Percocet Addiction: Signs, Symptoms & Treatment
According to Mayo Clinic, Percocet contains two different medications. Percocet will typically contain 325 mg (milligrams) of the medication acetaminophen (most familiar as Tylenol) and different amounts of the opiate medication oxycodone. The amount of oxycodone in Percocet tablets will typically range from 2.5 mg to 10 mg.
Is Percocet A Controlled Substance?
Percocet is a controlled substance because it contains the opiate medication oxycodone. It is classified as a Schedule II substance by the United States Drug Enforcement Administration(DEA). All medications containing oxycodone are classified in this category by the DEA. This means the drug can only be obtained with a written prescription from a physician.
Why is Acetaminophen in Percocet?
According to Medscape, the combination of acetaminophen and oxycodone leads to a more effective pain-relieving medication than the use of either drug alone. Acetaminophen can also be used to reduce fever, whereas oxycodone is primarily designed for pain control. Of course, acetaminophen is available over the counter in medications like Tylenol, and oxycodone is available in other medications such as OxyContin.
What Immediate Effects May Occur From Using Percocet?
Whenever a person uses Percocet, the drug addresses issues with pain through different mechanisms because of the different medications in the drug. Oxycodone works through the receptors in the brain that are specialized for opiate-like neurotransmitters, whereas acetaminophen works through a different mechanism.
The immediate medicinal effects of using the drug include:
Immediate Effects Of Percocet
Pain control (its primary use)
Relaxation and even sedation or lethargy
Reduced anxiety or stress levels
A reduction in response times, reflex actions, speed of thought, and motor coordination
The actions of the drug suppress the functioning of the neurons in the brain, and spinal cord, often referred to as the central nervous system (CNS). This reduced activity in the CNS accounts for the drug’s medicinal effects, but it can also result in other side effects. Side effects of Percocet include:
Persistent constipation
Upset stomach, nausea, and vomiting
Decreased automatic bodily functions, such as a reduction in breathing rate, heart rate, and blood pressure
A loss of appetite, dry mouth, and/or sweating
Lightheadedness, dizziness, headache, and cognitive issues (confusion, problems with attention and memory, or a loss of inhibitions or decreased emotional control)
A small number of individuals may experience allergic reactions that require medical intervention. The effects of the drug are dose-dependent, such that the higher the dose, the more likely it is that the person will experience extreme effects, such as lethargy, severe constipation, confusion, and problems with movement.
What are the Long-Term Effects of Abusing Percocet?
According to the book Prescription Painkillers: Oxycontin®, Percocet®, Vicodin®, & Other Addictive Analgesics, the effects of taking Percocet can be divided into the immediate effects of using the drug, any side effects that are associated with using the drug in some individuals, and long-term effects that can occur as a result of extended use.
The long-term effects of Percocet may appear in some individuals who use the drug for more than just a few weeks. They include:
The development of tolerance, or the need to use more of the drug to get the types of effects that were once realized with smaller doses
Changes in the neural pathways of the CNS
Liver and/or kidney damage
Cardiovascular issues
Higher likelihood of lung infections or lung disease
The development of physical dependence (withdrawal symptoms after developing some level of tolerance to the drug)
When a person uses Percocet under the supervision of a physician on a short-term basis, the potential to experience the above long-term issues is relatively rare. Extended use of Percocet may result in some individuals developing some of the issues listed above.
Drug abusers, who will typically use the drug in far higher amounts and at more frequent intervals than individuals who use the drug for medical reasons while they are under the care of a physician, are far more likely to experience detrimental long-term effects associated with Percocet. Of course, people who abuse Percocet are also more likely to develop a formal opiate use disorder.
Is Percocet Abused?
Opiate drugs like oxycodone are significant drugs of abuse. Percocet has a significant potential for abuse, as do all medications that contain opiate drugs.
The Substance Abuse and Mental Health Services Administration (SAMHSA) is a governmental organization that collects data regarding the use and misuse of medications and illicit drugs, mental health issues, and other related topics in the United States. SAMHSA releases yearly estimates of the number of individuals in the country who have used or misused certain drugs. These estimates are based on survey data collected by SAMHSA.
In 2016, almost 23.5 million individuals were estimated to have used a medication that contained oxycodone at least once. An estimated 2.6 million individuals misused a medication containing oxycodone at least once.
In 2017, more than 22.5 million individuals used a medication containing oxycodone at least once. An estimated 2.4 million individuals misused a product containing oxycodone at least once.
