Percocet is a medication primarily designed for the relief of moderate to severe issues with pain. Percocet contains both acetaminophen (a nonsteroidal anti-inflammatory drug that is available in over-the-counter medications like Tylenol) and the opiate medication oxycodone.
Varying strengths of Percocet are available. Percocet can contain 325 mg of acetaminophen with different concentrations of oxycodone, such as 2.5 mg, 5 mg, 7.5 mg, and 10 mg. Several different medications combine acetaminophen with an opiate medication (e.g., Vicodin). The acetaminophen accentuates the pain-relieving properties of the opiate medication and can also address other issues, such as swelling or fever. Acetaminophen is not believed to produce physical dependence in individuals who use it; however, chronic use of the drug and extremely large doses are believed to produce potential liver damage.
Oxycodone is an opiate drug. Opiate drugs are derived from substances in the Asian poppy plant or synthetically produced substances that mimic the chemical structure of different opiate drugs. Oxycodone is listed as a controlled substance, according to the United States Drug Enforcement Administration (DEA). Like many opiate substances used for pain management, it is classified as a Schedule II controlled substance. Medications in this classification have demonstrated medical uses; however, they are also extremely prone to being abused and likely to produce physical dependence in people who use them on a consistent basis for several weeks or more.
Physical dependence is a syndrome that consists of both the development of tolerance and withdrawal. Due to the nature of the development of physical dependence, people will develop significant tolerance to a drug (needing higher amounts of the drug to experience their effects) prior to the development of withdrawal symptoms. Withdrawal symptoms occur after the person’s body has adjusted itself to be able to only operate efficiently in the presence of certain levels of the drug in their system. Once these levels begin to decline due to the normal process of metabolism, the individual experiences ill effects, emotional distress, and other symptoms. The onset of withdrawal symptoms represents extreme motivation for the individual to begin taking their drug of choice again.
When individuals abuse drugs that have the potential for the development of physical dependence, they often become caught up in the cycle of using drugs to address the onset of withdrawal symptoms. This cycle of continued use exacerbates and accelerates their addictive behaviors.
Effects Associated with Percocet Use
The effects associated with use of Percocet can be divided into the immediate effects of taking the drug, the side effects associated with taking the drug, and long-term effects associated with use of the drug.
Briefly, the immediate effects of taking Percocet most often consist of:
- The diminished experience of pain
- Sedation, lightheadedness, and mild dizziness in some people
- Suppression of many normal bodily functions, including respiration rate, heart rate, blood pressure, etc., due to the central nervous system depressant effects of the drug
- Decreased response times and reflexes
- Feelings of euphoria
- Cognitive effects that are typically slowed thinking processes and issues with judgment
Nearly every medication is associated with some side effect profile. Some of the side effects that can be associated with Percocet use include:
- Nausea and vomiting
- Blurry vision
- Dry mouth
- Severe suppression of respiration rate
- In some rare cases, hallucinations and/or delusions
- In very rare cases, seizures
Some long-term effects associated with Percocet use can include:
- Respiratory issues
- Cardiovascular issues
- Liver damage
- Kidney damage
- Neurological damage
- Development of physical dependence
People who abuse Percocet are more likely to experience the side effects associated with the drug and far more likely to experience more intense effects of the drug, including long-term effects. This is because individuals abusing Percocet often take it in higher doses than typically prescribed, develop significant tolerance to the drug, and then continue to take more and more of the drug unless they can somehow discontinue use.
Withdrawal from Percocet
The withdrawal syndrome associated with Percocet use and abuse is often very distressing even though it is not usually lengthy. The actual intensity of the symptoms and the length of the withdrawal syndrome are dependent on several factors that can include how long they took the drug, how much of the drug they typically used, whether they typically use the drug in conjunction with other drugs, individual differences in metabolism, how they stop using it (stopping abruptly as compared to slowly tapering down the amount taken), and individual differences in emotional and psychological variables.
