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Oxycodone Withdrawal, Addiction, Side Effects, Alternatives, and Tapering

Medically Reviewed Fact Checked
Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD
Oxycodone (oxycodone hydrochloride) is a controlled release opioid analgesic narcotic medication, primarily prescribed for the treatment of moderate to severe pain. Oxycodone is categorized as a Schedule II drug due to its high risk of abuse, which may lead to psychological and/or physical dependence and addiction.

Oxycodone is a medication that has become commonly prescribed for moderate to severe pain. Oxycodone (which was sold under the brand name Oxycontin) has also become a frequently abused drug sold on the street, being used “to get high” rather than to treat a medical condition.


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Oxycodone Withdrawal Symptoms

This article outlines the most common oxycodone withdrawal symptoms and side effects and also provide important information about recovery after addiction to oxycodone, and what options are available in opioid recovery.

Oxycodone withdrawal symptoms can be extremely harsh and are best managed in a setting or facility that can provide adequate support throughout the process. To avoid the risk of dehydration due to loss of bodily fluids, it is recommended to drink 2 to 3 liters of water per day during Oxycodone withdrawal.9

Withdrawal symptoms may begin within hours of the last dose, and can include:
  • Elevated heart rate
  • Suicidal thoughts
  • Depression (can be extreme, and lingering)
  • Diarrhea
  • Nausea, vomiting (high risk for dehydration)
  • Insomnia, unusual dreams, interrupted sleep
  • Mood swings, irritability
  • Anxiety
  • Restlessness, restless leg syndrome
  • Agitation
  • Trouble remembering or focusing
  • Excessive sweating
  • Hot flashes, chills, goosebumps
  • Muscle twitches
  • Headache
  • Painful muscles and cramping
  • Runny nose
  • Watering eyes
  • Hoarseness
  • High blood pressure
  • Excessive yawning
  • Rebound pain, elevated sensitivity to pain

Neurotransmitters, Pain, and Opioids

Oxycodone is a member of the opiate drug class and, as is the case with all opioid drugs, interferes with the way that neurotransmitters respond to pain.

There are two main agents that control pain as a natural function of a healthy body:
  • Endorphins
  • Enkephalins1
Endorphins and enkephalins are natural chemicals that the body creates and releases into the bloodstream that have a powerful ability to kill the sensation of pain. These natural chemicals can block pain so thoroughly, that should a severe injury occur, the victim may be absent of pain for a period of time. Natural hormones can produce a sense of euphoria, which can be moderately addictive. For instance, a person may become chemically addicted to the rush of strenuous exercise, or the rush of endorphins that can accompany compulsive behaviors, such as “cutting” and gambling.4

The exact mechanisms of how opiates provide pain relief are not completely understood, but the depression on respiratory effects have been traced to suppression of activity in the brain stem.10


When the body is exposed to synthetic analogs, such as oxycodone, the body responds by stopping the production of these natural chemicals. This creates a pain control deficit — a major factor in the extremely painful withdrawal symptoms that occur when quitting a drug like oxycodone.

What Is Oxycodone Used For?

Oxycodone is used to control pain ranging from moderate to severe. Many compound drugs contain oxycodone, sometimes compounded with other analgesics, such as Vicodin and Percocet. Oxycontin is an extended-release form of oxycodone. Uses for these various medications have expanded to include certain “off-label” uses, such as Fibromyalgia, and treating mental disorders such as depression and anxiety.5

ptsd sufferers on opioidsVeterans returning from active duty are often at high risk for TBI (traumatic brain injury), chronic pain, and PTSD (post-traumatic stress disorder). Despite clinical guidelines advising to the contrary, a study published by NIMH showed that veterans with chronic pain, TBI, and PTSD were at a significantly higher risk of being prescribed opioids.6

Common with PTSD, patients will have been subjected to a threat, usually repetitive in nature, which acts as a continuing or repeating danger to survival. This constant threat strains the levels of endorphins and can cause a depletion of them. This is the engagement of a natural survival mechanism to increase the ability to perceive threats in the environment. This endorphin depletion may explain some of the chronic pain issues that often accompany PTSD, and also supports the caution that opioid treatment for this disorder may in fact worsen the condition, as stated by the aforementioned National Institute of Mental Health report.

Oxycodone Alternative Names and Slang

Oxycodone and drugs containing oxycodone have developed a significant street presence due to their addictive, euphoric effects. Some of the street or slang names include:

  • Hillbilly heroin
  • Blues
  • Kickers
  • Oxy
  • OC
  • Ox
  • Oxycotton
  • 40s or 80s (referring to the strength in mg)
  • Killers

Oxycodone Side Effects

Oxycodone produces pain relief and a temporary sense of joy or euphoria. These effects make the drugs high risk for abuse when used as prescribed, or used recreationally. Most persons become addicted to opiates unintentionally.

