OxyContin is a prescription painkiller containing the opioid drug oxycodone. It is a time-release formulation designed to treat significant pain around the clock.
It is a powerful narcotic drug. The U.S. Food and Drug Administration (FDA) medication guide explains that OxyContin tablets are to be taken once every 12 hours for continued management of severe long-term pain. OxyContin works through an extended-release function, meaning that the drug’s active ingredient (oxycodone) is doled out a little bit at a time in a controlled manner during the 12-hour dosage period.
Opioid drugs like oxycodone are extremely addictive and have a high abuse potential. This is why the FDA classifies them as Schedule II controlled substances, the highest classification for any drugs with accepted medicinal use in the United States. The National Survey on Drug Use and Health (NSDUH) reports that in 2016, nearly 4 million Americans misused prescription opioid medications containing oxycodone.
OxyContin can be abused by chewing a tablet or crushing it and then snorting or dissolving the powder in liquid before injecting it, which bypasses the time-release function and increases the risk for a life-threatening overdose. OxyContin has implemented an abuse-deterrent formulation that makes it harder to harvest the powder when the drug is crushed; it becomes mushy or gooey instead of an easily manipulated powder. It is still widely abused, however, and any use of the drug beyond the boundaries of a medically necessary and legitimate prescription is considered drug abuse.
OxyContin is extremely habit-forming. Even if a person takes it as directed to control pain, the individual may start to develop withdrawal symptoms and drug cravings in between doses, prompting misuse of the drug in the form of additional or higher doses. OxyContin abuse increases the possible risk factors and withdrawal symptoms.
OxyContin withdrawal is both physically and emotionally uncomfortable. However, several methods can help to manage the potential side effects of detox.
Opioid drugs like OxyContin are effective pain relievers because they interact with the brain’s chemistry and shut down some of the messages that tell the body to feel pain. Opioids also raise the levels of dopamine in the brain; this chemical messenger is involved in feelings of pleasure, movement abilities, sleep functions, and thinking and learning. Elevated levels of dopamine produce the powerful and pleasant high that opioids are known for.
OxyContin and opioid drugs also work as central nervous system (CNS) depressants, causing relaxation, drowsiness, lethargy, impaired balance and coordination, lowered body temperature, and reduced heart rate and blood pressure. With repeated use, the brain and body both get used to OxyContin being present and interacting with their chemical makeup. This is called drug dependence.
When OxyContin wears off, the body can still experience withdrawal symptoms. Opioid withdrawal can be decidedly significant and can occur even when a person takes OxyContin for medical reasons exactly as directed, The New Yorker warns. The National Library of Medicine (NLM) reports that opioid withdrawal usually starts within 12 hours of the last dose of the drug. While individual experiences vary, there is a general OxyContin withdrawal timeline.
The withdrawal timeline can be influenced by several things and will not be the same for each person. Things like personal metabolism, the presence of any other diseases or mental illness, genetic makeup, and environmental aspects can affect withdrawal intensity of duration.
Typically, the more physically and psychologically dependent a person is on OxyContin, the more significant withdrawal can be. Someone who has been taking large quantities of the drug for a long time is bound to experience heightened withdrawal symptoms.
The Los Angeles Times reports that, in 2014, more than half of the people prescribed OxyContin for more than three months were taking more than 60 mg of the drug at a time. This is higher than the normal recommended dose of 10 mg per 12-hour dose (not to exceed 40 mg at a time or 80 mg in one day except in special circumstances including prior opioid tolerance) per the maker of the medication, Purdue Pharma.
High doses of OxyContin, especially for an extended time, can definitely compound withdrawal. If other drugs and alcohol are taken in conjunction with OxyContin, withdrawal symptoms can be exacerbated, and the timeline will be extended.
While withdrawal is what occurs when the brain and body work through trying to reestablish stability after a drug wears off, detox is the process that makes this stage more manageable. There are several different methods for detox: detox at home, outpatient detox, and medical detox.
OxyContin as an opioid drug is not a medication that should ever be stopped suddenly after a person has been taking it regularly. This cold turkey approach can be extremely tough to handle, and it can cause intense cravings and withdrawal symptoms. At-home remedies and at-home detox methods are not recommended either.
