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Things You Should Know About Percocet Withdrawal

Things You Should Know About Percocet Withdrawal

Percocet is a short-acting combination drug that contains oxycodone and acetaminophen. This opiate drug is prescribed for individuals affected by moderate to severe pain. This Buzzle write-up provides information on the things you should know about Percocet withdrawal.
Smita Pandit
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the emergency department visits that involved oxycodone products, such as Percocet, increased by 152% between 2004 and 2008.
Marketed by Endo Pharmaceuticals, Percocet is the brand name for an opioid analgesic that contains oxycodone and acetaminophen. While the former is a Schedule II Controlled substance that is regulated by the Drug Enforcement Administration of the United States due to its high potential for abuse, the latter is an over-the-counter non-opiate analgesic with antipyretic properties. It was in 1976 that the FDA approved the oxycodone/acetaminophen combination. Like most opiates, sudden discontinuation of Percocet by individuals who have been using it for an extended period can give rise to withdrawal symptoms. The severity of these symptoms might vary, depending upon factors such as the daily dosage, duration of use, and the overall health of the individual. This combination drug is marketed under different brand names such as Primlev, Tylox, Xolox, Taxadone, Narvox, Magnacet, etc.

The regular use of this drug can lead to drug dependence, which is a physiological state wherein the user feels that he/she needs to take the drug to function normally. This state might be associated with drug tolerance, which in turn is a state in which a higher dose of the drug is needed to achieve the response felt on initial use. It must be noted that an individual affected by drug dependence does not necessarily develop an addiction.

Percocet Use and Withdrawal

Percocet works by binding to the µ (mu or morphine) and k-opioid receptors in the central nervous system. The acetaminophen component of the drug locates the cyclooxygenase enzyme that controls the production of prostaglandins. As the special nerve endings that sense pain are very sensitive to prostaglandins, they respond to it by transmitting the pain messages through the nervous system to the brain. Acetaminophen prevents the damaged cells from producing or releasing prostaglandin, thereby preventing one from experiencing pain. The oxycodone component binds to the opioid receptors and stimulates the production of endorphins to mask the pain. This not only changes the user's perception of pain, but can also give rise to feelings of euphoria. Unfortunately, many users develop a physical dependence on this potent, habit-forming analgesic, and the abuse of this prescription drug has become quite rampant due to its ability to provide pain relief, euphoria, slowed breathing, and relaxation.

It must be noted that abruptly discontinuing certain drugs can cause a rebound effect, wherein there might be the return of the original symptom in the absence of the original cause. Sudden discontinuation of Percocet after prolonged use can also cause withdrawal symptoms, which might appear 6-12 hours after the last dose. The symptoms usually peak 2-3 days after the last use, and might last for a week.

The intensity and duration of the symptoms could vary from person to person. The withdrawal symptoms might include:

✦ Fever
✦ Yawning
✦ Flu-like symptoms
✦ Anxiety
✦ Severe stomach ache
✦ Muscle pain
✦ Insomnia
✦ Nausea and/or vomiting
✦ Runny nose and tearing of eyes
✦ Sweating
✦ Goose bumps
✦ Dilated pupils

Coming to the opiate withdrawal timeline, the first two days after the last dose are usually the most difficult. During this time, the user is likely to experience pain and muscle aches, due to the discontinuation of the drug that was altering the perception of pain. Profuse sweating, anxiety/panic attacks, sleeplessness, and loss of appetite might be experienced. The user might also experience mild flu-like symptoms.

From the third day till the fifth day after the last use, the intensity of pain reduces considerably, but one might find it hard to eat. Other symptoms that might be experienced include goose bumps, shivers, abdominal cramping, and vomiting.

The withdrawal symptoms are likely to become mild or resolve after the fifth day, but some users might still experience nausea and anxiety. In some cases, mild symptoms might be experienced for a few months after discontinuation of the drug.

Assessment of Withdrawal Symptoms

The Clinical Opiate Withdrawal Scale (COWS) is a clinician-administered instrument that can be used to assess the physical dependence and the intensity of withdrawal, on the basis of eleven common opiate withdrawal signs or symptoms. These symptoms include:

✦ Resting pulse rate
✦ Sweating
✦ Restlessness
✦ Pupil size
✦ Joint pain
✦ Runny nose or tearing
✦ GI upset
✦ Tremors
✦ Yawning
✦ Anxiety/Irritability
✦ Gooseflesh skin

Percocet Withdrawal Treatment

The response to oxycodone can vary from person to person, which is why medical assistance must be sought by those who feel that they have developed physiological and psychological dependence on this drug. Users must never discontinue the drug abruptly. It is essential that the doses are tapered off by a doctor, so as to reduce the dependence on the drug. If a person attempts to reduce the dependence on his/her own, he/she might not be able to resist the cravings. Therefore, it would be best to get yourself enrolled in a licensed inpatient medical detox facility.

A person who has a severe addiction should join a drug rehabilitation center, where he can learn about ways to manage the craving or urges to use the drug. Individuals with prior experiences of substance abuse would definitely benefit by joining support groups and counseling. The chances of relapse reduce considerably in case of individuals who have enrolled in a drug rehab facility. Withdrawal syndrome can also be precipitated by opioid antagonists. Thus, the treatment might involve opiate replacement therapy with intravenous administration of suboxone (a combination of a mild opiate called buprenorphine and naloxone, which helps reverse the effects of opiates) or a quick detox.

Though Percocet is a prescription drug that can be purchased only on a doctor's prescription, the incidence of its abuse is increasing at an alarming rate. According to the National Institute of Drug Abuse (NIDA), opiates are one of the commonly abused prescription drugs. It is believed that 9% of the population of the United States have misused opiates at some point during their lifetime. Another study conducted by the government in 2011 found that seven million Americans have been abusing opioid analgesics for non-medical reasons. Unfortunately, many users resort to unscrupulous methods such as stealing pills, forging prescriptions, doctor shopping, etc., to replenish their supplies. Crushing, chewing, snorting, or liquefying the drug increases its effects, which is why some pharmaceutical companies even changed the formulation so that the drug becomes harder to crush.

Percocet is a habit-forming drug, and users can develop physical and psychological dependence on it, which is why it is essential that it is taken under medical supervision. The best way to avoid the withdrawal symptoms is to slowly decrease the dose, as per the doctor's advice. One should never discontinue the drug abruptly.
