Oxycodone Addiction: Signs, Effects, and Treatment

Oxycodone is a prescription opioid used to treat pain, and like many other prescription opioids, is often misused for its euphoric and pain-relieving effects.² In 2020, more than 9 million Americans misused opioid prescription painkillers, with more than 3 million misusing oxycodone.¹ Over 2 million people had an addiction to prescription opioids in 2020.¹

Understanding more about what oxycodone is and the potential for oxycodone addiction may help you or a loved one recognize when it’s time to seek help for oxycodone addiction. This article will explain:

• What oxycodone is and its addictive potential.
• Signs of oxycodone addiction.
• Oxycodone’s effects.
• Risk of overdose.
• What oxycodone withdrawal is.
• Treatment for oxycodone addiction.

What Is Oxycodone?

Oxycodone is a semi-synthetic opioid prescribed to treat moderate to severe pain, typically from injuries, surgery, cancer, and chronic pain. ^{2, 3, 4} It is available in immediate-release capsules (OxylR, OxyFast), extended-release tablets (OxyContin), and in liquid form, and it can be combined with other painkillers such as aspirin (Percodan) or acetaminophen (Roxicet, Percocet).^{2, 3} Nearly 50 million prescriptions of oxycodone were sold in 2018.³

Oxycodone products are labeled as Schedule II controlled substances, meaning that they have valid medical uses, but also a high potential for misuse and dependence.^{2, 5} Misuse can involve taking medication that isn’t prescribed to you, taking larger doses, using it more frequently or for longer than prescribed, or taking it in a manner different than prescribed.⁶

Chewing, crushing and snorting pills, dissolving them in water to inject them intravenously, or heating them and breathing in the vapors are common methods of misuse.^{2, 3} This drug may be referred to by street names such as:^{2, 3}

• OC.
• OX.
• Oxy.
• Roxy.
• Perc.
• Oxycotton.

Why Is Oxycodone Addictive?

Oxycodone has a high potential for misuse, which, over time, can develop into an opioid use disorder, the clinical diagnosis of addiction.^{3, 6} The addictive potential stems from how it works in the brain.

Opioids bind to receptors throughout the body and brain, leading to changes in how the body processes pain, releasing a flood of dopamine, which causes feelings of euphoria and relaxation. These pleasurable experiences reinforce the repeated use of oxycodone and may contribute to the development of an oxycodone addiction.^{4, 6}

Addiction is a chronic condition that causes changes to how the brain works, leading to a compulsive need to use, impaired impulse control, and difficulty stopping even after experiencing negative outcomes due to using.^{6, 7}

Signs of Oxycodone Addiction

Opioid use disorder is a chronic, progressive disease that can affect you physically and mentally, and change your behavior. There are characteristic symptoms of an OUD, that a medical or psychiatric professional can use to formally diagnose a person.

If you’ve experienced 2 or more of these symptoms of an OUD in the past 12 months, you may consider getting help for opioid misuse:^{4, 8, 9}

• Developing a tolerance (needing more oxycodone to get the same desired effect)
• Having strong cravings to use oxycodone
• Experiencing withdrawal symptoms when oxycodone use is stopped or dramatically cut back
• Having trouble completing important tasks at home, school, or work
• Inability to stop using oxycodone even after it has caused or contributed to a physical or mental health problem
• Inability to stop using oxycodone even after it has created or worsened issues in relationships with others
• Quitting or stepping back from important activities because they get in the way of oxycodone use
• Spending a lot of time engaging in activities to get, use, or manage aftereffects from oxycodone use
• Using larger amounts or taking oxycodone for longer than originally planned
• Using oxycodone in potentially dangerous situations (operating a motor vehicle)
• Wanting or trying to cut down or stop using oxycodone without success

OUD can range from mild to severe, and more symptoms mean a more severe OUD.⁹ Having an OUD can make it difficult to function normally, and often affects multiple areas of a person’s life.⁴ In addition, brain changes and cravings can increase the risk of relapse, and addiction can put a person at higher risk for physical or mental health issues.^{4, 7}

American Addiction Centers has helped thousands recover from addiction and we can help you or your loved one too. Check your insurance to find out instantly if your insurance provider may be able to cover all or part of the cost of rehab and associated therapies. You can also sign up 24/7 text support for addiction questions at your convenience.

