Experts suggests that the addiction of Oxycodone is a stage—wise process. In simple words, there are a number of red flags before reaching a point of opioid addiction. For example, Himmelsbach (1) suggested that opioid abusers develop tolerance and habituation first before reaching the third and final stage of physical opiate addiction.
Tolerance is when a person experiences that the prescribed dose is no longer sufficient or helpful at alleviating symptoms and a higher dose is needed to achieve similar degree of euphoria/ relief. Similarly, habituation is when you develop a craving and psychic dependence to continue the intake of drug and is marked by increasing influence on the brain receptors.
What are the other complications of Oxycodone abuse besides addiction?
Although dependence and addiction are fairly recognized and somewhat threatening complications of Oxycodone abuse, but is that all?
Just like most other therapeutic or prescription drugs, long term Oxycodone use is also associated with some dose dependent complications like
- Impaired hearing (2) that may progress to partial or complete (unilateral or bilateral hearing loss)
- Damage to liver since the drug is mainly metabolized by liver. The risk of complications is even higher if you are consuming other drugs (like NSAIDs and antibiotics/ antifungal/ anti-psychotics etc) for the management of other health issues.
- Personal issues in the family and personal life
- Mental health ailments like mood changes, inability to concentrate and behavioral problems
- Impairment of normal productivity with abuse may interfere with your performance at work and other professional responsibilities.
- Changes in the secretion of different hormones (especially sec steroids like testosterone and estrogen).(6)
- Decrease in the serum levels of Gonadotropin releasing hormone and Luetenizing hormone that impair fertility (6)
- Constipation and hemorrhoids are reported in 50 to 95% of opioid users according to research report published in Pain Physician (6)
- Urinary retention is reported in 3 to 18% abusers.
It is pretty ironic that the factors that entice people to opt for opioid therapy are deteriorated most with long term Oxycodone abuse.
What are the symptoms of Oxycodone withdrawal?
It is hard to say when and at what dose Oxycodone dependence develops. This is primarily because the addiction is dependent on a number of factors (that includes personal, psychological, emotional and physical). However, once addiction has developed, it is fairly difficult to stop the intake of Oxycodone altogether without consulting a healthcare professional because of severe withdrawal symptoms. A few of these are:
Acute or first order withdrawal symptoms (4)
These are reported within an hour of missing the first dose and include:
- Feeling of cold (marked by gooseflesh, shivering)
- Changes in the activity and energy levels (marked by yawning, watering of eyes, coughing, sneezing and hiccups)
- Abrupt changes in the perception of temperature (characterized by sweating and feeling of warmth)
- Watering from nose, eyes and excessive salivation
- Upper and lower gastrointestinal changes like nausea, vomiting, borborygmus, colic, diarrhea, abdominal irritation)
- Changes in the vision (as evidenced by mydriasis or dilation of pupil of more than 3 mm causing blurring of vision)
- Anxiety, agitation, mood changes, irritability, perception of muscular pain and fatigue
If no opiate is taken for significant duration of time, the above listed symptoms become even worse. In addition, other non- specific changes that are also observed include (4):
- Changes in the body temperature (0.3 deg C higher or lower than normal core body temperature).
- Abrupt changes in the respiratory rate (of more than 5 breaths/ minute)
- Changes in the blood pressure or more than 10 mm Hg
- Severe headache, dizziness, palpitation, pain in the heart and shoulders and loss of consciousness.
- Intention tremor (inability to control the movement of hands), rigidity of muscles
- Apprehension, severe agitation, fighting and quarreling tendency
- Insomnia, crying spells and severe discomfort
- Dehydration, loss of substantial body weight and collapse.
What is the influence of Oxycodone withdrawal symptoms on overall well- being of an individual?
Although, it may seems like a cost- effective alternative to detox opioid dependent individuals at home without seeking any professional help, but it is really possible to let your loved ones suffer to this extent?
Oxycodone rapid drug detoxification is performed without an expert supervision and outside of a medical facility can increase the risk of complications many folds. According to Charles Cherubin (5) the mortality rate is 16 – 30/ 1000 in opioid users depending upon the age, underlying medical conditions and opioid associated complications (as listed above). Likewise, these withdrawal symptoms may continue for days and weeks that further cause psychological trauma and emotional disturbance further affecting the quality of treatment and eventually resulting in relapse.
If you or your loved ones are experiencing Oxycodone addiction/ dependence, it is suggested to opt for practical and less time consuming detox treatments in a recognized and fully- equipped medical facility for physical as well as psychological treatment of addiction.
1. Kolb, L., & Himmelsbach, C. K. (1938). Clinical studies of drug addiction. III. A critical review of the withdrawal treatments with method of evaluating abstinence syndromes. Am J Psychiatry, 94(4), 759.
2. Tang Ho, M. D. (2007). Hydrocodone use and sensorineural hearing loss. Pain Physician, 10, 467-472.
3. Ricardo Buenaventura, M. D., Rajive Adlaka, M. D., & Nalini Sehgal, M. D. (2008). Opioid complications and side effects. Pain physician, 11, S105-S120.
4. Halbach, H., & Eddy, N. B. (1963). Tests for addiction (chronic intoxication) of morphine type. Bulletin of the World Health Organization, 28(2), 139.
5. CHERUBIN, C. E. (1967). The medical sequelae of narcotic addiction. Annals of Internal Medicine, 67(1), 23-33.
6. Ricardo Buenaventura, M. D., Rajive Adlaka, M. D., & Nalini Sehgal, M. D. (2008). Opioid complications and side effects. Pain physician, 11, S105-S120.