Oxycodone Dependency & Addiction Treatment

Oxycodone is a potent synthetic opioid drug that exists in two formulations.

  1. Immediate-release oxycodone is prescribed for certain types of severe pain for which other medications do not provide sufficient relief.
  2. Extended-release oxycodone is used to manage severe, persevering, daily pain that cannot adequately be controlled with non-opioid pain relievers or immediate-release pain medications.

Dosage and effects

Oxycodone is a strong opioid drug; its dose equivalent ratio to morphine is 1:1.5 for immediate-release and 1:2 for extended-release.

Opioids, including oxycodone, bring pain relief and pleasant feelings of relaxation and euphoria. However, in high doses, they can also cause drowsiness, slowed breathing, confusion, nausea, and decreased blood pressure.

Risks Associated with Taking OxycodoneOxycodone is associated with a risk for opioid misuse, abuse, addiction, overdose, and other risks associated with withdrawal. One of the effects of oxycodone overdose is respiratory depression. An oxycodone overdose can slow your breathing down to the point of stopping completely.

The risk of addiction is high, even when oxycodone is taken according to the doctor’s prescription. The risk of oxycodone addiction or overdose is even higher when the drug is taken without adhering to a doctor’s recommendations.

History of Oxycodone

  1. Narcotic
  2. It can treat moderate to severe pain.
  3. Controlled substance
  4. High risk for addiction and dependence. Can cause respiratory distress and death when taken in high doses or when combined with other substances, especially alcohol.(source)

Oxycodone is a semisynthetic opioid synthesized from thebaine, an opioid alkaloid found in the Persian poppy and one of the many opioid alkaloids found in the opium poppy. It is an analgesic generally indicated for relief of minor to moderate pain. It was developed in 1917 in Germany as one of several new semi-synthetic opioids in an attempt to improve on the existing opioids. Oxycodone is available as single-ingredient medication in immediate release and controlled release. Parenteral formulations of 10 mg/mL and 50 mg/mL are available in the U.K. for IV/IM administration. Combination products formulated with non-narcotic ingredients such as nonsteroidal anti-inflammatory drugs and paracetamol are also available as immediate release formulations; a combination with naloxone is available in managed-release tablets. The naloxone precipitates opioid withdrawal symptoms and blocks the faster onset were the tablet to be crushed and filtered for injection or otherwise tampered with in a manner not indicated.

In the 1990s, physicians started to prescribe opioids more frequently for pain relief. At the time, the addictive nature of opioids was not formally recognized, and pharmaceutical companies marketed them as non-addictive medications with strong pain relief potential. Over time, the higher prescription rate of opioid medications has led to a dramatic rise in the rates of opioid misuse, non-medical use, and overdose.

The highly addictive potential of opioid drugs is now widely recognized. The terms ‘opioid epidemic’ or ‘opioid crisis’ help raise awareness about the devastating and broad consequences of opioid misuse. The widespread nature of opioid drug misuse fully justifies the term ‘epidemic’.

Oxycodone in AmericaIn 2015, approximately 2 million Americans had a substance use disorder involving a prescription pain relief drug.

In 2018, there were 46,802 opioid-involved overdose deaths in the United States.

The consequences of opioid substance disorders affect even newborns. When women use opioids during their pregnancy, the baby may suffer from withdrawal symptoms. These cases are called ‘neonatal abstinence’ or ‘neonatal withdrawal syndrome’.

In 2014, 32,000 newborns were diagnosed with neonatal withdrawal syndrome in the United States of America.

With the improved understanding of opioid drugs and their risks, the efforts to provide treatments to affected individuals have also increased. Changes in public health policy and opioid drug prescription patterns, including a response framework by the Center for Disease Control and Prevention, have been introduced.

How does oxycodone addiction work?Opioid addiction, tolerance, and dependency arise as a result of neuroadaptive and biochemical changes in the brain. Endorphins are released from the pituitary gland in response to different stimuli such as pain, stress, or pleasurable activities. They help to alleviate pain and promote feelings of euphoria, or well-being. Opioids also trigger this response.

Opioid drugs like oxycodone activate opioid receptors in the brain. There are three subtypes of opioid receptors:

  1. µ-opioid receptors are most important for the pain-relieving and pleasure-inducing effect of opioids.
  2. δ-opioid receptor activation is characterized by anxiety-reducing activity.
  3. κ-opioid receptor activation leads to dysphoria, a state of depression.

With repeated opioid use, the opioid receptors gradually begin to respond in a less pronounced manner due to the development of neuroadaptations. Further, the production of natural endorphins decreases and the endorphin system becomes increasingly dependent on the opioid drugs for external stimulation.

Thus, a tolerance to the opioid drug (in this case, oxycodone) is developed, and a higher dose is required to achieve the desired pain-relieving or euphoric effect.

When opioid drugs bind to the opioid receptors regularly, this eventually affects the function of our dopaminergic neurons that regulate the feeling of reward and well-being. It also affects our noradrenergic neurons, which regulate alertness, wakefulness, blood pressure, breathing, etc.