Oxycodone side effects include:
  • False or unusual joy or euphoria, mood swings, crying, despondency, irritation
  • Drug cravings
  • Dizziness, syncope, lightheaded feeling
  • Fever, chills, cold sweats, perspiration, flushing
  • Difficulty or labored breathing, tightness across the chest
  • Lowered heart rate
  • Mental fog, confusion, impaired thinking
  • Pain in abdomen, chest, painful urination, headache, muscles
  • Convulsion, shaking, trembling
  • Swollen face, lips, tongue, hands, arms, legs and feet
  • Numbness or tingling, rashes, hives, itching
  • Cough, runny nose, flu-like symptoms
  • Dry mouth, inability to swallow
  • Tachycardia
  • Nausea, vomiting, heartburn, sour stomach, hiccups
  • Constipation (can be severe requiring medical intervention)
  • Increased thirst
  • Weight loss or weight gain
  • Sunken eyes or facial features
  • Miosis (pinpoint pupils)
  • Tender painful lymph glands (neck, armpit, groin)
  • Extreme fatigue, drowsiness, tiredness

Discontinuing/Quitting Oxycodone

Since synthetic opiates shut down the body’s ability to produce natural endorphins for pain control, quitting oxycodone reveals a state of deficiency in these chemicals, which results in not only physical pain but also elevated emotional distress and sensitivity. This state will last until the body can normalize its production of endorphins and enkephalins. Alternative to Meds Center’s oxycodone withdrawal program employs orthomolecular medicine as part of the protocols in recovery to assist in neurotransmitter rehabilitation.

Without assistance, the pain levels, both physical and emotional, can be quite severe and very difficult to bear. It is helpful to employ short-term bridge medications and deep tissue cleansing as well as therapeutic massage and other comfort therapies to ease these withdrawals for our clients at the center.

Oxycodone FAQs

Below are some frequently searched topics of information relating to oxycodone addiction, oxycodone withdrawal, and other topics of interest.

Is Oxycodone Synthesized from Opium?

Yes, oxycodone is made in a lab by synthesizing opium from opium poppies. Like all opioids, oxycodone binds to the various opioid receptors found prevalently in the bowels and certain parts of the brain. This binding characteristic is one of the mechanisms of opioid addiction.

Is Oxycodone Synthesized from Opium?

Yes, oxycodone is made in a lab by synthesizing opium from opium poppies. Like all opioids, oxycodone binds to the various opioid receptors found prevalently in the bowels and certain parts of the brain. This binding characteristic is one of the mechanisms of opioid addiction.

Is Oxycodone Safe in Pregnancy?

Apart from studies on sheep, rats, and other animals, few clinical trials have been done involving pregnancy and oxycodone. What is known is that infants born to mothers taking opiates regularly during pregnancy can suffer opiate withdrawals themselves, including difficulty breathing, irritability, and other problems requiring medical intervention.8,13

How Does Oxycodone Work?

Oxycodone provides a synthetic version of certain natural chemicals normally produced in the intestines and brain. The presence of oxycodone signals the body to shut down its production of the pain-dampening natural chemicals such as dopamine, endorphins, and enkephalins. A defense mechanism kicks in to compensate, and the body begins to build new pain receptors. This response is called “up-regulation.”11,12

The body is ready-made with this rugged survival mechanism, which might be compared to enhanced radar, increasing the capability for a heightened response to threats such as incoming pain signals. When the drug is withdrawn, two factors are thought to explain the level of discomfort. First, there is a general deficit of endorphins and dopamine being shut down. And magnification of pain occurs due to the extra pain receptors that have been created. These extra pain receptors will atrophy to normal levels after a period of time, especially with precisely targeted nutritive support, allowing the body’s central nervous system a chance to rebalance itself. Without assistance in a clinical setting, this transition can become unbearably painful.

Treatment for Oxycodone Withdrawal, Abuse, and Addiction

Alternative to Meds Center employs clinical protocols and a wide variety of comfort therapies that can ease oxycodone withdrawal and recovery. Physical therapies include yoga, equine therapy, Qi Gong, colon hydrotherapy, acupuncture, and others. At an appropriate point in the program, counseling in many genres is offered.

