Every day in the United States, approximately 44 people die from a prescription opioid drug overdose, per the Centers for Disease Control and Prevention (CDC). In 2009, drug overdose fatalities surpassed motor vehicle deaths for the first time in history. By 2010, approximately 60 percent of the drug overdose deaths in America involved prescription opioids. Deaths from these prescription drugs now outnumbers overdose deaths from all illegal drugs combined, the Department of Health and Human Services (HHS) publishes. High overdose statistics point to elevated abuse rates as well, thus indicating that the abuse of prescription opioid drugs is at epidemic levels.Percocet is the brand name of a narcotic painkiller that is a combination of the opioid oxycodone and the over-the-counter analgesic acetaminophen, which is the active ingredient in Tylenol. Oxycodone is considered a Schedule II drug under the Controlled Substances Act, as regulated by the Drug Enforcement Administration, or DEA. Schedule II drugs are the most tightly controlled substances in the US that have accepted medical use. The only drugs that are under stricter federal control are Schedule I drugs, which are considered illegal, with no approved medical usage in America.
Opioids are considered to be highly addictive. The American Society of Addiction Medicine (ASAM) reported that in 2014, close to 2 million Americans battled a prescription opioid substance use disorder. Recovery for abuse and addiction to Percocet is enhanced by treatment methods that include therapeutic models and often pharmaceuticals, especially during detox, to manage potential withdrawal symptoms.
Percocet is prescribed to treat pain, but it also has a side effect of creating feelings of relaxation, reduced anxiety, and increased pleasure. This may be a good thing for someone who needs pain relief; however, these feelings may also be sought out by individuals wishing for an escape from stress, or just to feel good and experience a “high.”
Opioid prescription drugs like Percocet are commonly diverted, meaning they are sold and given to people who don’t have a legitimate prescription or medical need for the drugs. Individuals may invent symptoms to receive a prescription, make appointments with multiple doctors (called doctor shopping) to obtain more of the medication, continue taking the drug after it is no longer needed, take more of the drug than recommended, or use Percocet strictly for recreational purposes. All of these methods are considered prescription drug abuse.
The National Survey on Drug Use and Health (NSDUH) of 2013 found that the most common way that individuals obtain prescription drugs is for free from a relative or friend (53 percent of Americans 12 and older who abused prescription drugs in 2012 obtained them this way).
The NSDUH of 2014 estimated that 4.3 million Americans (over the age of 11) were considered current abusers of prescription painkillers, with the majority of the abusers (2.8 percent) being between the ages of 18 and 25.
All other age demographics had roughly the same percentage of individuals abusing prescription painkillers.
Another way that abuse of specific drugs is measured is by looking at the number of people seeking emergency department (ED) treatment for adverse reactions to certain drugs. The Drug Abuse Warning Network (DAWN) measures these ED visits. In 2011, oxycodone products (which includes Percocet) were responsible for the largest number of ED visits involving the nonmedical use of narcotic pain relievers, at over 150,000 ED visits. HHS reports that abuse of opioid analgesics may cost upwards of $70 million annually in healthcare and medical costs.
Percocet is a combination drug also, which according to The New York Times, may make it more dangerous when used regularly, as it may lead to acetaminophen poisoning or overdose. The U.S. Food and Drug Administration (FDA) even places warning labels on Percocet regarding potential side effects when it is not used as directed or when it is mixed with other drugs or alcohol. The FDA also cites the potential for Percocet to be habit-forming and lead to drug dependence.
Opioids, such as Percocet, function to block pain by altering chemical pathways in the brain related to pain sensations. They also slow down some of the functions of the central nervous system, like respiration rates, blood pressure, and heart rate. The neurotransmitters, which are the brain’s natural chemical messengers, that are responsible for sending signals to feel pleasure, such as dopamine, are also disrupted with Percocet use or abuse. Opioid drugs fill opioid receptors and may cause a surge of dopamine levels in the brain, which is what causes the euphoric rush when these drugs are abused.
Percocet tablets may be crushed and snorted or smoked, or the resulting powder dissolved and injected. These methods send all of the drug into the bloodstream at once, causing an intense “high” as well as increasing the risk for a life-threatening overdose.
The journal Physiological Reviews, published by the American Physiological Society, states that opioid drug abuse can impact the positive reinforcement structure in the brain, causing emotional, physical, and behavioral changes, and transforming recreational drug abuse into compulsive usage and therefore potentially into addiction.