Over a period of regular usage, the brain neurons involved in the reward system adapt to the new routine of oxycodone consumption. When an overdose is taken, opioid receptors become overstimulated. This leads to excessive stimulation of dopaminergic neurons and the suppression of noradrenergic neurons which, in turn, leads to dangerous effects such as respiratory depression.

When the consumption of opioid drugs stops, dopaminergic neurons are suppressed and noradrenergic neurons are overactivated. This leads to withdrawal symptoms.

Oxycodone withdrawal symptomsIndividuals undergoing oxycodone withdrawal may initially experience:

  • Restlessness
  • Anxiety
  • Muscle aches
  • Teary eyes
  • Runny nose
  • Sweating
  • Yawning
  • Insomnia

Later symptoms may include:

  • Nausea and vomiting
  • Dysphoria
  • Dilated pupils
  • Hair standing on end and goosebumps
  • Diarrhea
  • Elevated blood pressure
  • Increased heart rate

The symptoms of oxycodone withdrawal can be both physical and psychological. How fast withdrawal symptoms will arise depends on a number of factors, including whether an immediate or extended-release drug formulation was used and via what route the drug was administered. Generally, withdrawal symptoms can arise as early as 6 – 10 hours after the last dose of immediate-release formulations and as late as 24 – 30 hours after the last dose of extended-release formulations.

Physical withdrawal symptoms may be present for up to 1 – 2 weeks. The duration of the withdrawal symptoms also depends on the period of time during which the opioid drug was taken, and the dose. It is also affected by the overall health of the person and the presence of other medical conditions or substances consumed.

The extent of the oxycodone withdrawal symptoms varies based on the duration and dose of previous oxycodone intake as well as the abruptness of withdrawal. The oxycodone withdrawal syndrome can be associated with a high degree of discomfort and suffering, although it is by itself not considered life-threatening.

However, some of the oxycodone withdrawal symptoms can lead to fatal complications. Vomiting can lead to the aspiration of material in the lungs and the development of an inflammatory lung process known as aspiration pneumonia.

In a heavy withdrawal, vomiting and diarrhea can lead to loss of electrolytes and fluids, which can lead to more serious health problems such as cardiovascular complications. Therefore, it is important to be properly monitored and medically supported during the withdrawal period. Medical support includes medications that relieve the withdrawal symptoms and if needed, support the substitution of fluids and electrolytes.

Oxycodone Withdrawal Timeline

Oxycodone Withdrawal Timeline

The ANR procedure is performed in a course of 4 – 5 hours during a total hospitalization of approximately 30 hours. The patients are admitted to the ANR Unit and thoroughly evaluated clinically, including laboratory examinations. During this time, medications are administered to prepare the patients for the ANR procedure.

Next, patients are sedated, and in the course of 4–5 hours, a withdrawal is induced with the use of the opioid antagonist naltrexone. The oxycodone withdrawal is tailored to the patient, taking into account their medical history and clinical/laboratory findings. The advantage of this approach is that it occurs under close surveillance by experienced medical personnel, who have treated more than 24,000 patients worldwide. They can provide maximum safety and effectiveness.

After the procedure, patients usually remain in the hospital for 1-2 days to be monitored during their recovery. They are instructed according to their individual case by the medical personnel and encouraged to take on their daily activities gradually.

Treatments for oxycodone withdrawal

Patients coping with opioid dependency must understand that addiction is a physical condition. It is not a psychological disease; it is a medical illness that stems from the failure of the body’s extremely important natural endorphin system to balance itself. This system is unable to balance itself after exposure to external acting opioids. This is because external opioids are made to mimic the body’s natural endorphins.

Oxycodone rehab and detox centers

Traditional oxycodone withdrawal involves rehabilitation or detox centers that offer a long stay in a facility. They handle the psychological aspects which are only a secondary effect of the dependency. Even that can create a lot of pain and suffering to the patient that is also undergoing withdrawals and severe cravings.

Methadone and other opioid agonists

Alternative detoxification protocols for opioid use disorder have utilized the opioid agonist methadone and partial opioid agonist buprenorphine. They are all conducted under a variety of time frames and dosing may also vary among different detoxification paradigms.

Agonists such as methadone stimulate the opioid receptors. Methadone is a long-acting opioid drug, which has been used in tapered down doses for detoxification from short-acting opioids. It is often used to treat heroin addiction, helping to reduce cravings and alleviate withdrawal symptoms. However, methadone itself also is highly addictive and dangerous.

Partial agonists such as buprenorphine partially activate the opioid receptors to alleviate cravings and withdrawal symptoms. Adjunctive medications are also usually used during the detox process to alleviate the discomfort and suffering of the patients. In particular, the a2-adrenergic receptor agonist lofexidine that might reduce the release of norepinephrine to relieve opioid withdrawal symptoms.

