Oxycodone, also known as ConZip, Ultram, and Ultram ER, is a potent synthetic opioid drug that exists as immediate-release and extended-release formulations. The immediate-release formulation prescribed for certain types of severe pain, for which other medications do not provide sufficient relief. The extended-release formulation used to manage severe, persevering, daily pain that cannot adequately be controlled with non-opioid pain relievers or immediate-release pain medications. Oxycodone is a strong opioid drug, and its dose equivalent ratio to morphine is 1-1.5 for immediate-release and 1-2 for extended-release. Opioids, including oxycodone, induce 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.
The Risks of Taking Oxycodone
The intake of oxycodone is associated with a risk for opioid misuse, abuse, addiction, overdose, and withdrawal. An oxycodone overdose may be lethal by slowing down and stopping breathing. The risk of addiction is high, even when oxycodone is taken according to the physician’s prescription, and it’s even higher when the drug is taken without adhering to the doctor’s recommendations.
Physicians started to prescribe opioids more frequently for pain relief in the early 1990s since, at the time, the addiction potential of opioids not recognized, and pharmaceutical companies marketed them as non-addictive medications with strong pain relief potential. With time, the higher prescription rate of opioid medications lead to a dramatic rise in the rates of opioid misuse, non-medical use, and overdose, and the high addictive potential of opioid drugs was recognized. With the raising awareness of the devastating and broad consequences of opioid misuse, the terms opioid epidemic or opioid crisis introduced. The widespread of opioid drug misuse fully justified the name epidemic.
In 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, called neonatal abstinence or neonatal withdrawal syndrome; in 2014, 32,000 newborns diagnosed with neonatal withdrawal syndrome in the United States. With the improved understanding of the high addictive potential and risks of opioid drugs, the efforts to combat opioid abuse and addiction and 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.
Why Oxycodone Is So Addictive And Dangerous?
Opioid addiction, tolerance, and dependency arise as a result of neuroadaptive and biochemical changes in the brain. Endorphins released from the pituitary gland in response to different stimuli such as pain, stress, or pleasurable activities. They alleviate pain and promote a feeling of well-being.
Opioid drugs, including oxycodone, also interact with opioid receptors and activate them. There are three subtypes of opioid receptors: µ-, δ-, and κ-opioid receptors. µ-opioid receptors are most important for the pain-relieving and pleasure-inducing effect of opioids, whereas δ-opioid receptor activation is characterized by anxiety-reducing activity, and κ-opioid receptor activation leads to dysphoria. 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 external stimulation with opioid drugs. 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, this eventually affects also the function of dopaminergic neurons, which regulate the feeling of reward and well-being, as well as of noradrenergic neurons, which regulate alertness, wakefulness, blood pressure, and breathing, etc. With time, the brain neurons involved in the reward system adapt to a new functional level. When an overdose is taken, opioid receptors are overstimulated, which leads to the excessive stimulation of dopaminergic neurons and the suppression of noradrenergic neurons that can lead to dangerous effects. When the consumption of opioid drugs is stopped, dopaminergic neurons are suppressed, and noradrenergic neurons are overactivated. This leads to withdrawal symptoms.
Detox From Oxycodone
Patients coping with Opioid dependency must understand that opioid dependency or addiction is a physical condition. It is not a psychological disease; it is a medical illness, which 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.
Traditional Oxycodone withdrawal Rehabs and Detox centers offer a long stay in a facility, handling the psychological aspects and are issuing only the secondary effect of the dependency, and even that, that comes with a lot of pain and suffering to the patient that is undergoing withdrawals and severe cravings.
Different detoxification protocols for opioid use disorder have utilized the opioid agonist methadone, partial opioid agonist buprenorphine. They 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, especially heroin, to reduce cravings and alleviate the Oxycodone withdrawal symptoms; however, methadone itself also is highly addictive and dangerous. Partial agonists such as buprenorphine partially activate the opioid receptors and 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 relieves withdrawal symptoms.
Accelerated Neuro-Regulation Treatment (ANR) aims to free the individual from the dependence, withdrawals, and cravings for oxycodone or any opioid, treating the root of the illness using protocols of modern medicine. Dr. Andre Waismann developed the treatment as the therapeutic goal changed from the old rapid detoxification method that he invented and performed in the 1990s.
Back then, his old “Rapid Detox” method was widely and quickly adopted, which led to drug rehab and detox centers implementing it without having enough 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, which targets the biological roots of opioid addiction. In contrast, other rapid detox paradigms cannot achieve that, even if done correctly.