When people are abusing Percocet, they may seem like they are under the influence of alcohol. They may slur their speech and have decreased motor coordination, lapses in short-term memory, and trouble concentrating or making sound decisions.
They may engage in potentially dangerous behaviors, and have lowered inhibitions and less control over their impulses. As the drug wears off, they may be irritable or dizzy, suffer from headaches and chills, notice an increase in blood pressure, yawn a lot, and have dilated pupils, a runny nose, and tear up easily. In addition, they may have difficulties sleeping, an irregular heart rate, and muscle aches. Depression and anxiety may also be present.
Dependence is when the body and brain expect the drug’s influence and therefore stop performing normally without it, due to the changes in brain structure and function related to regular and repeated drug abuse. Withdrawal and drug dependence are some of the potential signs of addiction, which may also be accompanied by drug tolerance.
The National Institute on Drug Abuse (NIDA) states that opioid addiction treatment that includes the use of medications, behavioral interventions, screening for potential co-occurring mental health and medical disorders or diseases, and measures to reduce overdose are the most comprehensive and beneficial in treating addiction. Drug abuse and addiction treatment programs encompass many different methods and formats. The most common forms include outpatient, intensive outpatient, and residential treatment programs. All three are likely to include some form of behavioral therapy that uses both group and individual sessions to help clients develop new tools and coping mechanisms. In addition, therapy helps to improve self-esteem and self-reliance by dispelling negative thoughts and destructive actions.
Family, group, and individual counseling sessions are useful for teaching healthy communication skills and providing relevant educational information. Outpatient programs can be flexible with a person’s existing schedule, fitting meetings and sessions around work, school, or family obligations. Residential programs may include more treatment options and often provide the most comprehensive substance abuse and addiction treatment. Intensive outpatient programs generally follow the same schedule as residential programs; however, the client commutes back and forth from home each day/night. Drug abuse treatment facilities employ trained professionals who can help individuals choose a program that best suits their specific needs.
Since opioid withdrawal can be rather intense without professional help, medical detox is always recommended. Medical detox provides around-the-clock mental health support and medical monitoring, ensuring clients remain safe throughout the entire process.
Pharmaceuticals are commonly used during medical detox from opioids. These medications fall into five main categories:
The FDA approves methadone, buprenorphine and combination products, and naltrexone for the treatment of opioid addiction, ASAM publishes. These medications may be used at different times throughout treatment and recovery, and they can help manage withdrawal as well as prevent relapse when used in conjunction with behavioral methods.
During detox, agonist or partial agonist medications may be useful in replacing Percocet to lessen withdrawal symptoms and cravings. The agonist drug methadone has a long half-life of about 30 hours, according to the FDA, meaning it can stay in a person’s system for much longer than Percocet, which has a half-life of 3-4 hours, per its manufacturer Endo Pharmaceuticals. The longer the drug stays in the body, the longer the withdrawal symptoms may be held off. Doses of methadone can then be tapered over a set period of time during detox.
Partial agonists like buprenorphine don’t fill the opioid receptor sites as completely as full agonists do, meaning that they are less likely to produce a “high”.
They may have a plateau effect after a certain amount is ingested. These drugs can be used as substitutions for full-agonists during detox to combat cravings and withdrawal as well.
Naloxone and naltrexone are opioid antagonists. They serve to block opioid receptors sites from receiving more opioids. In combination products, the antagonist drug lies dormant unless the drug is abused or more opioids are introduced. Once activated, antagonists may precipitate withdrawal, making these medications useful tools for preventing relapse and ensuring compliance beyond detox and into recovery.
Other medications or supplements that target specific symptoms may be useful during medical detox when prescribed and monitored by a medical, mental health, or substance abuse treatment provider. These medications can include anti-nausea, anti-anxiety, and antidepressant medications, among others.
Percocet, a combination of the narcotic opioid drug oxycodone and the analgesic acetaminophen, is commonly abused for the euphoric effects it can produce. Percocet can abuse can be fatal, as an overdose slows down breathing and cardiovascular functions to dangerously low levels. The New York Times reports that in 2014 almost 30,000 Americans died from an opioid overdose.
Opioid drugs are highly addictive, making changes to the brain that can lead to tolerance, dependence, and addiction. Withdrawal and drug cravings may be mitigated with medications during medical detox and treatment. Detox is part of a complete Percocet abuse and addiction treatment program that serves to improve the physical, emotional, behavioral, and social aspects of life that addiction can impact. Individuals and their loved ones can choose from a variety of programs that promote lasting recovery.