Percocet® Addiction

Percocet® Addiction

Percocet AddictionPercocet addiction has been on the increase since August 2011 when Purdue Pharmacies changed the format of their opiate painkiller OxyContin. The new formulation makes it harder to crush, chew, snort, or liquefy OxyContin because it turns to goo when you try any of these maneuvers addicts perform to increase the drug’s effects. Percocet still comes in crushable pill form and contains oxycodone, the main ingredient in OxyContin. Former addicts of OxyContin particularly desire Percocet pills that contain the largest amounts of oxycodone.

OxyContin addicts are also switching to heroin. In fact, one of their most frequently asked questions is, “Are heroin and oxycodone the same drug?” The answer is a qualified yes. Oxycodone turns into morphine in the body, and heroin is dicetyl morphine, which is morphine with an acetyl molecule. Heroin is about three times stronger than morphine and delivers a stronger “high” than oxycodone, although some addicts say they cannot tell the difference when they take a time-released version of oxycodone intravenously. Opium, heroin, morphine, and oxycodone are all close chemical cousins, and each one will produce a similar withdrawal syndrome when you try to quit them. Up to 9% of all Americans will have to go through opioid withdrawal syndromes at least once.

About seven million Americans or 4.8% of those over 12 years old are using opioid painkillers for nonmedical reasons, according to a November 2011 government report. Oxycodone drugs like Percocet are the most commonly abused opioid painkillers with 200 million prescriptions or 154,323 pounds of oxycodone consumed per year. Sadly, this painkiller epidemic is showing no signs of abating.

What Is Percocet?

Percocet is a combination of oxycodone, a narcotic painkiller; and acetaminophen, an over-the-counter painkiller commonly known by the trademarked name Tylenol. Percocet is a Schedule II Controlled Substance, which means it is highly regulated by the U.S. Drug Enforcement Agency because of its potential for addiction. You need a doctor’s prescription to legally acquire Percocet, and refills are not allowed without another prescription.

Percocet is made by Endo Pharmaceuticals, which also makes Percodan. Percodan is a combination of oxycodone and aspirin, and has been on the market since 1950. These drugs are prescribed for moderate and severe pain, most commonly from bursitis, fractures, neuralgia, arthritis, lower back pain, cancer, and for pain after certain surgeries or childbirth.

Percocet pills are easily recognized because they all have the word “Percocet” written on them. The lower dosage tablets are blue and pink and either round or oval-shaped, and the higher dosage ones are yellow and shaped like a capsule. The amount of oxycodone ranges from 2.5mg to 10mg per pill. The maximum dose is twelve 2.5mg pills or six 10mg per 24 hours. Urine tests for drugs can detect Percocet up to two days after using it.

Oxycodone, like all opioids, works by attaching itself to receptors in the central nervous system, brain, spinal cord, and gastrointestinal tract. It also affects areas of the brain associated with pleasure. The main effects of oxycodone are pain and anxiety relief, relaxation, euphoria, and slowed respiration.

Acetaminophen is made from sodium nitrate, sodium borohydride, and acetic anhydride, and probably relieves pain either by holding back cyclooxygenase (COX), an enzyme associated with pain and inflammation or by affecting spinal cord receptor cells.

Risks And Side Effects Of Percocet

The main risk of Percocet is oxycodone addiction, which can take less than a week to occur in some people. Everyone reacts individually to oxycodone. Some people would rather endure pain than enter a drug-induced stupor that can last many hours while others love the euphoric feeling oxycodone can produce. Once people become physically dependent upon Percocet, most will keep using it to avoid withdrawal symptoms.

Another risk from oxycodone use is a lowered rate of respiration. If Percocet is used with other drugs that depress the central nervous system, breathing can stop. The elderly and people with respiratory problems, such as asthma or hypercarbia, should not use Percocet. Percocet like all opioids takes away your ability to feel pain so you lose a useful warning sign of serious disease.