In general, the withdrawal syndrome will have the following progression:
- It begins with an initial period of acute and intense symptoms that will last for 1-3 days in most individuals. The onset of symptoms will typically occur within 24 hours for most users. Initial symptoms will typically include nausea, vomiting, muscle aches, sweating, diarrhea, clammy skin, fever, chills, headache, runny nose, watery eyes, and jitteriness. Some individuals experience mood swings, ranging from severe anxiety to depression, whereas others become very irritable and may even get aggressive. Most individuals will experience cravings throughout the withdrawal process. Cravings may become very intense in the initial stages of withdrawal. Some individuals may become confused, demonstrate poor judgment, and even demonstrate psychotic-like behavior (hallucinations and/or delusions).
- After 3-4 days, the symptoms will have peaked for most people and then begin to decrease in intensity. Low-level symptoms will still be present, but most individuals will find them to be far more manageable than the symptoms that occurred in the initial stages.
- The majority of people will continue to experience symptoms for 7-10 days that are decreasing in their intensity. Cravings will continue during this time, be intermittent, and fluctuate in intensity. Psychological symptoms, such as irritability, depression, anxiety, insomnia, issues with motivation, etc., will also continue for many.
- Within 1-2 weeks following discontinuation, the physical symptoms of withdrawal will have run their course for most people. Many individuals continue to experience issues with motivation, depression, periods of anxiety, irritability, romanticizing past drug use, and cravings for several weeks. Many may experience these symptoms on an intermittent basis for months and even years after discontinuation. Prolonged psychological symptoms that may occur during the acute phase of withdrawal and continue after 2-3 weeks most likely do not represent a formal withdrawal syndrome as is suggested by many sources but lacks empirical verification. Instead, these continuing experiences represent other emotional and psychological variables that often require therapy.
The withdrawal syndrome associated with opiate drug use is not generally considered to have potentially dangerous or fatal consequences; however, individuals may develop issues with emotional instability that can lead to irrational judgment, becoming accident-prone, and even suicidality. In addition, severe issues with diarrhea, vomiting, and appetite loss can result in an individual becoming severely dehydrated, which can have serious complications.
Treatment for Percocet Withdrawal
For patients who have used Percocet for medicinal reasons and under the supervision of a physician, the withdrawal syndrome is typically not an issue. Patients who have used Percocet for longer periods of time under the supervision of a physician are often not abruptly discontinued from the medication, but the physician will slowly taper down the dose they use to allow the person’s system to adjust before it is totally discontinued. People who abuse Percocet and take the drug in larger amounts are more often prone to having severe issues with withdrawal, relapse, and other complications. These individuals should be placed in a physician-assisted withdrawal management program when they are ready to discontinue their abuse of the drug.
A physician-assisted withdrawal management program for opioid drug abuse most often consists of the physician using opioid replacement medications (e.g., Suboxone) to avoid any significant withdrawal symptoms in the individual. The patient is given amounts of the opioid replacement medication that result in them not experiencing any withdrawal symptoms and then placed on a tapering schedule to wean them off the replacement medication. Other medications can be administered as needed to control any other symptoms, and other interventions for substance abuse should also be initiated during this period. The withdrawal management program will often take longer than the actual withdrawal process for many patients; however, it will be much more comfortable and the risk of relapse during the initial stages of recovery is significantly reduced.
Individuals who have opioid use disorders (who abuse Percocet or other opiate drugs) should not be under the impression that simply undergoing a withdrawal management program is sufficient to address their substance abuse. Anyone with a substance use disorder should become involved in a long-term aftercare program following participation in a withdrawal management program. Long-term aftercare consists of being involved in formal substance use disorder therapy, social support groups, treatment programs for any co-occurring psychological conditions, and other interventions as needed given the individual’s specific conditions.
The success of recovery from a substance use disorder is strongly associated with the length of time one spends in treatment, such that individuals who engage in treatment and recovery-related activities for longer periods of time have fewer relapses over the long-term.
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