Misuse of a drug simply refers to any use of a drug that is not consistent with the drug’s prescribed purposes. Although all cases of misuse do not signify abuse or a substance use disorder, all cases of substance use disorders begin when the person starts to misuse the drug.
Thus, it can be seen that slightly less than 10 percent of individuals who were estimated to use an oxycodone product also misused the drug at least once. This is consistent with other information provided by SAMHSA and reported by other governmental agencies regarding the number of individuals who may develop opiate use disorders as a result of being prescribed opiate medications.
SAMHSA also releases the Center for Behavioral Health Statistics and Quality Report and other data that consistently find that only a small percentage of individuals who are prescribed these medications actually go on to develop formal substance use disorders (drug abuse or addiction); however, the majority of individuals who use very powerful illicit drugs such as heroin (about 80 percent) began by abusing prescription opiate medications like Percocet. Thus, the problem of opiate abuse is very complex.
The findings also indicate that the majority of individuals who develop substance use disorders as a result of prescription medication abuse gets the drug illegally (either by buying it without a prescription, getting it from a friend or a relative, or stealing it).
What is the Risk of Overdose on Percocet?
Individuals who abuse any opiate drug are at an increased risk of experiencing an overdose on that drug, and Percocet is no exception. The book Poisoning and Drug Overdose reports that the development of tolerance to opiate drugs like Percocet results in individuals who abuse these drugs taking extremely high amounts of the drug that may be fatal to most other people.
In addition, drug abusers are notorious for combining potentially dangerous drugs. Opiate drugs like Percocet are commonly combined with other CNS depressants like alcohol, benzodiazepines, and even other opiate drugs, which can increase the risk of an overdose. Individuals who combine Percocet with stimulant drugs also increase the risk of an overdose of Percocet because the stimulant may reduce the sensations that they normally get from Percocet, and they may take dangerously high amounts of the drug even if they have significant tolerance to it.
“Percocet and other CNS depressants inhibit areas of the brain that control life-sustaining functions like breathing and heart rate. When an individual takes too much Percocet, they can actually shut down these areas of the brain, and this can result in a significant decrease or total shutoff of oxygen to the brain. Such a situation can, of course, lead to significant brain damage or be fatal. Moreover, large doses of Percocet can result in individual vomiting when unconscious, and the person may then choke to death.”
It should also be noted that one of the long-term effects of taking large amounts of acetaminophen is the development of liver damage, which can lead to significant health issues and also be fatal.
What are the Signs of a Substance Use Disorder?
The American Psychiatric Association(APA) now uses the term “substance use disorder” to refer to any case of clinically significant drug abuse or addiction. People who use opiate medications under the supervision of a physician and according to the physician’s instructions may develop a physical dependence on them, but this would not qualify them to have a substance use disorder. This is because the primary features of any substance use disorder are consistent nonmedical use of the substance and the development of significant stress or functional impairment as a result of their substance use.
APA reports that the other major signs of a substance use disorder include:
Problems with controlling the use of the drug. This involves:
Frequently using excessive amounts of the drug
Using the drug in situations where it is dangerous to use it
Being unable to stop using the drug even though it is causing problems in various areas of life
Giving up important activities or obligations as a result use
Expressing a desire to quit or cut down on use but not being able to do so
Having recurrent urges or cravings to use Percocet
Spending significant amounts of time using the drug
Developing tolerance
Developing physical dependence
The APA acknowledges that there is no easy answer to understanding why people develop substance use disorders, and there are most likely numerous reasons that a person develops any substance use disorder.
How Should Percocet Abuse Be Addressed?
According to the American Society of Addiction Medicine(ASAM), chronic abuse of Percocet will most likely lead to the development of physical dependence (withdrawal symptoms when the drug is discontinued). The first step to treating an individual who has chronically abused Percocet is to help them control the distressing withdrawal symptoms they will most likely experience.
Withdrawal symptoms from Percocet will most often consist of the following:
Percocet Withdrawal Symptoms
Pain and muscle spasms
Anxiety or mood swings
Nausea, vomiting, or diarrhea
Sweating, runny nose, headache, and other flu-like symptoms
Insomnia, irritability, confusion, or poor judgment
Significant cravings to use Percocet
ASAM suggests that individuals be thoroughly evaluated by a physician and a mental health care worker and then be placed in a medical detox program. In this program, the physician will administer an opiate replacement medication to control the withdrawal symptoms. This medication will allow the person to get through the withdrawal period with minimal stress (typically, the withdrawal process from Percocet can last between two and four weeks). Opiate replacement medications are commonly opiate drugs themselves, such as Suboxone. The physician will slowly taper down the dosage of this medication at specific points in the process to eventually be able to discontinue the drug altogether.