The other main danger of abusing Percocet is liver damage caused by acetaminophen. What happens is that people build up a tolerance to Percocet and take it in higher amounts in order to achieve the effects they want. However, their livers can only metabolize so much acetaminophen before incurring permanent damage that can lead to death. The most common scenario for such damage is taking too many Percocet at once or taking it with alcohol or over-the-counter drugs such as cold and allergy remedies that contain acetaminophen. Liver damage from acetaminophen causes the deaths of 400 Americans and 43,000 hospitalizations every year.

The medically recommended maximum dose of acetaminophen is 4000mg per 24 hours.

People with problems of the lungs, liver or kidneys should not take Percocet. It is not prescribed to those with histories of drug abuse or alcoholism, hypothyroidism, brain tumors, head injuries, low blood volume, mental illness, pancreatitis, seizures, Addison’s disease, or curvature of the spine with respiratory depression.

Whether Percocet is cancer-causing or whether its combination of acetaminophen and oxycodone is toxic are both unknown.

The most difficult side effect of oxycodone to manage is often severe constipation. Percocet causes this condition by lessening contractions in the intestine and increasing smooth muscle tone in the stomach and duodenum. Laxatives usually will not work, and some patients have to take opioid antagonists for this condition. Other common side effects are drowsiness, headache, nausea, sleeplessness, vomiting and weakness. Rare side effects of oxycodone can be seizures, confusion, fainting, chest pain, fever, chills, difficult or painful urination, irregular heartbeat, mental or mood changes, numbness of an arm or leg, seizures, severe or persistent dizziness or light-headedness, slowed or difficult breathing, unusual tiredness or weakness, and vision changes.

Side effects of acetaminophen can be bloody or cloudy urine or other problems in urination, fever with or without chills, skin rash, itching, sore throat, ulcers, sores, or white spots on the lips or in the mouth, bloody or black, tarry stools, hives, decrease in the amount of urine, bleeding or bruising, yellow eyes or skin, pain in the lower back and/or side, tiredness or weakness, and/or pinpoint red spots on the skin.

Some people are allergic to oxycodone, and they can even die the first time they try it. Symptoms of allergic reaction can be a rash, hives, trouble breathing or swallowing, seizures, confusion, loss of consciousness, slow or fast heartbeat, swelling of the hands and face, and itching.

Percocet And Drug Interactions

Percocet interacts adversely with hundreds of prescription and over-the-counter drugs. It should not be taken with any medication that slows the breathing or depresses the central nervous system, including drugs such as alcohol, benzodiazepines, barbiturates, and anti-histamines. Any other opioid drug, such as fentanyl, codeine or hydrocodone, will increase the effects of oxycodone and could cause overdose. Do not take Percocet with sedatives, tranquilizers, sleeping pills, general anesthesia, opioid agonists, or after bowel surgery.

Do not take Percocet with over-the-counter remedies that contain acetaminophen. Less than ten grams of acetaminophen taken once can cause permanent liver damage, and 15 grams can cause death. Acetaminophen reacts with aspirin, alcohol, anticholinergics, beta blockers, diuretics, ibuprofen, and many prescription drugs like Nalfon, Relafen, Daypro, Clinoril, and Tolectin.

Percocet Overdoses

You can overdose and die from either oxycodone or acetaminophen.

Symptoms of overdose from oxycodone can be slowed or stopped breathing, extreme sleepiness, stupor, coma, flaccid muscles, cold skin, constricted pupils, heart attack, and death rattle. Emergency medical personnel usually administer oxygen and IV fluids, and they may perform cardiac massage or defibrillation. They sometimes use naloxone, an opioid antagonist.

Symptoms of an acetaminophen overdose might be nausea, vomiting, excessive sweating, and feelings of malaise. At the emergency room, a physician might pump the stomach and administer certain medications. Laboratory work done 48 to 72 hours afterward overdose can determine the extent of liver damage. About half the people who overdose on acetaminophen are taking prescription medications like Percocet.

