Oxycodone Withdrawal: Symptoms, Timeline, and Treatment

Oxycodone is a short-acting, semi-synthetic opioid used to relieve moderate to severe pain. It is prescribed for both acute pain (after surgery or injury) and chronic pain (from disease or damage). Oxycodone is the narcotic component of various common combination drugs, including Percocet and Percodan. Oxycodone is also the active ingredient in Oxycontin, an extended-release version of the drug.

Taking oxycodone for more than a few weeks causes tolerance and dependence, regardless of whether or not you are using it as directed. Whether you’ve been using oxycodone for pain or recreationally, you can expect withdrawal symptoms.

Understanding Withdrawal From Oxycodone

Oxycodone withdrawal is different for everyone and symptoms can range from mild to severe. Your withdrawal experience will depend on various factors, including your current dose and how long you’ve been using opioids.

Your withdrawal experience will also be influenced by the way you use opioids.

People with an opioid use disorder (addiction) typically have a more challenging time detoxing. Opioid addiction is distinct from opioid dependence because it involves intense cravings and drug use that obstructs daily life. However, Oxycodone is a highly addictive drug, and it is not uncommon for a physical dependence to escalate into full-blown addiction.

Prescription drug misuse has become more prevalent across different age groups and backgrounds in recent years. In 2015, while only 591,000 individuals were abusing heroin, 2 million were battling an addiction to prescription opioids.

If you’re new to opioid withdrawal, you may be concerned about what to anticipate. Is it as daunting as it appears on TV? The answer varies.

Opioid withdrawal can be both uncomfortable and unpleasant without treatment, but it is rarely life-threatening.

Withdrawal symptoms typically begin within 8 to 24 hours of your last dose of oxycodone.

You might experience stomach and muscle cramps, diarrhea, sweating, chills, and insomnia, among other symptoms. Symptoms typically peak within a few days and then start to subside. The entire process usually lasts no longer than a week.

Common Oxycodone Withdrawal Symptoms

The signs and symptoms of oxycodone withdrawal can vary from person to person. Most individuals experience flu-like symptoms, but the severity of symptoms exists on a continuum. If you are interested in understanding the range of withdrawal symptoms, you can examine the diagnostic scale that clinicians use, known as the Clinical Opiate Withdrawal Scale (COWS).

The most prevalent oxycodone withdrawal symptoms include:

• muscle aches and pain
• a flu-like feeling
• sweating
• runny nose
• chills
• nausea or vomiting
• cramping or diarrhea
• insomnia or disturbed sleep
• teary eyes
• tremors
• anxiety or restlessness
• gooseflesh
• heart palpitations
• agitation
• skin-crawling

Symptoms typically manifest within 8 to 24 hours after your last dose. However, if you have been abusing oxycodone by crushing it to bypass the extended-release mechanism, your withdrawal symptoms will appear sooner. If you have been taking your medication as directed, on a regular schedule, your withdrawal symptoms may take longer to appear, particularly if you are taking extended-release tablets.

Depending on your situation, your withdrawal experience may also be accompanied by the return of pain. Prolonged opioid use temporarily decreases your pain threshold, signifying that your pain may feel more substantial than it did before you began using opioids. Pain can complicate withdrawal, so you should collaborate with your doctor to develop a plan to manage it.

The acute (immediate) symptoms of oxycodone withdrawal usually peak around day three and then begin to subside.

Acute symptoms seldom last longer than 5 to 7 days. However, there is another condition known as protracted (long-term) opioid withdrawal, which can last up to six months.

Protracted withdrawal symptoms are less severe but can be frustrating and often lead to relapse. In the months following your last dose, you may experience:

• depression
• low energy levels
• a low tolerance for stress (short fuse)
• trouble sleeping
• an inability to derive pleasure from anything
• difficulty with memory or concentration
• irritability or agitation

These symptoms typically come and go in waves, adding to the frustration of recovery. The crucial thing to remember is that they are temporary.

Coping Strategies and Relief

Medical professionals generally agree that medications such as clonidine can alleviate oxycodone withdrawal symptoms. Undergoing opioid detox without medical support causes unnecessary suffering, so it is essential to seek help. There are several avenues to explore:

• an addiction treatment facility
• a community health clinic
• your primary care physician
• a psychiatrist
• a methadone clinic
• a doctor authorized to prescribe buprenorphine (Suboxone)

Numerous medications can help prevent withdrawal symptoms and treat any symptoms that develop. The first group is opioids like oxycodone, but when used appropriately, they won’t induce a high.

