In the United States in 2012, there were 82.5 opioid pain reliever prescriptions written for every 100 people, NPR reports. This may not be due to increased levels of pain in America, but rather due to the addictive nature, and high diversion and abuse rates, of these drugs.
Percocet is a combination opioid drug containing both oxycodone, a potent opiate, and acetaminophen, an over-the-counter analgesic designed to treat short-term and acute pain as a quick-acting medication. The US Food and Drug Administration (FDA) publishes that Percocet is distributed in capsules and tablet forms in the following formulations:
Listed as a Schedule II controlled substance by the Drug Enforcement Administration (DEA), Percocet is recognized for having high rates of abuse, potentially leading to drug dependence and addiction. Percocet, and opioid drugs in general, fill opioid receptors in the brain, blocking pain sensations and causing a backlog of some of the brain’s “happy” chemicals like dopamine. Functions of the central nervous system are slowed. As breathing, heart rate, and blood pressure are decreased, relaxation results. Individuals likely feel mellow and happy while under the influence of an opioid drug. These good feelings are highly desirable, causing people to want to take these drugs again and again. The National Survey on Drug Use and Health (NSDUH) publishes that at the time of the 2014 survey, close to 4.5 million Americans (aged 12 and older) were currently abusing a prescription painkiller.
Opioid Abuse Epidemic
According to the survey, prescription opioid drugs like Percocet are most commonly abused by individuals between the ages of 18 and 25. That being said, opioid abuse spans all age, race, and gender demographics and has been classified as a serious national public health problem in the United States, per the National Institute on Drug Abuse (NIDA).
People may start out taking these drugs for real medical reasons and develop a tolerance to them with legitimate use. Drug tolerance can make the medication less effective at regular doses, and individuals then need to increase the amount they take in order for the drug to work. They may begin taking more of the pills at one time than prescribed. People may also try to take Percocet in a way other than how it was prescribed, such as chewing the tablets instead of swallowing them or crushing tablets to snort, smoke, or inject the powder. This can result in the drug entering the bloodstream more rapidly and producing a more instant and intense “high.” It can also increase the risk for becoming dependent on Percocet and developing an addiction to opioids.
Percocet Abuse Signs and Risks
The high Percocet can induce may not only make a person feel good, but it may also lower inhibitions, impair memory and decision-making abilities, and interfere with motor coordination and reflexes. The makers of Percocet, Endo Pharmaceuticals, place warnings on the labeling information of the drug, indicating that it can impair both physical and mental facilities, making complex and potentially hazardous tasks more difficult and dangerous. Slurred speech, falling down, drowsiness, decreased inhibitions, and acting in a manner that is out of character, such as getting involved in questionable sexual encounters or other potentially hazardous situations, are signs that a person may be under the influence of Percocet. Accidents, an increased risk for contracting a sexually transmitted or infectious disease, and being involved in a crime or the victim of trauma may coincide with Percocet abuse.
When someone has a licit prescription for Percocet and takes more than the prescribed amount at one time, or they take the drug in a way that it is not meant to be taken, this is considered drug abuse.
Around 52 million people in the United States have misused a prescription drug or used one for nonmedical reasons, NIDA estimates. Individuals may seek out more than one doctor to get multiple prescriptions, called “doctor shopping,” steal the drugs from a pharmacy, forge prescriptions, take medications from a relative or friend, or exaggerate pain symptoms to try and get more pills.
Abusing Percocet carries a high risk for an adverse reaction to the drug, which may lead to a potentially fatal overdose. The Centers for Disease Control and Prevention (CDC) publishes that in 2014, nearly 50,000 people died from a drug overdose in the United States and over 60 percent of these deaths involved an opioid drug. Almost 80 people die every day in America as the result of a prescription opioid drug, Reuters warns. An opioid overdose is recognizable by labored breathing, a drop in body temperature and blood pressure, a weak pulse and erratic heart rate, nausea, muscle weakness and lack of coordination, tremors, confusion, extreme drowsiness, a potential loss of consciousness, and a bluish color to nails, skin, or lips. Adding other drugs or alcohol to the mix only increases the risk for overdose or other negative side effects.
In addition to lives lost, in 2011, more than 150,000 people needed emergency department (ED) treatment after misusing an oxycodone product, the Drug Abuse Warning Network (DAWN) highlights. Boxed warnings – the most serious type of warning the FDA issues – highlighting the risks of abuse, overdose, and death associated with these drugs were added to immediate-acting oxycodone products like Percocet in 2016, U.S News & World Report reports.
Spotting Percocet Addiction
NIDA reports that over 50 million prescriptions were written for oxycodone products (including Percocet) in 2013 in America and that treatment admissions for substance use disorders listing prescription opioids as the number one drug of abuse jumped up 4 percent in 10 years (1997-2007). Percocet abuse, or even licit use, can quickly create physical drug dependence, as brain chemistry is disrupted and changed with regular use. As the brain gets used to Percocet artificially influencing dopamine levels, normal movement and production of this natural chemical messenger may be impacted. Dopamine is one of the brain’s neurotransmitters that regulates moods and emotions, and increases pleasure. When levels drop off, individuals may feel depressed, irritable, anxious, and agitated. Decision-making, short-term memory functions, and happiness levels are negatively affected by Percocet dependence.