Accelerated Neuro-Regulation Treatment (ANR)

ANR aims to free the individual from their dependence, withdrawal symptoms, and cravings for oxycodone or any other opioid. ANR is the only treatment who treats the root of the illness using modern medicine.

Dr. Andre Waismann developed the treatment as his therapeutic goal changed from the old rapid detoxification method that he invented and performed throughout the 1990s. Back then, his “Rapid Detox” method was widely and quickly adopted. This led to drug rehab and detox centers implementing it without sufficient medical information, experience, or knowledge to perform the treatment safely, as well as effectively.

The advantage of ANR is that it is the only method that targets the biological roots of opioid addiction. Something other oxycodone withdrawal treatments cannot achieve, even if done correctly.

ANR versus ‘fast’ or ‘rapid’ opioid withdrawal treatments

ANR is an oxycodone withdrawal procedure that balances the endorphin system in the brain and eliminates the patient’s opioid dependency using an individualized, biologically-based approach. ANR targets the neuroadaptive biochemical changes occurring in the brain with opioid addiction.

Patients are sedated with an anesthetic agent and opioid withdrawal is induced using the opioid antagonist naltrexone. The close monitoring of the patient under sedation by experienced medical personnel allows an individualized and flexible approach to the treatment. The withdrawal process is controlled and modulated using adjunctive medications. As a result, the baseline functional level of the receptors are regulated and modulated toward a normal, balanced level.

The ANR treatment was developed and introduced by Dr. Andre Waismann in 1997 and has since been applied to treat 24,000 patients worldwide from opioid addiction successfully. ANR differs from other rapid or fast detoxification methods because it focuses on the biological basis of opioid dependency. ANR brings the neurochemistry of the brain opioid receptors and endogenous endorphin system to its normal, pre-dependency state by using an individually tailored approach.

Oxycodone Addiction Treatment

People who have an opioid addiction or dependency are also more frequently affected by depression. However, antidepressant medications may not be as effective in individuals with opioid addiction. The ANR method focuses on this biological disbalance in the brain’s endorphin system and opioid receptors. It uses an induced withdrawal to return the functioning of the opioid receptors and internal endorphins to the normal functional level (for that individual), which existed before the dependency started. The ANR method focuses on the biological cause for addiction, bringing the central nervous system back into balance and utilizing an individualized approach based on the medical and substance abuse history of the individual. ANR returns the biochemical and opioid receptor balance back to its pre-addiction, a balanced level between endorphins and receptors, which counteracts the biological basis of the cravings. For each patient, an individual approach and dosing of naltrexone and adjunctive medications are used based on the duration and dose of oxycodone addiction and the presence of any other medical conditions. The fact that the treatment is carried out under sedation eliminates the suffering and discomfort from the withdrawal symptoms. After awakening, the patient begins a daily naltrexone regimen. Thus, a reset of the biological state of the opioid receptors is achieved. The duration of the naltrexone regimen is determined by the treating physicians individually for each patient, based on their personal needs to ensure the stabilization of opioid receptor functional balance and to avoid any risk of relapse.

Oxycodone Rehab Near Me

In the United States, the treatment is currently performed at the ANR Unit of the Landmark Hospital in Naples, Florida.

Outside of the US, we have ANR treatment centers in:

  • Thun, Switzerland, about 19 km south of the capital city Bern.
  • Israel, at the Barzilai Medical Center in Ashkelon.
  • Georgia, in the capital city of Tbilisi.

Oxycodone Rehab Facility

The ANR Unit at the Landmark Hospital in Naples, Florida, conducts oxycodone withdrawal treatments in an intensive care unit of a hospital with state-of-art medical facilities and resources. The unit specifically dedicated by the Landmark hospital for ANR therapy provides the ability to track vital signs using ICU monitors and to collect advanced patient data in real-time. Patients are cared for by experienced medical personnel, including a board-certified anesthesiologist with experience in critical care, an internal medicine physician, and an intensive care nurse. The team collaborates with expert cardiologists and nephrologists, which enables the treatment of patients with opioid addiction who also have cardiovascular or renal medical conditions. Their broad professional expertise and the state-of-art medical facilities provide the opportunity to safely address the biological roots of oxycodone addiction during a single short-term hospitalization.

Literature sources

Centers for Disease Control and Prevention. Understanding the epidemic. Link

Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings. Geneva: World Health Organization; 2009. 4, Withdrawal Management. Available from: Link

Darcq, E., Kieffer, B.L. Opioid receptors: drivers to addiction?. Nat Rev Neurosci 19, 499–514 (2018). Link

National Collaborating Centre for Mental Health (UK). Drug Misuse: Opioid Detoxification. Leicester (UK): British Psychological Society; 2008. (NICE Clinical Guidelines, No. 52.) 6, pharmacological, and physical interventions in opioid detoxification. Available from: Link

United States Food and Drug Administration. Information about Medication-Assisted Treatment (MAT). Link

US National Library of Medicine. Medline Plus. Opiate and opioid withdrawal. Link

US National Library of Medicine. Medline Plus. Oxycodone. Link

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