The Difference Between ANR vs. Other “Fast or Rapid Opioid Detox 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, targeting 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 precipitated withdrawal process is controlled and modulated using adjunctive medications. Thus, the baseline functional level of the receptors is 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 Withdrawal Timeline
The ANR procedure itself is performed in the course of 4–5 hours during hospitalization for 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 precipitated with the use of the opioid antagonist naltrexone. Oxycodone withdrawal is induced in a personalized to the patient method, taking into account their medical history, clinical, and laboratory findings. The advantage of this approach is that it occurs under close surveillance by experienced medical personnel, who treated more than 24,000 patients worldwide and 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 by the medical personnel and encouraged to take on their daily activities gradually.
Oxycodone Withdrawal Symptoms
The symptoms of oxycodone withdrawal can be both physical and psychological, and they are associated with the over-reactiveness of noradrenergic neurons. How fast withdrawal symptoms will arise depends on a number of factors, including on 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 length of the period, during which the opioid drug was taken and its dose. It is also affected by the overall health of the person and the presence of other medical conditions or simultaneously consumed substances.
Individuals undergoing withdrawal may initially experience restlessness, anxiety, muscle aches, tearing eyes, runny nose, sweating, yawning, and insomnia. Later symptoms may include nausea and vomiting, dysphoria, dilated pupils, hair standing on end, diarrhea, skin goosebumps, elevated blood pressure, and fast heart rate. The extent of the oxycodone withdrawal symptoms varies based on the duration and dose of previous oxycodone intake as well as on 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 serious complications that can even be fatal. Vomiting can lead to the aspiration of material in the lungs and the development of an inflammatory lung process in response to the aspirated material known as aspiratory pneumonia. In a heavy withdrawal, vomiting and diarrhea can lead to loss of electrolytes and fluids, which can lead to more serious health problems, including cardiovascular complications. Therefore, it is important to properly monitored and medically support patients during the withdrawal period. Support includes medications that relieve the withdrawal symptoms and if needed, the substitution of fluids and electrolytes.
Oxycodone Addiction Treatment
Oxycodone dependency or addiction, like other opioid addictions, is a medical condition. When oxycodone is taken for a longer period of time, the opioid receptors undergo neuroadaptive changes. Thus, the natural production of endorphins is disrupted, tolerance is developed, and increased oxycodone doses are necessary to achieve the same effect. Thus, the function of opioid receptors shifts to another dysfunctional level. The developing neuroadaptations lead to a strong craving for the opioid drug – and compulsively seeking it out, in order to get the medicine he needs to feel balanced again. They are also associated not only with withdrawal and dependence symptoms but also with interpersonal and professional problems. 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 endogenous endorphin system and opioid receptors. It uses an induced withdrawal to return the functioning of the opioid receptors and endogenous endorphins to the normal for the individual functional level, 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. Thus, 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 is 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 his personal needs to ensure the stabilization of his opioid receptor functional balance and to avoid any risk of relapse.
Oxycodone Rehab Near Me
Oxycodone detoxification and addiction withdrawal treatment are complex, and the experienced professionals of the ANR Clinic carry them out using a personally tailored approach. The short, one-time hospitalization for the ANR treatment allows patients more flexibility with their planning. In the United States, the treatment is currently performed at the ANR Unit of the Landmark Hospital in Naples, Florida. Outside of the US, the treatment center located in Thun, Switzerland, about 19 km south of the capital city Bern, in Israel, at the Barzilai Medical Center in Ashkelon, and in Georgia, the treatment is provided in Tbilisi, the capital.
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 ANT 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 an opportunity to safely address the biological roots of oxycodone addiction during a single short-term hospitalization.
Centers for Disease Control and Prevention. Understanding the epidemic. https://www.cdc.gov/drugoverdose/epidemic/index.html
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/
Darcq, E., Kieffer, B.L. Opioid receptors: drivers to addiction?. Nat Rev Neurosci 19, 499–514 (2018). https://doi.org/10.1038/s41583-018-0028-x
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: https://www.ncbi.nlm.nih.gov/books/NBK50618
United States Food and Drug Administration. Information about Medication-Assisted Treatment (MAT). https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat
US National Library of Medicine. Medline Plus. Opiate and opioid withdrawal. https://medlineplus.gov/ency/article/000949.htm
US National Library of Medicine. Medline Plus. Oxycodone. https://medlineplus.gov/druginfo/meds/a682132.html