OxyContin withdrawal physically can be like a really bad case of the flu and just as emotionally difficult. The mood swings, sleep problems, and dramatic lows make it hard to stop taking OxyContin, and the risk for relapse after stopping it for any period is high.
Both outpatient and inpatient detox programs often use a tapering system to wean the brain and body off OxyContin. With a taper, the dosage can be lowered a little at a time, allowing the brain to regulate itself each step of the way. In this manner, there will not be such a shock to the system, and brain chemistry can stabilize safely.
Other longer-acting opioids, such as methadone or buprenorphine, are often used in place of OxyContin during a detox to wean the body off opioids. Methadone is dispensed daily from federally regulated clinics as a long-acting opioid drug useful for detox, and buprenorphine can be prescribed by a physician out of their offices.
Buprenorphine is only a partial opioid agonist, so it has a lower abuse potential than full opioid agonists do, but it can still help to keep opioid withdrawal symptoms from being as intense by working on the same opioid receptors in the brain that OxyContin does. Buprenorphine often is dispensed as a combination medication, also containing the opioid antagonist naloxone that only activates if the drug, or other opioids, is misused while taking it.
A medical detox program is generally considered to offer the highest level of care for OxyContin withdrawal. With medical detox, vital physical signs can be continuously monitored, and medications can be used to manage specific side effects of withdrawal. Additionally, trained staff can provide continuous and ongoing support and encouragement to help prevent and minimize relapse.
The dangers of relapse include a heightened risk for fatal overdose. The National Institute on Drug Abuse (NIDA) publishes that nearly 20,000 Americans died from an overdose involving a prescription opioid pain reliever in 2016.
There are several factors to consider as you figure out the best option for detox. Each person is different, and what works for one individual may not be the best plan for someone else. Each family will need to consider what matters to them personally.
Medical detox is often the optimal choice when high levels of dependence are present, as it can provide the necessary medical monitoring and emotional support along with medication management during withdrawal. A calm, encouraging, stable, and safe environment is important during detox. It can be helpful to spend at least a week in a secure medical detox facility to allow the brain and body time to heal without outside distractions. Other drugs and alcohol can complicate withdrawal in unpredictable ways, so medical detox is generally considered the best place to manage withdrawal when multiple substances are involved.
Additional treatments that can be beneficial during OxyContin withdrawal in a detox program include:
The Behavioral Health Treatment Services Locator operated by the Substance Abuse and Mental Health Services Administration (SAMHSA) can provide information on local treatment options and types based on ZIP code. Families and individuals can use this tool to get more information on nearby program locations.
A detox program can manage the side effects of OxyContin withdrawal. In doing so, these programs help to minimize episodes of relapse and lessen the severity and duration of withdrawal in general.
(August 2015). Medication Guide OxyContin. U.S. Food and Drug Administration. Retrieved September 2018 from https://www.fda.gov/downloads/Drugs/DrugSafety/UCM208530.pdf
(September 2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Retrieved September 2018 from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm
Opioid Addiction 2016 Facts & Figures. American Society of Addiction Medicine. Retrieved September 2018 from https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf
(October 2017). The Family That Built an Empire of Pain. The New Yorker. Retrieved September 2018 from https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain
(April 2016). Opiate and Opioid Withdrawal. National Library of Medicine. Retrieved September 2018 from https://medlineplus.gov/ency/article/000949.htm
(May 2016). 'You Want a Description of Hell?' OxyContin's 12-Hour Problem. LA Times. Retrieved September 2018 from http://www.latimes.com/projects/oxycontin-part1/
(2018). Initiating OxyContin in Adults Who Are Not Opioid Tolerant. Purdue Pharma. Retrieved September 2018 from https://oxycontin.com/dosing/initiating-therapy-in-adults.html
(August 2018). Overdose Death Rates. National Institute on Drug Abuse. Retrieved September 2018 from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
Behavioral Health Treatment Services Locator. Substance Abuse and Mental Health Services Administration. Retrieved September 2018 from https://www.findtreatment.samhsa.gov/