Tapering off OxyContin and Withdrawal Timelines
OxyContin is an oxycodone-based opioid prescription medication designed to release slowly into the bloodstream to treat people with moderate to severe chronic pain. This painkiller stays in the body for at least 12 hours, so people with painful chronic illnesses, such as arthritis or cancer, get long-lasting relief from their symptoms.
OxyContin and other opioid painkillers are listed by the Drug Enforcement Administration as Schedule II substances. Although they have a beneficial medicinal purpose, they also carry a high risk for addiction and dependence.
What Are the Symptoms of Abuse?
People who take OxyContin, even as prescribed, can develop a physical dependence on this drug. Dependence and addiction are different; addiction is a disease that involves compulsive behaviors, while dependence simply means the body gets used to a chemical over time and becomes dependent on its continued presence. As a person’s body becomes tolerant to OxyContin, it means that the person will likely, at some point, need to adjust their dose to receive the same pain-relieving benefits. However, doctors worry less about this problem when their patients have a chronic or terminal illness that causes pain.
Dependence doesn’t necessarily lead to addiction. If a person starts abusing their prescription (e.g., taking more than prescribed, taking it more frequently than prescribed, or altering the medication in any way), addiction may quickly form.
Detoxing from OxyContin
When a person has become addicted to or physically dependent on opioids like OxyContin, they will experience withdrawal symptoms when they attempt to lower their dose or stop taking the drug. OxyContin withdrawal symptoms typically come in two phases: early and late withdrawal symptoms.
Early OxyContin withdrawal symptoms include:
- Muscle aches and joint pain
- Nervousness or irritability
- Tearing or watery eyes
- Runny nose
Late withdrawal symptoms include:
- Diarrhea and intestinal issues
- Enlarged pupils
- Nausea or vomiting
- Stomach cramps
- Rapid heartbeat
OxyContin withdrawal generally takes up to 10 days; however, individuals can experience long-term withdrawal symptoms, such as cravings and emotional changes. These long-term symptoms can last for months.
Withdrawal symptoms can range in intensity, depending on how long the person has taken the drug, their personal history with substance abuse, the presence of any co-occurring mental health or physical issues, and how large their regular dose was.
Since opiate withdrawal can be so uncomfortable, and relapse is likely as a result, medical detox is always recommended. Medical detox may involve slowly tapering the person off OxyContin by incrementally lowering the dosage over time until the person is no longer taking the drug. In some instances, replacement medications, such as buprenorphine, may be used in medical detox to ease the transition off opiates. The person would then be tapered off the replacement medication. The use of such medications is determined on a case-by-case basis by medical professionals.
While quitting OxyContin is not generally life-threatening, the medical support provided in a professional detox program can be critical to long-term recovery success. Just stopping the medication without any support from doctors, friends, or family, means that the individual is more likely to relapse. Relapses can lead to accidental overdose, as the person tries to compensate for the reduced amount of narcotic in their body.
- Pinpoint pupils
- Nausea or vomiting
- Extreme confusion or delirium
- Significantly depressed breathing
- Slow pulse
- Slow or labored breathing
- Bluish tint to the lips or fingernails
- Clammy or cold skin
- Lack of response
According to the World Health Organization, fatal opioid overdoses are common because breathing is likely to stop. The CDC notes that between 2000 and 2014, close to a half-million US citizens died from opioid overdoses, including OxyContin overdose.
The Use of Medications in Opiate Detox
As mentioned, medications are sometimes used to ease the opiate withdrawal process. Generally, a client is switched to a replacement medication, and then their dosages are slowly lowered over time until the person is eventually free of all drugs. These medications are not always used in opiate detox, but they can be helpful in some cases of long-term opiate abuse. These medications include:
- Buprenorphine: This partial opioid agonist was approved by the FDA as a prescription to help treat opioid addictions in 2002. Unlike methadone treatment, which often requires daily visits to clinics, buprenorphine can be prescribed by a physician. The drug binds to the same opioid receptors in the brain as OxyContin, blocking the brain’s absorption of the opioid painkiller, while also easing withdrawal symptoms and cravings.
- Suboxone: This medication is a combination of buprenorphine and naloxone. Naloxone by itself is currently used to stop opioid overdoses for a short time, since the medication will bind to the opioid receptors in the brain to prevent the uptake of opioids. When Suboxone is taken as prescribed, the buprenorphine in Suboxone acts on the brain to relieve opioid withdrawal symptoms; however, if the patient attempts to abuse their prescription and bypass the slow release of buprenorphine to get high, naloxone will instead stop any of the buprenorphine from being absorbed, thus sending the patient into withdrawal.
- Naltrexone: This medication is rarely prescribed in the course of opioid addiction treatment; however, for people who have struggled with an opioid addiction for a long time, it can help reduce the potential for relapse. Naltrexone was designed to bind to opioid receptors in the brain and stop the uptake of any opioid drugs, like OxyContin, if the individual relapses. The goal is to train the risk/reward system in the brain to stop craving opioid medications because they prove useless if the person takes them.
When replacement medications are used, prescribing doctors often slowly taper patients off these medications over time. While some patients may remain on these medications for months or even years, the ultimate goal is usually complete sobriety from all opiates.
Sometimes, an overseeing doctor will prescribe small doses of antidepressants or anti-anxiety medications, which can help ease the psychological symptoms of withdrawal. In addition to medical help, rehabilitation programs provide therapy, which makes up the bulk of addiction treatment. While medications can be helpful, they are not addiction treatment on their own; they should only be used in combination with therapy.