Why Do People Abuse Percocet?

There is a difference between becoming physically dependent on Percocet or becoming an Percocet addict. Many patients in chronic pain or with cancer benefit from Percocet, although they become physically dependent on it and experience withdrawal syndromes when they stop using it. However, their doctors usually lower their dosages gradually to prevent discomfort and these patients will not experience drug cravings and relapses, which are characteristic of addiction.

Several new studies about Percocet and other opioid painkillers indicate that they may do more harm than good for short-term pain and should not be prescribed to people with anxiety disorders. A recent study found that people injured at work and who were given opiate pain killers cost their insurance companies nine times more than those who did not receive the drugs. They also lost more time from work. The average insurance claim of an injured worker not using opioid painkillers was $13,000; those who used Percocet averaged $39,000; and those who were prescribed OxyContin averaged $119,000. A 2012 study published in the Journal of the American Medical Association found that veterans of the Middle Eastern conflicts suffering from posttraumatic stress syndrome were prescribed opioid painkillers more often and were more likely to engage in addictive behaviors such as refilling their prescriptions early and using sedatives with the opioids.

The majority of Percocet addicts have histories of drug abuse or alcoholism, and only about 10% started as pain patients. Percocet addiction affects people of all races, genders, and social economic classes. Three regions of the United States — Appalachia, Florida, and Philadelphia– are epicenters of oxycodone addictions.

Percocet addicts obtain their supplies by forging prescriptions, “doctor shopping,” stealing pills, robbing pharmacies, and from street dealers or unscrupulous medical professionals. They may bring fake x-rays to “pain clinics” to obtain Percocet.

Signs You Are Addicted To Percocet

If you can answer yes to one or more of these questions, it is time to consult your family physician about your abuse of Percocet.

  • Do you take Percocet when you feel upset, stressed or angry?
  • Do you take Percocet to avoid withdrawal symptoms such as severe headache?
  • Are you risking problems with the law in order to obtain Percocet?
  • When Percocet is not available to you, do you use illegal drugs?
  • Does your use of Percocet jeopardize your financial future?
  • Do you steal or present false medical information to obtain Percocet?
  • Is your abuse of Percocet interfering with your ability to meet your obligations at work or school, and with your family?
  • Do your friends and family criticize you because you abuse Percocet? Do they accuse you of being moody and withdrawn from them?
  • When you try to go a few days without taking Percocet, does it take over your thoughts until you can find a new supply?
  • Have you driven an automobile under the influence of Percocet?
  • Are you worried that you are jeopardizing your relationships and career if you continue to take Percocet?
  • Have you tried to quit Percocet and failed?
  • Do you know that Percocet is causing you health problems or other difficulties, and yet you continue to abuse it?

Percocet Addiction Withdrawal

Percocet withdrawal syndrome is the same as withdrawal from any other opiate, including heroin or OxyContin. Symptoms begin within six to eight hours of stopping the drug, and may first include teary eyes, feeling very tired, runny nose, yawning, sweating, muscle aches, anxiety, and agitation. Later symptoms are diarrhea, dilated pupils, goosebumps, nausea, vomiting, and abdominal cramps. People have described the syndrome as similar to an extremely agonizing case of the flu.

The most frequently asked questions about Percocet withdrawal is how long does it last, and is it possible do it alone. It takes 36 to 48 hours for the drug to completely leave your system, but how long the symptoms last varies by individual factors, such as how much Percocet was taken, how long it was taken, what is your general health, etc. It is possible to do it yourself, but your chances of success are much better if you enter a detoxification center. Medical professionals will monitor your progress on a 24-hour basis, and may administer certain drugs to help you experience less discomfort. Clonidine, for example, reduces anxiety and agitation, among other symptoms.

