Oxycodone Withdrawal Symptoms, Timeline, and Treatment

Opioid painkillers account for 214 million prescriptions in the US. Opioid misuse is common and fatal opioid overdoses continue to increase.Of the opioid analgesics, oxycodone is among the most popular; last year alone, 3.2 million people misused this drug. 

This article breaks down everything you need to know about oxycodone and its withdrawal so you can keep yourself (and your loved ones) safe. 

What Is Oxycodone and How Does It Work?

Oxycodone is a semi-synthetic opioid that helps relieve acute pain (after a surgery or accident) and chronic pain (from long-term illness). It works by binding to opioid receptors in the brain and triggering the release of endorphins (feel-good hormones), which blocks pain transmission. 

Is Oxycodone Addictive?

Frequent oxycodone users may develop tolerance to the medication because of structural changes in their brains. This means having to continually increase doses to feel the same pain-relieving effects. Over time, this evolves into a dependence and addiction.

Is Oxycodone Available Over-the-Counter (OTC)?

The FDA classifies oxycodone as a Schedule II substance given its potential for misuse and dependence. Thus, oxycodone is not available over-the-counter. 

How Long Do the Effects of Oxycodone Last?

The body takes a period of time equal to five half-lives (the time it takes for drug concentration in the blood to reduce by half) to eliminate any drug. Thus, the effects last the times indicated below:

• Immediate-release oxycodone formulations last 16 hours (given their 3.2 hour half-life).
• Delayed-release oxycodone formulations last 24 hours (given their 5.6 hour half-life).

What Causes Oxycodone Withdrawal Symptoms?

A part of the brain known as the locus coeruleus (LC) is abundant in opioid receptors. Oxycodone binds to these receptors, suppressing the release of noradrenaline (the fight-or-flight hormone). When users stop taking oxycodone abruptly, the LC produces excess quantities of noradrenaline, leading to withdrawal symptoms. 

Signs and Symptoms of Oxycodone Withdrawal

Symptoms:

Drug cravings

Diarrhea

Stomach pain

Muscle pain and body aches

Hot or cold flashes

Sleep disturbances

Irritability

Nausea

Vomiting

Difficulty concentrating

Low mood

Fatigue

Coughing

Drowsiness

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Signs:

Tachycardia (increased pulse)

Hypertension (elevated blood pressure)

Muscle twitches

Tremors

Diaphoresis (excessive sweating)

Rhinorrhea (runny nose)

Runny eyes

Mydriasis (dilated pupils)

Oxycodone Withdrawal Timeline 

Time since last dose and salient features:

First 48 hours

Withdrawal symptoms typically appear 8-12 hours after the last dose. 

Relapse is most common during this period.

Days 3-5 

Withdrawal symptoms intensify and peak during this time. 

1st week

Withdrawal symptoms begin to fade. 

Beyond the 1st week

Most users are symptom-free by this time. 

Factors Affecting Oxycodone Withdrawal Duration 

Several variables affect oxycodone withdrawal duration:

• Age – Data shows that oxycodone levels are 15% higher in older individuals (age 65 and over) than younger adults. This is because the body takes longer to break down opioids as it ages. For the same reason, oxycodone withdrawal lasts longer in the elderly population.
• Gender – Oxycodone quantities in women are generally 25% higher than in men (likely due to their greater fat deposits). As a result, women experience withdrawal for a longer duration. 
• Liver health – The half-life of oxycodone increases in people with liver disease, as the liver is responsible for opioid metabolism. In other words, patients with liver disease experience longer oxycodone withdrawal. 
• Kidney function – The kidney is responsible for excreting opioid metabolites (the end-product of the liver’s metabolism). Thus, patients with kidney disease retain 50% greater quantities of oxycodone than people with normally functioning kidneys, lengthening their withdrawal. 
• Genetics – Some genes determine how quickly the body will metabolize oxycodone. This means that individuals with these genes go through shorter periods of withdrawal than those without them. 
• Oxycodone use duration and dosing –Prolonged (and high-dose) oxycodone use leads to structural changes in the brain. As a result, these patients experience longer, more severe withdrawal. 
• Polydrug use –Combining medications (for example, benzodiazepines and methamphetamine) with opioids can prolong oxycodone withdrawal due to their cumulative sedative effect. 
• Mental health illnesses – Studies show individuals with mental health disorders suffer more severe withdrawal symptoms, though the reasons for this are unknown. 

Quantifying Oxycodone Withdrawal Severity: Clinical Opioid Withdrawal Scale (COWS)

Doctors utilize a clinical scale known as COWS to quantify oxycodone withdrawal severity. This 47-point scale classifies opioid severity into the following categories:

• Mild (between 5 and 12 points)
• Moderate (between 13 and 24 points)
• Moderately severe (between 25 and 36 points)
• Severe (37 or more points) 

Oxycodone Withdrawal Complications 

Oxycodone withdrawal complications include:

• Infections – Oxycodone misuse and withdrawal increases infection risk because:
• It suppresses the immune system (the body's defense mechanism). 
• Users in withdrawal often turn to injectable opioids for quick relief of their symptoms. The sharing and use of needles increases transmission of viral hepatitis and HIV. 
• The vomiting associated with withdrawal can lead to aspiration (regurgitation of stomach content into the lungs), which increases the risk of respiratory infections. 
• Dangerous heart rhythms – Studies show that high doses of certain opioids (such as oxycodone) can lead to fatal cardiac arrhythmias. 
• Electrolyte imbalances –Persistent withdrawal-associated diarrhea and vomiting depletes the body's fluid reserves, leading to dangerous chemical imbalances.
• Nasal septum perforation –Users in withdrawal may resort to snorting opioids for symptom relief, which may lead to septal perforation. 
• Neonatal abstinence syndrome (NAS)
• Liver damage–As the liver processes and breaks down opioids, excess doses can cause issues for the organ. 
• Sexual dysfunction –Oxycodone suppresses sexual hormone release, which leads to erectile dysfunction in males and amenorrhea (i.e., infertility) in females. 
• Post-acute withdrawal symptoms – Some users experience oxycodone withdrawal symptoms weeks to months after their last dose. 

