Oxycodone (Percocet, Roxicodone) Addiction and Treatment
The generic narcotic pain reliever oxycodone is in highly abused medications such as Roxicodone and Percocet. Treatment options for addiction to these drugs include using FDA-approved medications like methadone or buprenorphine as a form of substitution therapy. The following additional recovery services can help with oxycodone abstinence maintenance:
- Individual counseling with a therapist
- Group counseling with a therapist
- Group recovery meetings (e.g., Narcotics Anonymous)
- Nutritional counseling and exercise
- Complementary medicine, such as yoga, acupuncture, chiropractic care, and massage
- Programs oriented toward artistic expression, such as art, music or drama therapy
- Family programs including family counseling, drug education, and social events
- Aftercare planning
Recovery services can establish abstinence from oxycodone abuse, help a person to avoid a relapse, and provide the skills needed to build a drug-free life.
Oxycodone is a generic narcotic pain reliever for moderate to severe cases of pain. As such, oxycodone is an active ingredient in several drugs that are sold under different brand names. The medication is exceptionally effective as a part of a medically supervised pain management plan, but this drug has a high potential for abuse.
Individuals who take oxycodone under a doctor’s supervision will likely develop a physical dependence on this narcotic, but are unlikely to develop an addiction, provided they strictly observe the doctor’s directions for use. However, individuals who have a legitimate need for oxycodone, as well as those who are looking solely to achieve a high, can develop an addiction, and rather rapidly, if they take too much.
For this reason, it is helpful to know the branded drugs that include oxycodone:
- OxyContin (oxycodone only)
- Roxicodone (oxycodone only
- Oxaydo (oxycodone only)
- OxylR (oxycodone only)
- Percocet (oxycodone and acetaminophen)
- Endocet (oxycodone and acetaminophen)
- Roxiprin (oxycodone and aspirin)
- Percodan (oxycodone and aspirin)
- Endodan (oxycodone and aspirin)
- Percodan-Demi (oxycodone and aspirin)
- Targiniq ER (oxycodone and naloxone)
At present, the US is experiencing a prescription pill abuse epidemic. Prescription pills are included the following main categories: opioids, tranquilizers, and stimulants. The National Institute on Drug Abuse provides the following illuminating facts and statistics on prescription drug abuse:
- In the US, it is estimated that 2.1 million individuals are abusing prescription opioid painkillers.
- In 2012, it was estimated that 467,000 Americans were addicted to heroin.
- The number of fatal overdoses (unintentional) from prescription opioid medications has increased by more than 400 percent since 1999.
- Research supports that there is strong crossover between heroin and prescription pain reliever abuse (i.e., individuals who start abusing prescription painkillers my transition to heroin for any number of reasons, such as it being less expensive and more available).
- Worldwide, it is thought that 26.4-36 million people are abusing opioids.
There are numerous ways to alleviate the strain of addiction, such as through public prevention efforts, the ongoing development of useful treatment methodologies, and helping people who are experiencing substance abuse to gain admission to drug recovery treatment programs. It is helpful to point out that drug recovery programs take a multi-pronged approach, one of which is to use any medications that are approved by the Food and Drug Administration. This treatment intervention is called medication-assisted therapy (MAT) or sometimes referred to as substitution therapy (because an unsafe narcotic is being replaced with an FDA-approved, therapeutic, narcotic medication). Not all drugs of abuse are amenable to MAT, but oxycodone is.
What Is Medication-assisted Therapy for Oxycodone Abuse?
Irrespective of a person’s specific drug abuse history or where they seek treatment, the safest first step in the recovery process is to undergo medical detox.
However, the term detox is not always entirely accurate in the context of treatment for oxycodone abuse. A team of addiction experts working at a rehab may recommend that the individual seeking recovery start a substitution therapy program. In other words, the individual recovering from narcotic abuse, such oxycodone abuse, is gradually transitioned over to a safer narcotic. In this way, the safer drug is substituted for the more dangerous oxycodone. This approach is taken for at least two main reasons.
First, the substitution therapy helps the person to not experience full-blown withdrawal symptoms. Typically, withdrawal symptoms will start 30-72 hours after the last time oxycodone was taken. Second, the treatment helps to ensure there is not a relapse, as the medications work to reduce cravings for oxycodone or other opiates.
Even aside from the medication, the fact that a person is in a supervised treatment setting can go a long way to maintaining the process.
With a detox on one’s own, without the benefit of supervision or medication, there may be too great a risk of relapse.
