Roxicodone Withdrawals: What to Do (& Timeline)
Oxycodone is an opioid medication that is marketed under numerous brand names, one of them being Roxicodone. Roxicodone is an immediate-release formula for oxycodone hydrochloride and available in doses of 5 mg, 50 mg, and 30 mg. Abusers of opiate drugs develop significant tolerance to these substances and may not always take them orally. They may grind up the pills and either snort the powder or mix it with water and inject the substance. Street names for Roxicodone include blues and Roxies.
Oxycodone is developed from morphine, and its effects are similar to other opiate or narcotic drugs.
People who abuse oxycodone will also experience the above immediate symptoms, but as these individuals typically take much larger amounts of the drug than people who use for medicinal purposes, the effects are magnified. This can also include any side effects that occur as a result of drug use, such as lethargy, nausea, constipation, paradoxical effects (an actual increase in pain or anxiety), etc.
The immediate effects of using the drug as prescribed are:
- Decreased reflex actions, decreased speed of thought, and mild issues with motor coordination
- A feeling of mild sedation
- A decrease in the subjective experience of pain
- Some mild euphoria or giddiness
The DEA classifies products that contain oxycodone in the Schedule II controlled substance listing, indicating that while these drugs do have useful medical applications, they are also drugs that have a significant potential for abuse. These drugs are only considered safe when they are used under the supervision of a physician. Purchasing or obtaining these drugs without a prescription is illegal.
Physical Dependence and Withdrawal from Roxicodone
Physical dependence as a result of using opiate medications is not limited to abuse of the drug; it may also occur in people who use these drugs medicinally for significant periods of time. When oxycodone products are taken under the supervision of a physician and according to their prescribed instructions, the development of physical dependence is not considered to be a sign of addiction or a substance use disorder; a substance use disorder that develops as a result of abusing oxycodone products would be labeled an opiate use disorder.
The level of physical dependence that occurs due to the medicinal use of a drug is not as severe as the level of the physical dependence in abusers because abusers habitually use very high doses of the drug (compared to medicinal users) and will often use it more frequently.
Physical dependence on any substance consists of two separate but interconnected syndromes: tolerance and withdrawal. Tolerance occurs relatively commonly as a result of continual use of many different medications. A person’s body adjusts itself to the presence of any drugs in the system, and people find that they need more of the drug to get the same effects that occurred when they first started using it.
When drugs are used medicinally, this situation can be addressed by a prescribing physician; however, when drugs are abused, the development of tolerance drives the individual to continue to use more and more of the drug because the psychoactive effects of the drug will naturally diminish over time.
The withdrawal syndrome associated with oxycodone is not normally considered to be potentially fatal, but may produce severe emotional distress, confusion, and issues with judgment that can result in an individual engaging in self-harm (e.g., potential suicidality) or overdosing on the drug in an attempt to self-manage their withdrawal symptoms. The overdose effects associated with opiate drugs can lead to significant brain damage and even fatalities.
As tolerance develops, the potential to develop withdrawal syndromes to certain types of drugs also increases. The withdrawal syndrome occurs when levels of the drug in the person’s system drop due to normal metabolic processes (detoxification), and the person’s system is thrown out of balance. The person will often begin to experience the type of symptoms that the medication is initially designed to control; in the case of oxycodone, pain, muscle stiffness, muscle cramps, etc., will be early symptoms. Withdrawal also often entails an exacerbation of the side effects of the drug (e.g., nausea, vomiting, anxiety, etc.) in addition to other effects, such as psychosis, tremors, etc. The withdrawal syndrome associated with some drugs of abuse, such as alcohol, can lead to serious complications, especially seizures that can produce fatal complications.
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The Withdrawal Timeline
The withdrawal syndrome from oxycodone products will follow a similar timeline in most individuals. An acute phase will often begin after a few hours of discontinuing use in people with high tolerance, and it will typically begin within 24 hours of discontinuation for most abusers.
