Oxycodone: Treatment and rehabilitation

Last modified: Saturday, 20. June 2009 - 2:35 pm

Addiction to prescription painkillers is a major reason people are admitted to drug rehabilitation centers. In the early part of the twentieth century, however, treatment for addiction to opiates was actually self-administered. Private doctors would prescribe narcotics for opiate addicts, but that practice was soon outlawed, and local governments and communities established formal morphine clinics. By the 1920s, these clinics too were closed and opiate addicts were jailed or treated, usually unsuccessfully, in public health hospitals.
In the 1960s, the emergence of a new drug lifestyle among young people led to increases in opiate addiction as well as deaths from overdose. This growing problem resulted in researchers looking for newer, more effective approaches to treating opiate dependence.
There is some evidence that addiction behaviors may be genetic; in other words, some people who take prescription pain medication may become addicted because of an inherited tendency. However, genetic predisposition is likely to be only partially to blame. Environmental factors, underlying mental illness, and history of known addictions to alcohol or drugs are other factors that contribute to compulsive or addictive drug use.
When a person stops taking, or sharply reduces, the daily amount of oxycodone, severe withdrawal symptoms may occur. These symptoms are similar to those seen in people experiencing morphine withdrawal. To avoid this problem, pain experts slowly reduce the amount of drug the person takes each day.
Withdrawal symptoms can be quite uncomfortable when they do occur, but they are not life-threatening. Typical withdrawal symptoms may begin with yawning, restlessness, insomnia, goose flesh (commonly called goose bumps), and anxiety. Within a few hours symptoms worsen, and may include stomach pain, diarrhea, nausea, vomiting, muscle aches and pain, fevers, sweating, and runny nose and eyes. Symptoms usually begin within six to eight hours of the last dose of short-acting oxycodone, and 24 to 48 hours after the last dose of long-acting oxycodone (such as OxyContin).
One of two common treatment approaches is to combat withdrawal symptoms by treating them with appropriate medications. A drug commonly used in withdrawal treatment is clonidine, a medication most often used to lower blood pressure. For people going through withdrawal, clonidine may help lessen some symptoms. A variety of other drugs also may be used to deal with symptom-specific complaints. Examples include ibuprofen for headaches, muscle, joint, or bone pain, and mild tranquilizers to combat anxiety and/or insomnia.
Withdrawal may also be treated by replacing the drug of abuse with methadone, a long-acting opiate that does not usually produce the heightened sense of well-being characteristic of a drug high. Methadone is typically given every four to six hours under close supervision. The patient’s reactions are monitored and the dosages of methadone are slowly decreased until withdrawal symptoms disappear. Methadone withdrawal usually takes about three weeks. Most methadone withdrawals are conducted in hospitals or residential facilities on an in-patient basis, rather than in methadone maintenance programs, which are outpatient programs in which patients who are unwilling to stop using opiates receive methadone as a legal, long-term substitute.
Some experts recommend a newer option for withdrawal known as rapid opiate detoxification (ROD). This method is typically carried out in a hospital or private treatment facility, and as its name implies, it is faster than some of the more conventional methods. In some cases, withdrawal treatment with ROD can be completed in just a few days. Compared with conventional withdrawal treatment, ROD also has been found to cause less physical discomfort. Even more recently, some researchers have investigated an even faster method called ultra-rapid opiate detoxification (UROD), in which the patient goes through withdrawal while asleep under anesthesia. The entire process takes four to seven hours.
Patients undergoing ROD or UROD are given clonidine plus a drug called naltrexone, which blocks opiate receptors and makes withdrawal signs and symptoms occur more rapidly. This method is still considered experimental.

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