After a recovering person transitions over to a safe narcotic-based drug, maintenance can occur. In other words, a person can be inducted into medication-assisted treatment during withdrawal and continue on the prescribed medication for weeks, months, or even years. The medications that are available to help are limited in number but broad in their effectiveness. The following is a list with descriptions of the medications used in substation therapy for oxycodone or other opioids:
- Buprenorphine: This is a generic drug that is present in two separate branded drugs: Subutex and Suboxone. As WebMD discusses, a person who is a candidate for buprenorphine may start on Subutex around two days after the last use of oxycodone. This medication is given directly to the recovering person by a doctor. It comes in one format: sublingual tablet. The next step can be to take the recovering person off Subutex and medicate with Suboxone, a drug that contains both buprenorphine and naloxone (Note: Subutex’s main active ingredient is buprenorphine alone). Suboxone has two formats: sublingual film and sublingual tablet.
Buprenorphine works by bonding with the same receptors in the brain that opioids such as oxycodone occupy. In this way, buprenorphine can stop withdrawal symptoms from emerging and also reduce cravings for opioids or opiates. Both Subutex and Suboxone have this effect.
The presence of naloxone in Suboxone makes it such that if a person takes an opioid (including methadone), withdrawal symptoms will likely emerge. In this way, naloxone serves to deter a recovering person from relapsing on an opioid.
- Methadone: As the National Institute on Drug Abuse explains, methadone is a synthetic opiate that has a slow onset and a long-acting effect. When methadone is taken in the prescribed dosage, a person will not likely experience a high or any psychoactive effects. In other words, while methadone is a narcotic, at the right dosage, it can give someone in recovery a therapeutic benefit without causing any abuse issues. Methadone is well established in the field of addiction treatment. It has repeatedly been shown to reduce the feelings of opioid withdrawal and relieve cravings for opioids.
- Naltrexone: Notes WebMD, naltrexone is an opioid antagonist. In the brain, this drug prevents a person from feeling the effects of an opioid if one is taken. It reportedly also reduces the desire to take opioids. Naltrexone can also be used for the treatment of an alcohol use disorder.
- Naloxone: This drug is used in the limited situation of reversing an opiate overdose. Naloxone works by blocking the effects of opioids, such as respiratory depression, drowsiness, and falling into unconsciousness. If naloxone is administered to reverse an overdose, additional medical care should follow.
After reviewing these medications, one important question may arise: Why would someone take buprenorphine (a new treatment) over methadone (a long-time treatment that works well)? The reason relates in good part to the person’s schedule and life circumstances. As Harvard Medical School explains, by law, methadone can only be given to approved users in a clinical setting. This, of course, means that a recovering person will have to travel to a methadone clinic every 24-36 hours (dosage effectiveness window). The clinical setting helps to ensure that a person will not abuse methadone, since only the allowed dose is provided. There is no end date on methadone therapy; from a medical standpoint, a recovering person may safely stay on methadone as long as it is effective and there is no abuse of this drug.
Per research findings, approximately 25 percent of recovering individuals who use methadone will at some point reach full abstinence and no longer need it. About 25 percent will indefinitely use methadone as a substitution treatment. Approximately 50 percent will go through a cycle of using methadone and then not using it.
Buprenorphine (Suboxone or Subutex) can be conveniently given to a recovering person in a doctor’s office. Usually, buprenorphine is taken under the tongue approximately three times each week. A qualified doctor can provide the recovering person with a prescription; there is no reason to go to the doctor’s office for each dosage. There are reports of buprenorphine abuse, although this drug was not at first thought to be addiction-forming.
While opioid or opiate substitution therapy is effective and a major achievement within the field of addiction treatment, from a clinical standpoint, it is not enough. An effective opiate treatment program must necessarily involve therapies and supportive service that address the root causes of addiction. Known sometimes as primary care for addiction, after detox or medication therapy stabilization, a recovering person enters into this second phase of treatment.
Therapy and Additional Treatments for Oxycodone Abuse
Just as no two individuals seeking treatment are the same, no two treatment programs are the same.
An exemplary rehab center that provides a full continuum of care will start the admissions process with a full client intake (i.e., a pointed and extensive Q&A). From there, addiction specialists work together as a team to design a program that is tailored to the individual client’s needs.
For an individual with a history of oxycodone abuse, again, the treatment may include substitution therapy. But recovery services necessarily go beyond the physical needs of the client and provide a multilayered, dynamic day-to-day program. Individuals typically stay in an outpatient or inpatient rehab program for at least 28 days, but the National Institute on Drug abuse advises that at least 90 days of care is advisable, and longer treatment programs are sometimes needed.
