Percocet Addiction and Misuse: Signs, Withdrawal Symptoms, and Treatment

What is Percocet, and What is Percocet Used For?

Percocet is a brand name for a prescription pain-relieving drug comprising acetaminophen and oxycodone, the latter of which is an opioid with a high potential for dependence and addiction.¹ Given this potential, Percocet is classified as a Schedule II controlled substance by the U.S. Drug Enforcement Administration (DEA).²

Not surprisingly, then, along with its analgesic effects, Percocet also can be misused for its rewarding opioid effects such as relaxation and euphoria. That’s because oxycodone attaches to and activates the brain’s opioid receptors to moderate pain signals. Thanks to this opioid activation, dopamine activity increases in key regions of the brain, which can significantly reinforce oxycodone consumption and prompt people to repeat the experience.³ While Percocet is available in tablet, capsule, and liquid forms, which can be consumed orally, tablets are sometimes crushed and/or liquified to allow for misuse via snorting and injection.^4,5

Given the fact that Percocet is a prescription opioid (similar to hydrocodone, oxymorphone, morphine, codeine, fentanyl, and more), it’s one of the key substances involved in the opioid epidemic.³ Data from the 2022 National Survey on Drug Use and Health reveals that among those 12 and older, more than 20 million people in the U.S. used or misused prescription opioids in the last year, with more than 2 million of these individuals misusing oxycodone products such as Percocet.⁶

Percocet vs. Norco 

While both Percocet and Norco are brands of pain-relieving prescription opioids that contain acetaminophen, the former includes oxycodone, and the latter includes hydrocodone.^1,7 However, to be clear, the Norco brand has been discontinued.⁸

Few studies directly compare these substance combinations, and fewer produce clear contrasts. In fact, a relatively recent clinical trial showed no significant differences in pain-relieving efficacy when treating acute musculoskeletal extremity pain between these generic combinations.⁹ One point is clear, however, both oxycodone and hydrocodone products carry a high potential for dependence and addiction.^2,3

Short- and Long-Term Adverse Effects of Percocet Misuse

When it comes to Percocet side effects, the most frequent nonserious reactions include dizziness, lightheadedness, drowsiness, sedation, nausea, and vomiting.¹

Additional side effects can include:¹

• Euphoria.
• Unease/dissatisfaction (i.e., dysphoria).
• Constipation.
• Itching.

Similar to other opioids, oxycodone/acetaminophen use can result in a life-threatening overdose (involving respiratory depression, respiratory arrest, and coma) or addiction. ^1,3

Note also that acetaminophen (a component of Percocet) may produce serious adverse effects when consumed at high doses. In fact, acetaminophen has been associated with cases of acute liver failure that sometimes result in liver transplant and/or death. Most often, these cases involve doses that exceed 4,000 mg per day. While fatal liver cell death is the most dangerous effect of acetaminophen overdose, other potential effects include kidney damage, hypoglycemic coma, and coagulation defects.¹

Dangers of Mixing Percocet and Alcohol

Mixing the prescription painkiller Percocet with alcohol and other central nervous system depressants (e.g., benzodiazepines, tranquilizers, muscle relaxants, etc.) can significantly slow breathing and potentially lead to a fatal overdose.^10-12

Signs of Percocet Misuse and Addiction

According to the National Institute on Drug Abuse, misuse of opioids such as Percocet can involve:³

• Taking an opioid to get high.
• Taking someone else’s prescription.
• Taking the opioid in a dose other than prescribed.
• Taking the substance by a route other than prescribed (such as snorting or injecting).

Misuse can also lead to addiction, which is diagnosed as an opioid use disorder by addiction treatment professionals and other clinicians. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), criteria used to diagnose opioid use disorders include:¹³

• Taking opioids for longer periods of time or in larger amounts than intended.
• Being unable to cut down or stop substance use.
• Spending a lot of time obtaining, using, and recovering from the effects of the substance.
• Experiencing cravings, or intense desires or urges for the substance.
• Failing to fulfill obligations at home, work, or school due to substance use.
• Continuing substance use despite having interpersonal or social problems that are caused or worsened by substance use.
• Giving up social, recreational, or occupational activities due to substance use.
• Using the substance in risky or dangerous situations.
• Continuing substance use despite having a physical or mental problem that is probably due to substance use.
• Developing tolerance or needing more of the substance to achieve previous effects.*
• Suffering from withdrawal, meaning that unpleasant symptoms occur when you stop using your substance of choice.