Effects of Oxycodone Use

In addition to the desired euphoric and pain-relieving effects, oxycodone side effects can be uncomfortable and potentially dangerous. While it is commonly misused to feel euphoria and relaxation, or for pain relief, it can also have negative effects in the short- and long-term.² Some negative short-term side effects of oxycodone can include:

• Confusion.⁴
• Constipation.^{2, 3}
• Nausea.^{4, 10}
• Feeling lightheaded or dizzy.¹¹
• Headaches.¹¹
• Itchiness.¹¹
• Sleepiness.^{2, 3}
• Slowed or stopped breathing.^{2, 3}
• Vomiting.¹¹

Some of the effects of long-term oxycodone misuse can include:

• Greater likelihood of contracting blood-borne diseases, such as HIV or hepatitis if it is injected.¹⁰
• Increased risk of developing an OUD.^{6, 10}
• Liver damage from acetaminophen-containing formulations.^{2, 3}

Certain populations are more at risk of developing harmful effects from misuse of oxycodone. Older adults are more likely to experience drug interactions due to slowed metabolization of medications and other drugs, especially if they take a variety of prescription medications.^{6, 10}

Pregnant women who misuse oxycodone are more likely to experience miscarriage, babies with low birth weight, and babies born with a physical dependence on opioids, leading to withdrawal symptoms shortly after birth.^{6, 10}

Oxycodone Overdose

An opioid overdose, such as one that can occur with oxycodone, is when a person takes enough of a substance to cause symptoms that may be fatal.^{6, 12}

Opioids suppress breathing, and an oxycodone overdose typically causes the breathing to slow to dangerous levels or stop completely.^{6, 12} When this happens, the brain doesn’t get enough oxygen, which can cause permanent brain damage, coma, and death.^{6, 12}

Prescription opioid overdose is an ongoing issue in the United States, which averaged nearly 40 deaths per day in 2019.¹³ Nearly 50,000 people died from opioid overdose in 2019, more than 70% of all overdose deaths.¹⁴ Prescription opioids were associated with almost 30% of all fatal opioid overdoses in 2019.¹³

Common signs of an overdose on prescription opioids include:

• Body going limp.^{15, 16}
• Breathing that is slow, shallow, or has stopped.^{2, 3}
• Confusion.²
• Excessive sleepiness, loss of consciousness, or coma.^{2, 15}
• Low blood pressure.³
• Making choking or gurgling noises.^{15, 16}
• Muscle weakness.^{2, 3}
• Skin that is clammy, cold, pale, or blue.^{2, 15}
• Slowed heart rate.²
• Tiny pupils.^{2, 12}

Risk Factors for Oxycodone Overdose

An oxycodone overdose can happen to anyone, but some risk factors can make an overdose more likely. These factors play a role in how strongly oxycodone affects you. Common risk factors for prescription opioid overdose include:

• Being over 65 years of age.¹⁵
• Combining opioids with other drugs or medications, especially depressants.^{12, 15, 17}
• Getting illicit oxycodone pills, which may include other substances.¹⁷
• Having one or more mental health disorders.¹²
• History of overdose.¹⁷
• Injecting opioids.¹²
• Misusing opioids or having an OUD.^{10, 12}
• Some types of medical conditions, including HIV, kidney problems, liver disease, or respiratory problems.^{12, 15}
• Taking high doses, especially if they are not prescribed.^{12, 15}
• Using after a period of abstinence where tolerance has decreased.^{12, 17}

Treating Oxycodone Overdose

If you suspect that someone might be having an overdose, there are some steps you can take to help. The first thing you should do is to call 911 immediately, and request medical attention.⁶