Therapy is a main pillar of treatment after medical detox. To be clear, literature on addiction often refers to therapy as psychotherapy or behavioral therapy. These terms both exist under the same canopy but take different approaches. There are numerous different types of therapy. Typically, a rehab center will provide clients with the therapy types that are most closely in line with their overall treatment philosophy.
The following are some of the most common types of therapy that are offered at rehab centers for the treatment of oxycodone abuse:
- Cognitive Behavioral Therapy: This approach is unique, and very much in practice, because it combines psychotherapy and behavioral therapy. A fully qualified and trained therapist will guide individuals or groups to identify the thought processes underlying oxycodone abuse and then teach them how to develop new, healthy strategies for coping with stress, which is often a key trigger for substance abuse. A therapist can guide a person with a history of oxycodone abuse to understand why that drug was abused and how to make healthier decisions, all the while acknowledging and healing destructive thought patterns that cause anger, fear, self-doubt, and self-distrust, which may have led to the oxycodone abuse in the first place.
- Group therapy: This service is therapist-led (as opposed to group recovery or mutual aid meetings, such as Narcotics Anonymous). The therapist will use one or more established, research-based therapy models to guide discussions and healing. At the same time, this process utilizes the unique traits of interpersonal healing. Research and recovering individuals agree that group therapy can be of great benefit due to the simple fact that everyone is similarly situated, with each person as a student and a teacher within the group. Often, a group has substance abuse in common and not a particular drug of abuse. However, if a rehab program has a specialization in the treatment of prescription opioid abuse, there may be drug-specific group therapy offerings.
- Family therapy: It is well observed in the addiction treatment community that addiction is a family disease. As such, it makes good sense – and research supports – that families can play an instrumental role in the recovery process. A therapist, working in a group that includes the recovering person and family members, can help everyone to shift out of old, negative patterns. For instance, codependency issues may be revealed, and therapy can help to heal relationships. Codependency, described most basically, is behaving in an addictive-like way to support a person who is abusing drugs or alcohol. Codependent people risk losing control over their own lives while at the same time enabling the addiction, though what they really want is for the addiction to end. As oxycodone abuse can lead at worst to a fatal overdose and at best to a host of problems, it is understandable why an entire family needs help healing.
- Recovery-oriented challenge therapy: This is a hands-on, pragmatic approach that helps recovering individuals to engage in safe activities during sessions and build skills that will promote healthy choices. As therapy evolves and deepens, the person develops greater inner strength and self-sufficiency. For instance, a person who has a history of abusing oxycodone may have any number of insecurities (we’re all human) but for some reason chose in the past to address those feelings with oxycodone abuse. This therapy approach can help a person to become stronger from the inside out, thus weakening the chance of using oxycodone again.
- Expressive arts and music therapy: These therapies encourage a recovering person to express their inner emotional life – one that may have suppressed for many years – in artistic endeavors, including painting, sculpting, crafting, or making music. This approach helps a person to build confidence in their emotional and psychological life by drawing out feelings, expressing them, and realizing that they’re invaluable.
Many programs set aside time for exercise within the daily schedule. Some programs make complementary therapies available to clients in recovery. Depending on the location and the rehab center’s treatment philosophy, any number of the following complementary therapies may be available:
- Equine-assisted therapy
- Animal therapy (different types)
- Chiropractic care
Group recovery meetings, which may or may not be based on the 12-Step model, are a feature of most, if not all, drug treatment programs. These groups are member-run, and typically, a therapist is not in attendance. Most programs, both inpatient and outpatient, offer one or more group recovery meetings per day. In many rehab centers, there is time set aside on the daily itinerary to attend group recovery or peer support meetings.
The last phase of treatment is known as aftercare. At this point, the recovering individual has completed the intensive part of a drug recovery program. Back in day-to-day life outside rehab walls, the individual will be required to take even greater charge of the recovery process. The following are some main forms of aftercare:
- Continuing to go to individual and/or group therapy
- Living in a sober living home
- Maintaining the demands of a substitution therapy program (e.g., getting prescription refills of Suboxone)
- Getting regular checkups (may include submitting to drug tests)
- Regularly going to 12-Step or peer support meetings (e.g., mutual aid meetings like Narcotics Anonymous)
- Getting help, such as engaging case management services, as needed
Many individuals who experience oxycodone abuse, as well as their families, are only too familiar with the devastating consequences. But on the other side of that negative experience, there is hope. There are countless stories of individuals who have recovered from prescription opioid abuse.
No matter how hard things may get at times, it’s critical to know that recovery is always possible.