Understanding more about opiates and their effect on the emotional and physical aspects of an individual can help in the recovery process. An educational component is part of the program to increase understanding of how opiates affect the body in specific ways.

holistic protocols for getting off opioidsIf a person has normal and adequate levels of natural endorphins, this provides something of a buffer against emotional upheavals and pain. Without adequate endorphin production, a person may experience too much emotional or physical pain.

It is this sort of vulnerable disposition found in low-endorphin individuals that can draw them toward long-term opiate use, in an attempt to blanket or shut out these uncomfortable sensations.

Quite apart from emotional pain, physical pain can take a similar grip, especially profound in a low endorphin person. There are various methods to counter these problems which may benefit a person who wishes to correct such neurochemical deficiencies.

This is why changing the diet is extremely important during the withdrawal and recovery phases of treatment and can significantly shorten recovery time and de-intensity oxycodone withdrawal symptoms.

The diet can provide the necessary precursors for their corrective effects on neurochemistry. This is one factor that can dramatically aid the recovery process.

Peptides, dopamine, and endorphins are constructed from amino acids. These can be made amply available through food-grade supplements as well as a diet rich in proteins from meats and dense vegetables. With our orthomolecular-based meal planning, the needed proteins can also be derived from a vegan diet and can be provided in the program.

If desired, in addition to natural endorphin support, where needed, short-term use of bridge medications such as Suboxone as well as alternative drug-free treatments can be used to ensure the withdrawal process is as mild and tolerable as possible.

More information on the treatments at Alternative to Meds Center for inpatient opiate recovery is given in the opiate alternatives section of this website and we encourage you to become acquainted with all the information there and on our services overview pages. If you would like to receive more information about our oxycodone withdrawal program, please contact Alternative to Meds Center with any further questions about how our treatments and protocols may help you or a loved one become free from opiate dependence.

Sources:


1. Carroll RG Elsevier’s Integrated Physiology Ch. 13 Endocrine System, Elsevier 2007.

2. Enkephalins Encyclopedia Britannica

3. Blum K, Noble EP, Sheridan PJ, Finley O, Montgomery A, Ritchie T, Ozkaragoz T, Fitch RJ, Sadlack F, Sheffield D, et al. Association of the A1 allele of the D2 dopamine receptor gene with severe alcoholism. Alcohol. 1991 Sep Oct; 8(5):409-16.

4. Hoyt A “Can You Be Addicted to Endorphins?” 2018 Jul 30.

5. Zagorski N “Many Prescription Opioids Go to Adults With Depression, Anxiety” Psychiatric News, 2017 Aug 17.

6. Seal KH, Bertenthal D, Barnes DE, Byers AL, Gibson CJ, Rife TL, Yaffe K “Traumatic Brain Injury and Receipt of Prescription Opioid Therapy for Chronic Pain in Iraq and Afghanistan Veterans: Do Clinical Practice Guidelines Matter?” PubMed 2018 Aug 19.

7. Shah M, Huecker MR. Opioid Withdrawal. [Updated 2022 May 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526012/  [cited 2022 Aug 17]

8. Vassoler FM, Oranges ML, Toorie AM, Byrnes EM. Oxycodone self-administration during pregnancy disrupts the maternal-infant dyad and decreases midbrain OPRM1 expression during early postnatal development in rats. Pharmacol Biochem Behav. 2018 Oct;173:74-83. doi: 10.1016/j.pbb.2018.07.009. Epub 2018 Jul 26. PMID: 30055180; PMCID: PMC6126918. [cited 2022 Aug 17]

9. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Geneva: World Health Organization; 2009. 4, Withdrawal Management. Available from: https://www.ncbi.nlm.nih.gov/books/NBK310652/ [cited 2022 Aug 17]

10. FDA package insert Oxycontin [oxycodone HCI] controlled release tablets [cited 2022 Aug 17]

11. University of Minnesota Study Guide Cellular Regulation [online] [cited 2022 Aug 17]

12. Clinical Trials.gov Brain Dopaminergic Signaling in Opioid Use Disorders [June 19, 2017, updated Aug 9, 2022] [cited 2022 Aug 17]

13. Bateman BT, Hernandez-Diaz S, Rathmell JP, Seeger JD, Doherty M, Fischer MA, Huybrechts KF. Patterns of opioid utilization in pregnancy in a large cohort of commercial insurance beneficiaries in the United States. Anesthesiology. 2014 May;120(5):1216-24. doi: 10.1097/ALN.0000000000000172. PMID: 24525628; PMCID: PMC3999216. [cited 2022 Aug 17]


Originally Published Sep 13, 2018 by Diane Ridaeus


This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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