For most people, the initial symptoms include:
- Feelings of jitteriness or anxiety
- Nausea, diarrhea, stomach cramps, and vomiting
- Severe confusion, irritability, aggressiveness, and emotional distress may be present
- Muscle aches, headache, runny nose, and watery eyes
- Mood swings, depression, and cravings to use the drug
- Fever, clammy skin, chills, and excessive sweating
Symptoms in the acute phase will most often last three or four days and then slowly begin to decrease in intensity, although some people who develop significant tolerance and abuse very high amounts of Roxicodone or other oxycodone products may experience a longer acute phase. Severe symptoms lasting more than a week may suggest some other co-occurring issue.
Once the intensity of the symptoms begins to decrease, there will be a longer period of seven days to two weeks where symptoms may be present but will slowly decrease in intensity.
The psychological and emotional symptoms may not subside as quickly as the physical symptoms, and people may experience issues with insomnia, anxiety, depression, and cravings at a more intense level than the physical symptoms of withdrawal.
For most individuals, the symptoms will have run their course within one to four weeks after discontinuation. Prolonged symptoms that continue are often related to psychological issues, such as depression, the aftereffects of a substance use disorder, etc. These symptoms are often not related to the physical withdrawal process, but represent psychological issues as a result of attempting to adjust to abstinence, or they may represent issues that were present before one’s drug use. Symptoms like depression, cravings for Roxicodone, problems with motivation and severe pessimism, etc., should not be ignored; they should be addressed by competent mental health professionals.
As mentioned above, the withdrawal syndrome associated with opiate drugs is not considered to have potentially serious physical complications on its own, but people can become dehydrated, which can lead to serious issues. In rare cases, they may become psychotic and suffer extreme emotional distress that can result in self-harm or accidents due to poor judgment.
What Should a Person Who Experiences Withdrawal from Roxicodone Do?
It is strongly recommended that anyone who uses opiate drugs like Roxicodone for a period of more than three or four weeks on a regular basis not attempt to discontinue their use of the drug without professional medical supervision. This recommendation is especially relevant for abusers of opioid drugs who typically develop significant tolerance levels. The potential for overdosing on an opioid drug is significantly increased when an individual attempts to stop using it, becomes emotionally distraught, and then relapses. Tolerance to the drug may have decreased and/or the person may take a significantly higher amount than they can endure, resulting in an overdose.
The safe approach to discontinuing use of any opioid drug is to become involved in a physician-assisted withdrawal management program (a medical detox program). The physician, most often an addiction medicine physician or psychiatrist, will monitor the person during the early stages of recovery and often prescribe an opiate replacement medication (most likely Suboxone, but there are other medications that can be used as well). The medication will be prescribed at a dose that will result in any withdrawal symptoms being very mild or not being present at all. Other medications to address lingering symptoms may also be prescribed, and treatments for any co-occurring issues such as depression will also be instituted.
The opioid replacement medication will be prescribed and administered on a schedule that allows the physician to taper down the dosage. This means that the physician will slowly decrease the dose of the drug at specified intervals to allow the person to slowly be weaned off the drug and at the same time not experience significant withdrawal symptoms. The process is personalized and adjusted to suit the specific withdrawal period of the individual; however, it often takes at least several weeks to several months to complete. This tapered approach is far safer and reduces the risk of relapse.
Simply completing a withdrawal management program is not a program of recovery from an opiate use disorder. Individuals should get involved in an intensive aftercare program once the withdrawal process from Roxicodone is complete. This program should include substance use disorder therapy (in either a group or individual session format), involvement in peer support groups such as 12-Step groups, getting help and support from family and close friends, continued medical management of issues that need to be addressed, and other interventions and complementary treatments that were recommended as a result of the initial overall evaluation that was performed before the person entered the withdrawal management program. Recovery from an opiate use disorder is a long-term process that requires commitment to abstinence and the development of new skills and attitudes.
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