Naloxone (Narcan) is an opioid antagonist medication that binds to opioid receptors to rapidly reverse the effects of an opioid overdose and block opioids from having an effect. In other words, administering naloxone to someone with opioids in their system will put them into opioid withdrawal.^{4, 6} This medication can often be obtained through local pharmacies, although this can vary depending on your state, and is available as a nasal spray or an injection.^{4, 6}

Even if you administer naloxone, it is still important to get medical help, since the effects of naloxone can wear off before the effects of the opioid.¹⁸

After you have called 911 and administered naloxone, try to keep the person conscious and breathing.^{15, 16} If the person is unconscious, turn them so that they are laying on their side to keep their airway clear.^{15, 16} Finally, stay with the person until paramedics get there.^{15, 16}

Risks of Mixing Oxycodone and Other Drugs

Using more than one substance at a time is known as polysubstance use, and can involve prescription opioids, other medications, illicit drugs, or alcohol.¹⁹ Polysubstance use can increase the effects of each substance and can have unpredictable or even fatal results.¹⁹ This can occur with prescribed medications as well, making this especially risky for older adults or people who take multiple medications.¹⁶

Some types of substances that are dangerous to combine with oxycodone include:

• Alcohol, which can increase the effects of both substances, leading to heart rate slowing, organ damage, and respiratory depression.^{10, 19}
• Benzodiazepines, which can increase the depressant effects and significantly increase overdose risk.^{12, 19}
• Muscle relaxers, which can increase the depressant effects.¹⁶
• Sleep medications (Ambien, Lunesta), which can increase the depressant effects.¹⁶
• Stimulants (Adderall, Ritalin, cocaine, crystal meth), which can make it difficult to realize how the substances are impacting you, raising the risk for overdose.¹⁹

Oxycodone Withdrawal

If you stop using oxycodone when you are dependent, uncomfortable withdrawal symptoms occur.⁴

Dependence is a physiological adaptation of the body to a substance, wherein the body becomes so used to the drug being present in the system that when the individual cuts back on their use or quits, withdrawal symptoms emerge. In other words, a person feels like they need this drug to feel and function normally. With significant levels of physiological dependence, a person may continue to compulsively drink or use drugs to avoid unwanted withdrawal symptoms.⁶

There can be potentially dangerous complications associated with opioid withdrawal, so medically supervised withdrawal is recommended to identify these issues early and address them.²⁰ Opioid withdrawal generally begins within 6 to 12 hours of last use, with symptoms peaking within 3 days and slowly improving over the course of a week.⁸

Prescription opioid withdrawal commonly includes:^{4, 6, 8, 11, 20}

• Anxiety.
• Chills.
• Muscle pain.
• Depressed mood.
• Diarrhea and nausea.
• Dilated pupils.
• Fever.
• Increased pulse, blood pressure, body temperature, and breathing.
• Insomnia.
• Irritability.
• Strong cravings.
• Sweating.

Oxycodone Addiction Treatment

Although opioid use disorder itself is incurable, signs and symptoms can be treated effectively and as a result, the individual can live a healthy and meaningful life. Treatment should ideally be individualized for your unique needs, addressing all the ways in which addiction has affected your life, including physically, mentally, socially, legally, financially, and professionally.⁷

This is often done by using a combination of behavioral therapy (cognitive behavioral therapy, contingency management, community reinforcement, and family behavior therapy), medication, and other treatment interventions.^{4, 7}

Available treatment settings include:

• Detox, where you go through withdrawal in a supervised setting.⁷
• Inpatient, where you stay at a facility for intensive treatment.⁷
• Outpatient, where you attend scheduled appointments regularly while living at home.⁷

Medications are often used as part of the treatment process. Methadone or buprenorphine can be used to manage or ease symptoms of withdrawal during the detox process and can also be used as long-term maintenance to help with cravings and urges.⁴