*These criteria should not be considered met in those solely taking an opioid like oxycodone therapeutically under appropriate medical supervision.

Percocet Withdrawal Symptoms and Detoxification

Once a person becomes physiologically dependent on a substance and they stop or significantly reduce their dose, withdrawal symptoms may occur.¹⁴ Percocet withdrawal symptoms vary in severity based on factors such as typical dosage, dosing interval, duration of use, and a person’s individual biology and health conditions.¹⁵

The following range of withdrawal symptoms may develop when any type of opioid drug is abruptly stopped:¹⁵

So how can detox for Percocet and other opioids aid the withdrawal process?

While it’s typically not life-threatening, opioid withdrawal can certainly be uncomfortable.¹⁵  But medically assisted detox can help keep patients as safe and as comfortable as possible during the initial phases of withdrawal. This type of supervised medical detox involving opioid withdrawal may include medications such as buprenorphine, methadone, or lofexidine.¹⁶

Percocet Addiction Risk Factors

Risk factors are defined as psychological, biological, community, family, or cultural factors associated with a higher likelihood of negative outcomes.¹⁷ Thus, risk factors related to addiction are complex, involving a host of personal and environmental variables. That said, some of the more common risk factors for a substance use disorder include:¹⁸

• Childhood trauma.
• Family history of substance misuse.
• Individual risk factors (e.g., grief, age-related life changes, trauma, academic stress, etc.).
• Peer influences.
• Environmental factors.
• Genetics.
• History of substance use.
• Misuse of over-the-counter pharmaceuticals.

One risk factor of note is a co-occurring disorder—a term used to  describe simultaneous occurrence of a substance use disorder with another mental health disorder (e.g., anxiety, depression, post-traumatic stress disorder, etc.). Unfortunately, co-occurring disorders are common in those with addiction. While one condition doesn’t always lead to the other, mental health professionals recommend treating both illnesses at once—as opposed to individually.¹⁹

Percocet Overdose Potential and Symptoms

The most immediate and dangerous effect of an opioid overdose is respiratory depression (i.e., slowed, shallow, or stopped breathing), which requires immediate emergency attention.⁴ However, several additional symptoms of an opioid overdose include:¹

• Diminished level or loss of consciousness.
• Pronounced drowsiness or sedation.
• Constricted pupils.
• Limp skeletal muscles.
• Cold, clammy skin.

In the case of an acetaminophen overdose, acute liver injury symptoms can include:¹

• Nausea.
• Vomiting
• Excess sweating.
• Malaise.

Percocet Addiction Treatment Options

Treatment for Percocet addiction—aka opioid use disorder—includes multiple levels of care. While patients often enter treatment via a detox program, this is just the first step in the treatment process. Often, patients transition to inpatient care, which involves 24/7 support and monitoring in a safe and supporting environment.²¹

Another option, which can follow detox or inpatient care, is outpatient treatment, during which patients live at home while attending treatment. Outpatient options vary in intensity and include traditional outpatient care, partial hospitalization programs (PHPs), intensive outpatient programs (IOPs), and telehealth services.²¹

Additionally, many individuals participate in aftercare programs to maintain sobriety long term. Options include 12-Step programs, sober living facilities, ongoing therapy, and more.

Providing all levels of care via evidence-based treatment programs, American Addiction Centers (AAC) offers multiple facilities nationwide that treat substance use disorders for a wide range of substances, including opioids such as Percocet.

If you or a loved one is struggling with addiction, the best time to reach out for help is always today. Available 24/7 for a free and confidential conversation, admissions navigators at AAC can not only listen with empathy to your story (as many of them have been in your shoes themselves) but also provide insight on the various treatment options available to you. Plus, they can verify insurance (or you can verify insurance benefits online), discuss payment options, and help you or a loved one take your first steps toward recovery today.