Oxycodone is an opioid medication that’s sold under the brand names OxyContin and Roxicodone. Oxycodone is a semi-synthetic opioid, which means it isn’t found in nature but instead is created with naturally occurring chemicals. In this case, oxycodone is made using codeine, an opiate found in opium poppy plants. The drug is primarily used to treat patients’ moderate-to-severe pain symptoms.
It may be used in hospital settings, or you may take it home with a prescription. It’s typically used to treat acute pain caused by injuries and surgeries. However, it may also be used to manage chronic pain symptoms, which can increase a patient’s risk for tolerance, dependence, or addiction. Oxycodone, typically taken by mouth, is available in immediate and extended-release formulations. The drug, first created in 1916, is a pain reliever used globally. In the United States, there were 14 million-plus oxycodone prescriptions in 2019, making it the 49th most common prescription drug in the country.
Oxycodone has a significant potential for abuse, and it’s been implicated as a factor in the opioid crisis during the past several years. Abuse and long-term use can cause opioid use disorders (OUDs). Long-term use and abuse can also lead to tolerance, which can complicate treatment and lead to other problems.
How Oxycodone Affects the Brain
As an opioid, oxycodone can have profound effects on the brain and body. Since it’s a pain reliever, oxycodone interacts with your body’s pain messaging system. When you experience pain, pain receptors called nociceptors send signals to your spine and then to your brain via a chemical messaging system. This system involves sending and receiving pain signals from one nerve cell to another.
A naturally occurring chemical called endorphin binds to opioid receptors on your nerve cells and blocks the pain signals from being sent and received. This is important in mitigating pain symptoms and allowing you to recover from strain and injury. However, pain that is severe enough may be too much for endorphins to remedy on their own. Oxycodone is chemically similar to endorphins, so it can bind to opioid receptors and activate them in the same way. However, prescription opioids like oxycodone are more potent than endorphins, and they have more profound effects.
Oxycodone can cause relief from even severe pain symptoms. It can also cause sedation, drowsiness, and euphoria. The euphoric feelings may come from another function of oxycodone in the brain. Opioids can elevate dopamine levels. Dopamine is a natural chemical responsible for rewarding feelings of pleasure. They are typically released when you do something you enjoy, like eating a good meal or getting into a warm bed at the end of the day.
Dopamine is also tied to your brain’s reward center, which is designed to motivate you to repeat important tasks, just like pain is intended to encourage you to avoid unhealthy activities and damage. Oxycodone’s euphoric effects and other opioids can contribute to the development of an opioid use disorder.
Oxycodone Tolerance Development
Oxycodone use can come with several side effects, including tolerance. Tolerance is a common side effect of many prescription drugs. The term “tolerance” describes a person’s reduced sensitivity to a drug after repeated use. It presents a problem for doctors and patients who are seeking long-term treatment options for persistent pain symptoms. If you develop tolerance while you’re still experiencing pain symptoms, you may have trouble finding relief for pain symptoms.
Tolerance occurs because of physiological changes in the brain that come with repeated opioid use. Your brain is very adaptable and can respond to consistent chemical changes in your body, like changes caused by frequent drug use. In order to adapt to oxycodone’s constant presence in your system, your brain will change its native chemistry to balance around the opioid.
This can include increased pain sensitivity and decreased sensitivity to opioids. Your brain chemistry can adapt in many ways. One way your tolerance may grow is if your body responds to the drug by reducing the number of opioid receptors and increasing the number of pain receptors in the brain.
To you, tolerance will feel like your typical dose of oxycodone is less effective than it once was. If you continue to take the drug, you may notice that its effects become more ineffective over time. If you increase your dose to compensate for the diminishing effects, your tolerance may continue to get worse. You may find that you need heavier doses to maintain the drug’s pain-relieving effects. Opioid tolerance can grow extremely high. An opioid-tolerant person may be able to take a dose that would be dangerous to a person without tolerance.
OxyContin doses typically start at 10 mg (milligrams) per day. It’s generally recommended to use the smallest effective dose possible. If you need 30 mg of oxycodone a day or more, you are considered opioid-tolerant.
What Are the Effects of Oxycodone Tolerance?
Oxycodone tolerance could also build your tolerance to other opioids. One of the most significant problems associated with opioid tolerance is the fact that you will have fewer pain relief options. Opioids may be the most effective medication when it comes to stopping pain symptoms. In many cases, they are reserved for people who have tried other options with limited success. If opioids are no longer effective, it may be challenging to find relief from the pain until the underlying cause is treated.
Oxycodone Dependence and Withdrawal
Tolerance is also a common sign of developing chemical dependence. If you notice that a drug is less and less potent, your body may be adapting to include the opioid in your balanced brain chemistry. If you stop using the drug after becoming dependent, you will experience withdrawal symptoms. Opioid withdrawal isn’t known to be life-threatening, but it is very uncomfortable. Opioid withdrawal symptoms are similar to the flu, but they reportedly feel like a particularly bad case of the flu with vomiting, fever, nausea, sweating, fatigue, agitation, runny nose, and teary eyes. On top of these flu-like symptoms, you may also experience powerful drug cravings. Opioid withdrawal can be dangerous if a rapid loss of fluids leads to dehydration, just like the flu.
Increased Risk of Opioid Overdose
Opioid tolerance can be dangerous, especially when you return to using a drug after a period of abstinence. While tolerance can grow over time, it can also go away if you take a break from the drug. Opioids can cause dangerous overdoses because tolerance gives users a false sense of what they can handle. Deadly overdoses often occur after a period of abstinence.
For instance, if you’ve become opioid-tolerant and quit because of a medical procedure, jail time, or just to get off the drug, your tolerance will diminish quickly over a few days to weeks. If you return to your typical dose, you could experience a life-threatening overdose. Opioid overdose symptoms include sedation, passing out, inability to maintain consciousness, and respiratory depression. Dangerous cases of opioid overdose often involve slowed or stopped breathing, coma, rapid muscle breakdown, and brain damage.
Can You Reverse Oxycodone Tolerance?
Yes, oxycodone tolerance can be reversed by stopping use of the drug. This is commonly called a tolerance break, and your doctor or pharmacist may recommend it to avoid or address tolerance. An oxycodone tolerance break will allow your body to readjust to your brain’s chemistry without the drug. When you start using the drug again, your body’s sensitivity to the drug’s effects will be back to normal.
Unfortunately, an oxycodone break will likely mean you will have to take a break from other opioids as well. This can pose a problem if you are dealing with pain symptoms, especially if you experience chronic pain. If you can manage pain in other ways, it may be worth it to reserve oxycodone or other opioids for when you really need them. That way, you will have something to fall back on rather than build up a tolerance for the last resort.
How to Manage Pain Without Oxycodone
While opioids are some of the most potent pain relievers available, there may be other options that can help. Of course, pain management is something you should discuss with your doctor. If you’re recovering from an injury or surgery, you may need to speak with your pain management team. If you’re going through physical or occupational therapy, you may also gain some insight into how you can best manage your pain.
According to the Centers For Disease Control And Prevention, there are several options for pain management, but some will depend on the type of pain you have. Options include:
- Topical ointments like lidocaine
- Exercise therapy
- Physical therapy
- Occupational therapy
- Interventional therapies (injections)
- General exercise
- Weight loss
- Antidepressants with pain relief qualities
- Anti-seizure medications
- Cognitive behavioral therapy (CBT)
- Other psychotherapies
- Other alternative therapies like acupuncture and massage
The right pain relief options may vary from person to person. Finding the right method for you may take trial and error with your doctors.