Percocet Addiction Treatment Programs

Like treatment for any other addiction, Percocet addiction treatment is complex and protracted, and requires a multi-disciplinary approach. Usually, people who enter residential treatment centers for at least a month have higher success rates than those who try to do it on their own or use out-patient or day treatment centers. Residential treatment allows them to get out of their old drug environment and get a fresh start. Detoxification from Percocet is just the first step; many Percocet addicts will think and talk about their drug for months and sometimes years after they no longer use it. Relapse is usually considered a normal part of long-term recovery.

Within a residential treatment center, a patient learns to relax without using Percocet through techniques like yoga, art, meditation, working with animals, and so forth. Art, drama, and music therapy helps a person get in touch with his or her emotions. Family support and family therapy are usually vitally important to success, as well as individual therapy. Cognitive behavioral therapy is most often used in drug rehabilitation because it helps a patient recognize and change maladaptive thinking patterns.

The vast majority of people addicted to Percocet or other substances have comorbidities. These are separate psychiatric conditions that were probably never diagnosed or treated. The most common are depression, severe childhood trauma, bipolar disorder, attention deficit disorder, and anxiety disorders. These are addressed within separate medical protocol.

Drugs are available to help people in recovery from Percocet addictions. Naltrexone is a long-lasting opioid receptor blocker used after detoxification. Naloxone is a short-acting opioid receptor blocker, also used to treat overdoses. Buprenorphine and methadone are man-made opioid drugs sometimes used to help addicts.

Suboxone, a combination of buphrenorphine and naloxone, comes in film or tablet form and is sometimes taken once a day during Percocet maintenance programs.

The Future Of Percocet

In 2009, an advisory panel from the U.S. Food and Drug Administration recommended that Percocet be taken off the market because of the danger of liver damage from acetaminophen. However, the recommendation never went into effect. In 2011, another FDA panel recommended that Percocet and similar prescription drugs contain no more than 325mg of acetaminophen. This recommendation would not apply to over-the-counter drugs containing acetaminophen.

Currently, the Obama administration wants to mandate better training for doctors who prescribe opioid painkillers, a measure that would require Congressional action to amend the Controlled Substance Act of 1970. So far nothing has been done. Over 600,000 doctors, dentists and physician assistants can legally prescribe any of the more than 400 opiate painkillers on the market today.

Sources:

Goodnough, Abby and Katie Zezima. “Drug Is Harder to Use but Users Persevere,” the New York Times. June 15, 2011.

Ibid.

“Oxycodone,” U.S. Office of Diversion Control, The U.S. Department of Justice, 2009, see http://www.deadiversion.usdoj.gov/drugs_concern/oxycodone/summary.htm

“Overdoses of Prescription Painkillers, November 2011,” The Centers for Disease Control. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm

Ibid.

“Stronger Form Of Oxycodone Means More Pain For The USA,” The Florida Sun-Sentinel, December 29, 2011.

Harris, Gardiner. F.D.A. Plans New Limits on Painkillers. The New York Times, January 13, 2011.

“Oxycodone,” U.S. Office of Diversion Control, The U.S. Department of Justice, 2009, see http://www.deadiversion.usdoj.gov/drugs_concern/oxycodone/summary.htm

“Our Products,” Endo Pharmaceuticals, see http://www.endo.com/endopharma/our-products

“Percocet,” Daily Med, the National Institute of Health, see http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=22184

Ibid.

“Oxycodone and Acetaminophen (Oral Route),” the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603201

“Facts on Opioid Painkillers, Prescription Drug Abuse,” the National Institute of Drug Abuse, see http://teens.drugabuse.gov/peerx/pdf/PEERx_Toolkit_FactSheets_RxDrugs.pdf

“Percocet,” Daily Med, the National Institute of Health, see http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=22184

McNicol, Ewan (PhD). How Tylenol Works, Ask the Professor, Tufts University, see http://tuftsjournal.tufts.edu/2008/04/professor/01/

Andersson DA, Gentry C, Alenmyr L, Killander D, Lewis SE, Andersson A, Bucher B, Galzi J-L, Sterner O, Bevan S, Högestätt ED, Zygmunt PM (2011). “TRPA mediates spinal antinociception induced by acetaminophen and the cannabinoid Δ(9)-tetrahydrocannabiorcol”. Nat Commun 2: 551

“Oxycodone and Acetaminophen (Oral Route),” the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603201

Harris, Gardiner. “FDA Plans New Limits on Painkillers,” The New York Times, January 13, 2011.