Once a physical drug dependence is formed through chronic Percocet use, individuals likely experience both emotional and physical withdrawal symptoms. Mood swings, nausea, vomiting, constipation, tremors, sweating, hypertension, irregular heart rate, breathing difficulties, trouble concentrating or remembering things, diarrhea, decreased appetite, nervousness, chills, and stomach cramps are common symptoms of opioid withdrawal.
Addiction to Percocet is complex and encompasses more than just drug dependence and withdrawal symptoms. A person can become dependent on Percocet without being addicted to it, for example. Addiction is a disease that involves changes in brain chemistry and function, and it also impacts behaviors, relationships, and many different aspects of a person’s life. When someone is addicted to a drug like Percocet, they are unable to control how much or how often they use the drug and likely have made multiple unsuccessful attempts to stop taking it. Addiction causes individuals to keep taking drugs even though they know that doing so is harmful and potentially dangerous. Things that were important before, such as grades at school, production at work, social or recreational activities, and regular obligations, may become less of a priority. As a result, employment status, interpersonal relationships, and family and home life may suffer. Legal problems may crop up, and finances may become an issue. Weight loss, irregular sleep patterns, a shift in personality including unpredictable and erratic behaviors, change in social circles, and a decline in physical appearance may be signifiers of Percocet addiction.
Detox and Help for Opioid Dependence
While someone who is dependent on Percocet may not be addicted to the drug, the reverse is almost always the case. The longer a person has used Percocet, the more likely they are to be significantly dependent on the drug and the more severe withdrawal symptoms will be. Individuals who snort, smoke, or inject the drug are also likely more heavily dependent on it as well. Drug dependence levels can also be influenced by stress levels and other environmental factors as well as by biological and genetic ones. A family history of addiction may make it more likely for someone to become more dependent on drugs, for example. Polydrug abuse and any co-occurring mental health or medical conditions can also complicate withdrawal and the severity of the drug dependence.
Removing Percocet from the body safely after a dependence is formed is best done through medical detox, which is often the first step in an opioid addiction treatment program. Oxycodone, the active opiate in Percocet, is considered to be a short-acting opioid with a half-life of around 3-5 hours, as published by the journal Clinical & Translational Oncology. This means that the drug will be mostly inactive in 6-10 hours, and when the drug stops working in the body, withdrawal symptoms can occur.
The emotional and physical symptoms of opioid withdrawal are optimally managed by trained medical and mental health professionals during medical detox. Vital signs can be continuously monitored, and medications can be prescribed to control difficult symptoms. Since oxycodone is a short-acting opioid, it may be replaced with a longer-acting opioid drug like methadone or buprenorphine during detox. Then, it can be slowly weaned off in a controlled taper until opioids are completely and safely removed from the system. Other medications can help to stabilize a person during detox by attending to specific symptoms as well (e.g., antidepressants, sleep aids, or gastrointestinal medications).
Percocet Addiction Treatment Options
Percocet abuse and addiction treatment often begins with detox to achieve physical stability first before moving on to a full therapy regime. Detox lasts 5-7 on average, and many programs then allow for individuals to transition seamlessly into a comprehensive residential, or inpatient, treatment model, which may use a combination of therapeutic, supportive, and pharmacological methods. Outpatient programs are an option too, which can be more flexible to those with scheduling conflicts and a highly supportive home network. A detailed and thorough assessment is often done prior to entering into a treatment program in order to tailor the program to the individual specifically, thus ensuring it is the right fit.
Combination buprenorphine medications, such as Suboxone, Zubsolv, and Bunavail, are all approved by the FDA to treat opioid dependence. As the Substance Abuse and Mental Health Services Administration (SAMHSA) reports, they are often helpful as part of a comprehensive opioid addiction treatment plan. In addition to the partial opioid agonist buprenorphine, these products also contain naloxone, which is an opioid antagonist that helps to maintain treatment compliance by precipitating withdrawal if abused.
Behavioral therapies like Cognitive Behavioral Therapy (CBT) aids in helping individuals to recognize emotions or thoughts that may be detrimental and may have led to destructive behaviors in the past. Stress and anger management skills are taught, and people will learn new life skills and tools for coping with potential triggers during individual and group CBT sessions. Families can get involved by engaging in family counseling and education programs to improve their communication skills and restore the health of the overall family unit.
During treatment, individuals may also join a support group and/or a 12-Step group that can help to foster healthy relationships with others who are empathetic, working together to sustain abstinence. Participation in these groups often continues well into recovery.
Regardless of how Percocet abuse or addiction began, it is highly treatable. With the right help, recovery is within reach for anyone who wants to get well.