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OxyContin is a controlled-release form of the opioid oxycodone and is a medication used to treat severe pain.1 It is in the class of opioid drugs which includes heroin, morphine, codeine, methadone, and hydromorphone, or Dilaudid.2 Due to OxyContin’s high potential for physical and psychological dependence, as well as misuse, the risk for OxyContin withdrawal is high.
When Does OxyContin Withdrawal Occur?
OxyContin withdrawal occurs after repeated use, but it does not always relate to addiction. It can happen in anyone who takes OxyContin regularly, including for medical reasons. Those under the care of a doctor are weaned slowly and safely, with close monitoring from their providers, because oxycontin withdrawal can range from unpleasant to life-threatening.4
People may need to go through OxyContin withdrawal for various reasons, such as:
- Getting pregnant and breastfeeding
- Ending a course of OxyContin treatment for a medical condition
- Seeking sobriety or abstinence after a period of misuse
OxyContin Withdrawal Symptoms
Early OxyContin withdrawal symptoms can include:4
- Aches in the back and legs
- Hypersensitivity to pain
Some men also experience spontaneous ejaculation as an early symptom of withdrawal.4
Within minutes to several days after your last dose of OxyContin, you may experience4
- Depressed mood
- Nausea and vomiting
- Achy muscles
- Runny eyes and nose
- Pupil dilation
- Piloerection, better known as “goosebumps”
- Lack of sleep
OxyContin Withdrawal Timeline
Although all types of opioid withdrawal are similar, the withdrawal timeline depends on the half-life of the drug you are withdrawing from. For example, heroin withdrawal can begin a few hours after taking it, while methadone withdrawal can take several days to start.5
OxyContin is released over approximately 12 hours, with two half-lives at about 40 minutes and 6 hours after taking, respectively.1 That is a much slower half-life than oxycodone, the immediate-release version, which is about 20 minutes.1
The severity and timeline for opiate/opioid withdrawal depends on:5,6
- The type of opiate/opioid you take
- How long you have been using it
- The amount you take
- Your age and overall health
A general timeline for OxyContin withdrawal begins with withdrawal symptoms starting 12-24 hours after your last dose.
Symptoms may be at their worst for up to 5 days. During this initial phase of acute withdrawal, you may require hospitalization. It can take up to six months or more to return to your baseline health from before you started OxyContin. 5,6
Who is at Risk for OxyContin Withdrawal?
The biggest risk factor for Oxycontin withdrawal is consistent, ongoing use of the medication, whether prescribed or not. If you have an opioid use disorder, you’re at a high risk of experiencing withdrawal symptoms if you stop taking the drug.
You have an opioid use disorder if you experience at least two of the following within a year.4
- Taking more opioids than intended
- Ongoing cravings
- Unsuccessful attempts at quitting
- Inability to meet professional or educational and personal responsibilities
- Repeated use despite negative consequences on interpersonal relationships
- Recreational, social, or occupational activities which used to be important are given up
- Facing physical hazards or dangers related to opioid use
- Tolerance, or needing more to achieve the same effect
Opioid use disorder can happen to anyone, but it’s been found to be more prevalent among minority and financially disadvantaged populations. However, opioid use disorder is becoming more prevalent among middle-class, white individuals, especially women.
Opioid use disorder is also more common among people going through marital difficulties and divorce, unemployment, and inconsistent employment. The most common age range for the onset of opioid use disorder is late teens to early 20s.4
In some situations, opioid use disorder begins with a prescription. People “graduate” from prescription OxyContin to street opioids like heroin. This puts a person at a markedly increased risk for violence and infectious diseases. Additionally, those who obtain OxyContin from the street are at higher risk for violence and other crime-related hazards.4
Side Effects of OxyContin Dependence
Although OxyContin dependence may be related to valid medical use, for many people its side effects and risks outweigh its benefits. An in-depth discussion with your provider is warranted before taking it. Some of the common experiences and side effects of OxyContin-dependent users include:4
- Dry mucous membranes
- Severe constipation
- Visual problems related to eye pupil constriction
- Addicted infants and low birth weight with opiate-dependent mothers
- High rates of depression and suicide
- Higher rates of mortality related to accidents, injuries, infections, and medical complications
Quitting OxyContin on Your Own
It is not safe to withdraw from OxyContin on your own, especially if your use has been heavy and prolonged.