• Methadone: Methadone is a long-acting opioid that must be administered once daily to prevent withdrawal symptoms. When used correctly, it prevents withdrawal symptoms and drug cravings without leading to euphoria or sedation. However, it is only accessible at certified clinics, which you usually must visit daily.
• Buprenorphine: Buprenorphine is also a long-acting opioid that can prevent or reduce withdrawal symptoms. It is often combined with naloxone, an opioid antagonist sold under the trade name Suboxone. Numerous doctors can prescribe Suboxone for at-home use. Suboxone is beneficial once withdrawal symptoms have manifested.
• Lucemyra (lofexidine hydrochloride): Lucemyra is a recently approved non-opioid medication for managing opioid withdrawal symptoms. Since it contains no opioids, any doctor can prescribe it for home use.

It can take some time for your body to habituate to a stable dose of methadone or buprenorphine. During this period, you might experience mild withdrawal symptoms. The American Society for Addiction Medicine recommends the following medications to treat break-through withdrawal symptoms:

• Clonidine: A hypertension drug frequently used off-label to treat opioid withdrawal symptoms. It is available as a pill or a transdermal patch.
• Loperamide: To treat diarrhea.
• Ondansetron: To treat nausea and vomiting.
• Benzodiazepines: To treat short-term anxiety.
• OTC pain relievers: (Tylenol or Advil) To relieve muscle aches and pains.

If you have trouble sleeping, you may want to consider (with a doctor’s approval) an OTC antihistamine like Benadryl. If you are allergic to antihistamines or prefer something else, discuss prescription sleep aids with your doctor.

Warnings

Opioid withdrawal is seldom life-threatening for healthy adults, but it can be highly uncomfortable without detox medications.

While it is safe to detox at home, many individuals benefit from inpatient detox centers where they receive 24-hour medical care.

Inpatient detox facilities offer a safe, trigger-free environment for going through withdrawal, but they can be prohibitively expensive. Contact your insurance provider to determine what type of addiction treatment they cover and the duration of that coverage.

Inpatient treatment is an excellent option for individuals battling opioid use disorder. Detox is the first step in addiction treatment and a crucial one, but the key to long-term sobriety is sustained relapse prevention. Detox facilities can help you transition into a more long-term program. Without continued addiction treatment, individuals who complete detox typically relapse within one or two years.

Because relapse is common after detox, understanding how rapidly your tolerance can change is crucial. Your pre-detox dose can potentially cause an overdose post-detox. Discuss obtaining a Narcan kit with your doctor to have on hand in an emergency (Narcan can reverse an opioid overdose).

Inpatient or specialized outpatient treatment is also recommended for pregnant women. Oxycodone withdrawal can lead to pregnancy complications, including miscarriage and premature birth. This underscores the importance of avoiding withdrawal symptoms. Fortunately, methadone is proven safe and effective for use during pregnancy.

Long-Term Treatment Options

The primary goal of long-term treatment is to prevent individuals with opioid use disorder from relapsing.

Long-term addiction treatment employs a multifaceted approach that encompasses medical, social, and therapeutic support. Your medical approach may involve a long-term maintenance dose of methadone or Suboxone, or you may choose to discontinue opioid use entirely.

Naltrexone is a non-opioid medication that can be used for long-term relapse prevention. It is an opioid antagonist, meaning it prevents opioids from inducing a high. It is now available as a once-per-month injection or a daily pill. Naltrexone is a reliable safeguard against impulsive relapse.

Studies demonstrate that combining psychotherapy with medication enhances your chances of achieving long-term sobriety. Individual and group therapy takes place in various settings, including addiction treatment programs, community clinics, hospitals, and private practices.

Finally, social support is the third pillar of relapse prevention. Knowing you’re not alone is crucial. And a shared commitment to sobriety helps many individuals stay strong. Many people find enduring support at local 12-step meetings, which are free and conveniently located.

Resources for Further Information and Support

For various resources that can aid in finding appropriate treatment and support for opioid addiction:

• The National Institute on Drug Abuse: 1-800-662-HELP
• The Substance Abuse and Mental Health Services Administration: 1-800-662-HELP
• The National Alliance on Mental Illness: 1-800-950-NAMI *