How Is Oxycodone Withdrawal Diagnosed? 

Doctors diagnose oxycodone withdrawal based on:

1. A history of oxycodone misuse and dependence. In general, users that see themselves reflected in the following statements are dependent on oxycodone:
2. Used high doses of oxycodone for more than a few weeks
3. Experience three or more withdrawal symptoms within a few hours of taking oxycodone
4. Oxycodone use interferes with day-to-day life and can cause the user to neglect obligations
5. Misuse has directly led to conflicts
6. Attempts to reduce oxycodone use have failed
7. Feel the need to increase oxycodone dosage to achieve the same effect 
8. Laboratory investigations – in particular, urine tests – can be used to detect oxycodone levels and diagnose withdrawal. 

How to Stop Taking Oxycodone Without Withdrawal: The Taper

Doctors recommend tapering oxycodone dosage over the course of weeks to months rather than quitting cold turkey. This careful approach prevents dangerous withdrawal symptoms. To avoid complications during the tapering process, healthcare providers may:

• Monitor patient temperature, blood pressure, and pulse
• Conduct urine or blood tests
• Coordinate with mental health professionals
• Prescribe treatment medications

Oxycodone FAQs

Will Hydrocodone Help with Oxycodone Withdrawal? 

In the short term, hydrocodone can help reduce oxycodone withdrawal symptoms (since it’s also an opioid). In the long term, however, users can develop a hydrocodone dependence, which is why doctors do not recommend this approach. Instead, other medications are approved to treat opioid use disorder. 

How Long Does Oxycodone Withdrawal Last?

This varies considerably on a case-by-case basis, but most patients are symptom-free one week following their last dose. 

Oxycodone Withdrawal Treatment and Medication

Oxycodone withdrawal treatment aims to achieve two goals: reduce symptoms and prevent relapse. 

Easing Oxycodone Withdrawal Symptoms

The following can help ease oxycodone withdrawal symptoms:

1. Lifestyle Changes That Help with Oxycodone Withdrawal 

• Exercise –Like oxycodone, exercise triggers the release of feel-good hormones. This reduces oxycodone cravings and relieves symptoms.   
• A healthy diet –Patients dependent on oxycodone often suffer from malnutrition because the drug interferes with their eating schedule. This creates nutritional and hormonal imbalances that worsen withdrawal symptoms. Understandably, a healthy diet helps reverse these imbalances and relieve symptoms.
• Meditation – A six-month study showed that brief meditation sessions can help patients struggling with opioid withdrawal. The practice is helpful because it relieves stress and reduces cravings for opioids. 
• Hydration –Withdrawal-associated vomiting and diarrhea can create electrolyte imbalances that worsen symptoms. Naturally, hydrating adequately can help reverse this and ease the impact of withdrawal symptoms. 
• Good quality sleep – Opioid misuse leads to lower-quality sleep because it interferes with the REM cycle. In turn, this worsens pain and withdrawal symptoms. Prioritizing sleep can prevent this. 

1. Home Remedies to Ease Withdrawal Symptoms 

• Cold sponging helps with withdrawal-associated body temperature changes.
• St. John's wort can ease oxycodone withdrawal tremors
• Chinese herbal remedy Tai-Kang-Ning (TKN) is research-backed and can alleviate opioid withdrawal symptoms
• Small (but frequent) bread-rich meals reduce nausea and vomiting
• Black cumin seed can help with withdrawal fatigue (according to some users)

1. Medications to Relieve Oxycodone Withdrawal Symptoms

Doctors may prescribe the following medications to manage withdrawal symptoms.

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Symptoms:

Anxiety

Itching

Runny nose

Runny eyes

Nausea and vomiting

Diarrhea

Abdominal cramps

Muscular spasm

Headache

Muscular pain

Joint pain

Insomnia

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Medications:

 Diazepam or Lorazepam

Hydroxyzine or diphenhydramine

Prochlorperazine, metoclopramide, or ondansetron

Loperamide 

Hyoscine butylbromide or dicyclomine

Baclofen or cyclobenzaprine

Aspirin, ibuprofen, or paracetamol

Temazepam or trazodone

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Medications to Prevent Oxycodone Relapse

Early withdrawal symptoms are the number one cause of treatment failure and patient relapse. To prevent this, doctors may prescribe FDA-approved medications to treat opioid use disorder, including: 

• Buprenorphine (a partial opioid agonist)
• Methadone (a short-acting opioid agonist)
• Naltrexone (an opioid antagonist)

These medications help people overcome opioid addiction.

Oxycodone Dependence Can Take Away Your Freedom: We Help You Reclaim It!

The experts at Confidant Health use research-backed and proven treatments to help you overcome your oxycodone dependence. If you are looking to regain control of your life and live the way you want, get in touch today!