One of the most hazardous risks of withdrawal on your own is relapse—you may find that you are not able to withstand OxyContin withdrawal symptoms and end up using again. This makes you vulnerable to overdose, which is a medical emergency.4
Symptoms of OxyContin overdose include:1
- Slow, heavy breathing
- Muscle limpness
- Cold, clammy skin
- Constricted pupils
- Slowed heart rate
- Low blood pressure
The severe OxyContin withdrawal symptoms can be mitigated with inpatient medical treatment, tapering the medication safely, or establishing maintenance therapy. Overdosing can progress to coma and death if not treated.
OxyContin Withdrawal Treatment
The goal of OxyContin withdrawal is to get rid of physical dependence, prevent dangerous withdrawal symptoms, and prevent future dependence.7
Your provider will do a physical assessment and ask you questions to determine the severity of your withdrawal. Many providers use an assessment tool called the Clinical Opioid Withdrawal Scale, or COWS. It helps providers know if medication is necessary to manage your withdrawal and what type of medication.2
Medical providers may want to confirm that your symptoms are related to withdrawal with a urine toxicology test. They will assess whether another medical diagnosis can explain your symptoms. They may also check your heart rhythms and do certain blood tests to check for any imbalances related to withdrawal.2
Medications Used to Treat OxyContin Withdrawal
Medication management of OxyContin withdrawal may include: 2,5
- Administration of oxygen
- Initiation of withdrawal with naloxone
- Methadone maintenance and tapering
- Temporary buprenorphine
- Maintaining abstinence with naltrexone
- Medications to address specific symptoms
- Intravenous fluid administration
Naloxone, with brand names Narcan and Evzio, rapidly reverses an OxyContin or other opioid high causing withdrawal symptoms to appear. Naloxone is often prescribed as a harm reduction agent to prevent death from overdose in those who misuse opioids. In some clinics, it is the first step in withdrawal treatment for certain patients and may require several doses as the body clears OxyContin from the body.2,8
Medications like methadone, buprenorphine, or suboxone (a combination drug) work to ease withdrawal, reduce the effects of oxycontin, and prevent relapse.7 Naltrexone is used to maintain abstinence by blocking the euphoric effects and preventing relapse. It is also used for alcohol use disorder.8
Other medications may be used to target specific symptoms like diarrhea, nausea and vomiting, muscle aches, and high blood pressure.2
Rehab and Long-Term Treatment for OxyContin Addiction
After the initial withdrawal and detoxification, depending on the extent and cause of your withdrawal, addiction treatment may be recommended.
Many who have misused OxyContin enter inpatient treatment after acute withdrawal. Inpatient treatment usually lasts 1-3 months, followed by an abstinence maintenance program. Ongoing OxyContin treatment may include:
- Long or short-term inpatient rehabilitation
- Intensive outpatient rehabilitation
- Group abstinence programs like Narcotics Anonymous (NA) or SMART Recovery
- One-on-one counseling
- Medication management and oversight
OxyContin and the Opioid Crisis
OxyContin is among the drugs considered problematic amidst the opioid crisis in the U.S. The epidemic of opioid misuse was declared a public health emergency by the U.S. Department of Health and Human Services (HHS) in 2017.
- In 2020, 10.1 million people misused prescription medication in the past year, 1.6 million of them for the first time.
- Almost 50,000 people died last year from an overdose from synthetic opioids like OxyContin.
- In 2016, there were approximately 11.5 million Americans who misused prescription opioids, of whom 1.8 million developed substance use disorder from prescription medication.
- In 2012, 259 million opioid prescriptions were written, enough for each American adult.2
It’s not limited to the United States; opioids are also among the most common drugs of misuse in Asia, Europe, Australia, and surrounding areas. Opioid consumption worldwide is quickly rising.
- Package insert Oxycontin (PDF). (May 2007). Stamford, CT: Purdue Pharma L.P.
- Shah M, Huecker, M. R. (2020). Opioid Withdrawal. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
- Drug Scheduling. (n.d.). US Drug Enforcement Agency.
- Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Fifth edition. American Psychiatric Association; 2013.
- Miller, S. (2018). The ASAM Principles of Addiction Medicine. Wolters Kluwer.
- Himmelsbach, C. (1942), Clinical Studies of Drug Addiction: Physical Dependence, Withdrawal, and Recovery. Archives of Internal Medicine (1908), 69(5), 766–772.
- Rehni, A. (2013). Opioid withdrawal syndrome: emerging concepts and novel therapeutic targets. CNS & Neurological Disorders Drug Targets., 12(1), 112–125.
- Substance Abuse & Mental Health Services Administration. (2020, August 19). MAT medications, counseling, and related conditions. Retrieved February 2021.