abused by humans preferentially increase synaptic dopamine concentrations in the mesolimbic system of freely moving rats. Proc Natl Acad Sci U S A, 85(14), 5274-5278.
  12. Grant, J. E., Potenza, M. N., Weinstein, A., & Gorelick, D. A. (2010). Introduction to behavioral addictions. Am J Drug Alcohol Abuse, 36(5), 233-241.
  13. Koob, G. F., & Le Moal, M. (2001). Drug addiction, dysregulation of reward, and allostasis. Neuropsychopharmacology, 24(2), 97-129.
  14. DuPen, A., Shen, D., & Ersek, M. (2007). Mechanisms of opioid-induced tolerance and hyperalgesia. Pain Manag Nurs, 8(3), 113-121.
  15. Dumas, E. O., & Pollack, G. M. (2008). Opioid tolerance development: a pharmacokinetic/pharmacodynamic perspective. AAPS J, 10(4), 537-551.
  16. Mukherjee, S., Das, S. K., Vaidyanathan, K., & Vasudevan, D. M. (2008). Consequences of alcohol consumption on neurotransmitters -an overview. Curr Neurovasc Res, 5(4), 266-272.
  17. Scott O. Lilienfeld, & Arkowitz, H. (2014). Why “Just Say No” Doesn’t Work. Scientific American.
  18. Cornish, J. L., & Kalivas, P. W. (2000). Glutamate transmission in the nucleus accumbens mediates relapse in cocaine addiction. J Neurosci, 20(15), RC89.