Other essential components of a recovery program include:
Substance use disorder therapy in either group or individual sessions
Participation in support groups like Narcotics Anonymous or different types of similar groups
Treatment of co-occurring psychological disorders
Strong family support
The development of a relapse prevention program that will typically be part of therapy
A continued commitment to abstinence
Simply completing a medical detox program without further treatment will likely result in relapse. Even individuals with solid treatment programs have an increased potential to relapse, but they often can move forward in their recovery.
ASAM suggests a minimum of five to seven years in treatment with ongoing abstinence before a person is considered to have a reduced risk of relapse. Many people will remain in recovery for many years after initially stopping using their drug of choice.
How is Percocet Stored in the Body, and For How Long?
Acetaminophen and oxycodone are mainly processed out of the body through the liver and, in part, excreted through the kidneys and urine. Oxycodone is metabolized into both oxymorphone and nor oxycodone, which are not detectable on routine federal workplace drug testing, the Substance Abuse and Mental Health Services Administration (SAMHSA) publishes.
As a semi-synthetic opioid, oxycodone typically needs to be tested for with immunoassay (EIA) methods that use a cutoff of 300 ng/mL. It is helpful to know what type of drug test will be administered to prepare for a drug test. Primary ways that drugs are tested for include:
Types Of Drug Tests
Urine
Saliva
Hair
Blood
A urine test is one of the most common forms of drug testing. In general, Percocet is likely to be detectable in urine within about two hours of taking the drug and up to three or four days after the last dose.
Saliva tests tend to detect the drug more quickly, but potentially for not as long as a urine test. Percocet may be detectable in saliva within 15 to 30 minutes and about one to four days after the last dose.
A blood test is generally only able to detect oxycodone for the first 24 hours after taking it, while hair testing typically provides the most extended detection window. Blood drug tests are not often done; they are considered highly invasive and can pick up on drug use only for a reasonably short time.
A hair drug test can often track drug use for as long as 90 days; however, drug use typically has to be reasonably heavy for Percocet to show up in hair. Hair tests are considered the most noninvasive and can provide a good indicator of regular drug use. Still, they do not typically show intermittent use of drugs, the journal Child and Adolescent Psychiatric Clinics of North America publishes. A hair drug test can show what drugs are used regularly and provide a three-month drug record.
Percocet combines 2.5 mg (milligrams) and 10 mg of oxycodone per tablet. The more oxycodone in the dose you are taking, the more likely it is to show up on a drug test.
“In general, intermittent use of Percocet is liable to show up on a drug test for a few days (except for a hair drug test). It may be detectable for up to a week or so in a chronic and heavy user.”
To be safe, when taking a urine, blood, or saliva drug test that checks for oxycodone metabolites, you should stop taking Percocet at least a week before the test. Drug tests cannot differentiate between drug misuse and necessary medicinal use, so consider that.
Since oxycodone cessation can come with intense withdrawal symptoms, do not stop taking it suddenly if you have been taking it for a prolonged period. You should consult a physician who can devise a safe tapering schedule or refer you to a medical detox program.
Can Treatment Reverse Long-Term Effects of Percocet Use?
Whether Percocet abuse has continued for weeks, months, or years, if the person cannot stop on their own and the adverse effects continue to pile up, treatment is the best way to address the problem. Engaging in a drug rehab program that offers comprehensive addiction treatment is the only researched-based method of managing a substance use disorder safely and effectively. This means choosing rehabilitation that offers:
Medical detox to address drug withdrawal symptoms safely
Medical supervision to ensure the individual does not succumb to relapse during the detox process and beyond
Medical care to manage chronic pain if needed
Traditional talk therapies are effective in helping clients to identify the reasons behind their use of Percocet.
Mental health care for co-occurring disorders as needed
Alternative therapies to provide a creative outlet for self-expression and self-discovery during recovery
Holistic treatments augment traditional therapies and medical care, aid in lowering stress levels, and support a well-rounded treatment program
Peer-support and therapy
Aftercare and support after the cessation of treatment
If your loved one is struggling with a substance use disorder, learn more about how to address the issue medically and therapeutically through comprehensive drug treatment.