“Acetaminophen,” Medline.Plus, the National Institute of Health, see

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a681004.html

“Percocet,” Daily Med, the National Institute of Health, see http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=22184 and “Oxycodone and Acetaminophen (Oral Route),” the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603201

Ibid.

Ibid.

Vondrackova D, Leyendecker P, Meissner W. et al. Analgesic efficacy and safety of oxycodone in combination with naloxone as prolonged release tablets in patients with moderate to severe chronic pain.J Pain. 2008; 9(12): 1144-1154.

“Oxycodone,” Medline Plus, The U.S. Library of Medicine, The National Institute of Health, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682132.html

“Oxycodone,” Drugs.com, see http://www.drugs.com/sfx/oxycodone-side-effects.html

Acetaminophen, The Mayo Clinic, See http://www.mayoclinic.com/health/drug-information/DR601885

“Oxycodone and Acetaminophen (Oral Route),” the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603201

“Facts on Opioid Painkillers, Prescription Drug Abuse,” the National Institute of Drug Abuse, see http://teens.drugabuse.gov/peerx/pdf/PEERx_Toolkit_FactSheets_RxDrugs.pdf

“Oxycodone and Acetaminophen (Oral Route),” the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603201

“Percocet,” Daily Med, the National Institute of Health, see http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=22184

Ibid.

Acetaminophen, The Mayo Clinic, See http://www.mayoclinic.com/health/drug-information/DR601885

“Overdoses of Prescription Painkillers, November 2011,” The Centers for Disease Control. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm

“Percocet,” Daily Med, the National Institute of Health, see http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=22184

Ibid.

Harris, Gardiner. F.D.A. Plans New Limits on Painkillers. The New York Times, January 13, 2011.

Meier, Barry. Pain Pills Add Cost and Delays to Job Injuries, The New York Times, June 2. 2012.

Dao, James. For Veterans With Post-Traumatic Stress, Pain Killers Carry Risks, The New York Times, March 7, 2012.

“Percocet,” Daily Med, the National Institute of Health, see http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=22184

Intelligence Bulletin: Oxycodone Diversion, July 2009, see http://www.justice.gov/ndic/pubs10/10550/index.htm

“Oxycodone,” U.S. Office of Diversion Control, The U.S. Department of Justice, 2009, see http://www.deadiversion.usdoj.gov/drugs_concern/oxycodone/summary.htm

“Opiate Withdrawal,” Medline Plus, The National Institute of Health,  see http://www.nlm.nih.gov/medlineplus/ency/article/000949.htm

Ibid.

Treatment Episode Data Set (TEDS), Substance Abuse and Mental Health Services Administration, seehttp://wwwdasis.samhsa.gov/webt/tedsweb/tab_year.choose_year?t_state=US

“Facts on Opioid Painkillers, Prescription Drug Abuse,” the National Institute of Drug Abuse, see http://teens.drugabuse.gov/peerx/pdf/PEERx_Toolkit_FactSheets_RxDrugs.pdf

“Suboxone,”  see http://www.suboxone.com/

Harris, Gardiner. F.D.A. Plans New Limits on Painkillers. The New York Times, January 13, 2011.

Ibid.

Meier, Barry and Abby Goodnough.  Administration Wants Tighter Painkiller Rules, The New York Times, April 19, 2011.

“Stronger Form Of Oxycodone Means More Pain For The USA,” The Florida Sun-Sentinel, December 29, 2011.

Find relief in recovery. Life gets better with addiction treatment.

Call our experts today.