Roxicodone Abuse and Detox
Roxicodone (oxycodone hydrochloride) is an opioid analgesic medication that may be prescribed for the treatment of moderate to severe pain. Roxicodone is one of the brand names for the opiate drug oxycodone, which can also be found in the drugs Percocet and OxyContin.On the street, the drug may be referred to as roxies or blues. Roxicodone is most often used as a tablet taken orally when prescribed. The dose of oxycodone in Roxicodone may be 5 mg, 15 mg, or 30 mg.
What Is Oxycodone?
Oxycodone is a very potent, semisynthetic, opiate drug that is developed from morphine. It produces similar effects to other opiate drugs (often referred to as narcotic drugs). In addition to its analgesic effects, oxycodone use also results in sedation, euphoria, and overall feelings of wellbeing.
Opiate substances like oxycodone readily attach to the neurons in the brain that are specialized for neurotransmitters associated with the natural control of pain, stress, and exertion. These neurotransmitters are often referred to as endorphins or enkephalins, and their chemical structure is similar to the chemical structure of drugs derived from opium (opiate drugs).
Oxycodone is classified as a Schedule II controlled substance by the United States Drug Enforcement Agency (DEA). The drugs classified under this schedule are all considered to have empirically validated medicinal uses, but they are also significantly dangerous drugs of abuse that are likely to result in the development of physical dependence in individuals who use them on a regular basis.
The development of physical dependence on oxycodone (displaying both the syndromes of tolerance and withdrawal) may or may not indicate that an individual has developed a substance use disorder (issues with abuse or addiction). Individuals who use oxycodone under the supervision of a medical doctor and according to its prescribed instructions are likely to develop physical dependence on the drug; however, because these individuals do not abuse the drug, they would not be diagnosed with a substance use disorder. Individuals who misuse or abuse the drug and develop physical dependence will inevitably have the symptoms of physical dependence documented as evidence that they have developed a substance use disorder. Misuse is often defined as any use of the drug that does not coincide with its prescribed purposes, and abuse refers to the misuse of a drug that leads to negative consequences for the person.
The Effects of Using Roxicodone
According to the book Opiate Receptors, Neurotransmitters, and Drug Dependence: Basic Science-Clinical Correlates, the effects of using oxycodone are varied.
- Initial effects: The initial effects of the drug are typically experienced as sensations of relaxation, a significant decrease in a person’s subjective experience of pain (its major prescribed use), decreases in feelings of anxiety, sedation, and feelings of wellbeing or euphoria. Several of the effects are dose-dependent, such that issues with sedation will develop into severe lethargy at higher doses that are often taken by individuals who misuse or abuse the drug.
- Common side effects: All drugs can produce side effects in individuals who take them. Side effects that are associated with oxycodone can include issues with nausea, stomach cramps, constipation, flushed skin, sweating, dry mouth, dizziness, and, in some cases, muscle weakness and headache.
- Rare side effects: All drugs are also likely to produce rare side effects in certain individuals. For instance, some individuals may develop allergic reactions to narcotic drugs. Other individuals may develop postural hypertension, which occurs when their blood pressure decreases as they move from a lying position to a sitting or standing position. Some individuals who use the drug for significant periods of time may be vulnerable to respiratory issues as a result of chronic suppressed breathing rates associated with the drug, whereas other individuals may develop issues with their liver or kidneys, or even cardiac issues. In very rare cases, individuals may develop hallucinations, delusions, and/or seizures associated with using the drug.
- Issues associated with long-term use or abuse: Individuals using Roxicodone for longer than a few weeks are likely to develop tolerance to the drug and withdrawal symptoms if the drug is discontinued or the dosage one uses is decreased rapidly. Individuals who misuse or abuse the drug are likely to develop a significant opiate use disorder. In addition, some individuals who abuse the drug may be more prone to developing other mental health disorders, such as depression, anxiety disorders, etc.Nearly everyone who takes the drug for a significant length of time will experience changes in the pathways in the brain. The extent and severity of these changes are dependent on the manner in which the drug is taken, such that individuals who abuse the drug in ways inconsistent with its prescribed instructions and in higher doses will experience more severe and debilitating brain alterations than individuals who simply use it under the supervision of a physician. Other organs, such as the liver, heart, and kidneys, can also be significantly affected by long-term use of Roxicodone.
Symptoms of an overdose on Roxicodone include:
- Extreme lethargy, sedation, issues with motor coordination, and slurred speech
- Pinpoint pupils, significantly decreased breathing, significantly decreased heart rate, a bluish tint to the lips, and flaccid muscles
- Extreme confusion, irrational behavior, and disorientation
- Unconsciousness or a comatose state
If anyone suspects an individual has overdosed on Roxicodone, they should call 911 immediately. If the person is unconscious, roll them on their side so they will not choke on regurgitated food, which can result in blocking their ability to breathe. Individuals who have overdosed on Roxicodone are often administered the opiate antagonist drug naloxone (brand name Narcan), which can reverse the symptoms of overdose if it is administered quickly. Some communities offer training in the administration of this drug for nonmedical personnel.
The risk of serious detrimental effects for individuals who use the drug for medicinal reasons and under the supervision of their physician is actually quite low. Most of these serious long-term side effects occur as a result of misuse or abuse of the drug. Individuals who abuse drugs like Roxicodone suffer numerous behavioral, social, and occupational issues associated with their substance use disorder.
In addition, the risk of overdose on Roxicodone is significantly increased when individuals misuse or abuse the drug. Because Roxicodone is a central nervous system depressant, meaning that its actions slow down the functioning of the central nervous system that regulates an individual’s breathing, heart rate, metabolism, etc., overdosing on the drug can result in a complete shutdown of these systems that can lead to significant organ damage or death.
Abuse of Roxicodone
Roxicodone is very potent, meaning its effects can be achieved with very small doses, and it has a rapid onset of action, meaning that its effects are experienced relatively quickly, and these features contribute to its potential for abuse.
The risk of developing an opiate use disorder as a result of Roxicodone abuse is increased in individuals who:
- Take the drug more frequently than prescribed
- Use the drug frequently and higher doses than prescribed
- Administer the drug in manners that are inconsistent with its prescribed uses, such as grinding it up and snorting it or mixing it with water injecting it
- Use the medication without having a prescription for it
The Substance Abuse and Mental Health Services Administration (SAMHSA) releases the most reliable figures regarding the abuse of many substances. According to its 2015 estimates, approximately 20 million people in the United States would qualify for a diagnosis of a substance use disorder, and about 2 million of these individuals would formally qualify for a diagnosis of a substance use disorder as a result of the abuse of prescription pain medications like Roxicodone.
The prevalence of opiate use disorders as a result of prescription pain medication abuse increased rapidly up until recently when the DEA, SAMHSA, and individual states began to monitor the prescription of these drugs and require physicians who prescribe them to perform risk management assessments on their patients. These actions resulted in the development of a database that allows physicians to determine if an individual has been getting prescriptions from multiple sources (an illegal practice) and to identify potential abusers of these drugs. These monitoring and education programs resulted in a significant decrease in the amount of prescriptions for medications like oxycodone being written, which reduce the drugs’ availability to potential abusers. As a result, the abuse of oxycodone products and other opiate drugs has declined significantly, but these drugs still remain significant substances of abuse, and the federal government, local state governments, and physicians need to continue to be vigilant regarding their distribution.
Treatment for an Opiate Use Disorder as Result of Roxicodone Abuse
Because individuals who abuse drugs like Roxicodone often develop significant tolerance, and this results in severe issues with withdrawal if these drugs are unavailable or intentionally discontinued, the treatment approach for a person with an opiate use disorder follows a specific progression to help the individual deal with the inevitable withdrawal syndrome they will experience. Even though treatment for Roxicodone abuse follows an overall blueprint, all treatment protocols for substance use disorders need to be adjusted to fit the specific needs of the individual in order for them to be effective.
According to the American Society of Addiction Medicine, the treatment approach should consist of the following components:
- The individual’s psychological, cognitive, and physical functioning should be thoroughly assessed before entering treatment in order to identify all the issues that require intervention and to understand the specific aspects of the person’s case.
- Individuals with opioid use disorders will initially be placed on a physician-assisted withdrawal management program (medical detox) that will most often include the use of an opiate replacement medication such as Suboxone to assist them in managing the withdrawal syndrome and controlling cravings. Suboxone is initially administered in a dose that will result in the individual experiencing no withdrawal symptoms or very mild withdrawal symptoms. After this, the dose is slowly tapered down at specific intervals to allow the person to adjust to decreasing levels of the opioid drug in their system and slowly wean themselves off the drug. This approach reduces the extreme potential for relapse, overdose, and recidivism in the early stages of recovery for individuals with opiate use disorders. These programs can be administered on an inpatient or outpatient basis, depending on the specific needs of the individual and the specific aspects of the case.
- Individuals in recovery should become involved in a formal substance use disorder therapy program that addresses the issues that fueled the person’s substance abuse, educates them about the abuse of substances, teaches them positive coping skills, helps them manage their stress, and engages them in a proactive program of relapse prevention. Individuals can become involved in individual therapy or group therapy, or, if possible, they can attend both individual and group sessions. The preferred method of substance use disorder therapy is Cognitive Behavioral Therapy; however, other approaches can also be used, depending on the needs of the individual.
- Recruiting family members and close friends of the individual to assist them in the recovery is often critical for an overall successful recovery plan. Family members can also participate in therapy via family therapy sessions, a type of group therapy where family members are also treated along with the individual suffering from the substance use disorder.
- Becoming involved in support groups, such as 12-Step groups, community center groups, and other forms of social support, is extremely beneficial in recovery. In addition, these programs are ongoing, and substance use disorder therapy is often time-limited. These programs can be used over the long-term to assist the individual in maintaining long-term recovery.
- Continued medical management of any co-occurring conditions should be implemented throughout the treatment process and beyond. In addition, addressing any other mental health disorders is crucial in order for successful recovery to occur. Individuals need to have all these issues addressed concurrently with their substance use disorder treatment.
- Any other interventions as appropriate in the individual case should also be implemented.
One crucial factor in recovery is to ensure that the individual remains involved in treatment and treatment-related activities for a sufficient period of time. A minimum of three months is often required for individuals to achieve sustained abstinence; however, a minimum of several years of involvement in therapy-related activities, such as social support groups, therapy, etc., is generally required for individuals to maintain long-term abstinence. Individuals who simply go through a medical detox program are not engaging in a healthy program of recovery, and these individuals will likely inevitably relapse.