Oxycodone Withdrawal Symptoms and Timeline

Last Updated: June 24, 2020

Authored by Roger Weiss, MD

Reviewed by Michael Espelin APRN

When it comes to drug abuse, prescription medication is the drug of choice for the majority of Americans. The National Institute of Drug Abuse has estimated that among Americans over the age of 12, around 20% has abused a prescription medication at least once. Oxycodone is high up on that list because of the intense effect it has on the pleasure centers of the brain. However, Oxycodone withdrawal is a painful consequence of this abuse.

The History of Oxycodone

Though opiates have a very long history of recreational use, dating back to 15th century China, modern abuse of the drug is fueled by a semi-synthetic version of Opium, Oxycodone.
Oxycodone was derived in the early 20th century and became an important ingredient in analgesics. In 1996, OxyContin was approved by the FDA as a pain-relief drug, which has become a very common drug of abuse.
People often come in contact with it when it is prescribed to them as OxyCotin following an injury, or as pain management after surgery, or even after wisdom teeth removal. In 2013 the FDA changed the labeling guidelines on long-acting and extended-release opioids (such as Oxycodone) indicating that it should no longer be prescribed for moderate pain but only for “pain severe enough to require daily, around-the-clock, long-term opioid treatment.” Despite the changes, this new labeling technique did not in any way prohibit doctors from prescribing opioids for moderate pain.

Oxycodone’s Popularity

The prescribing of Oxycodone exploded in America when a large drug company hosted more than 40 pain management conferences from 1996 to 2001 to promote its new drug OxyCotin. By significantly downplaying the risk of addiction, OxyCotin became the go-to drug for pain management. The problem is it’s not risk-free and it is extremely addictive, so much so that America now finds itself in the middle of an “opium epidemic”. It has gotten to the point where out of all drug abusers 75% choose Oxycodone or Hydrocodone, according to the National Council on Alcoholism and Drug Dependence.
One of the most frightening effect of this widespread epidemic is the fact that by the time most people’s prescriptions run out, they are already hooked on Oxycodone. Craving the effects of the drug often leads them to either purchasing the drug on the streets or when that proves too expensive, turning to heroin. This alternative drug with very similar effects is simply cheaper.

Why is Oxycodone so addictive?

The most popular form of Oxycodone is a prescription medication called OxyCotin. This is a painkiller that not only blocks pain receptors but also alters the dopamine levels in the brain, creating a feeling of euphoria. It activates opioid receptors along the central nervous system, sending messages to the brain that it is happy and relaxed. This slows down breathing, lowers blood pressure, body temperature and heart rate.
The altering of dopamine levels which produces a feeling of happiness and euphoria is what makes the drug so highly addictive drawing many people to abuse it. After an extended period of use, the brain starts expecting the drug’s interference in its processes.
When regular doses of Oxycodone stop being supplied to the brain, it tries to self-regulate. Stopping abruptly can be very dangerous, sending the central nervous system into shock. This can disrupt vital signs and potentially be life-threatening. Various physical and psychological symptoms may occur at varying degrees of severity. This experience is called Oxycodone withdrawal.

Oxycodone Withdrawal

What is the Oxycodone withdrawal timeline?

Withdrawal from Oxycodone typically lasts up to two weeks. The Oxycodone withdrawal timeline begins within 24 hours of the last intake and peaks around the second or third day after the symptoms begin. This period of acute withdrawal has the most severe symptoms. Lesser symptoms of Oxycodone withdrawal may last for a few months.

Oxycodone Withdrawal Symptoms

Today, millions of people are addicted to Oxycodone, and those who try to break the addiction suffer severe withdrawal symptoms. These include:

  • Nausea and vomiting
  • Fatigue
  • Coughing
  • Diarrhea
  • Runny nose
  • Teary eyes
  • Sweating
  • Anxiety
  • Shaking
  • Twitching and kicking
  • Muscle aches
  • Increased heart rate

In addition to the physical symptoms, the psychological effects of Oxycodone withdrawal can make the process agonizing. These symptoms may linger longer than the physical side effects, due to the fact that it takes a while for the brain to restore its natural levels of chemicals, responsible for positive emotions.
Some psychological symptoms you can expect to see during oxycodone withdrawal include:

  • Suicidal thoughts
  • Depression
  • Insomnia
  • Irritability
  • Confusion
  • Mental ”fog”
  • Apathy
  • Trouble concentrating

However, staying off a drug is easier said than done. Subsequently, there are two significant factors that play into Oxycodone withdrawal, which are time span and dosage tolerance.

Oxycodone Withdrawal Time Span

Time plays an important role in Oxycodone withdrawal. Users who have been on the drug for years are likely to have a more prolonged withdrawal experience than those who have not. However, even those who have been using it for only a few weeks or months may experience withdrawal. Just like the severity of the symptoms varies from person to person, so does the time span of withdrawal.
Depending on the dose, Oxycodone has a relatively long half-life, lasting up to 12 hours. The withdrawal symptoms start to surface right after the drug has left the bloodstream, causing the user to experience the first signs of the grueling withdrawal process.
Withdrawal usually begins within the 24-hour period after the last Oxycodone intake, reaching its peak around the onset of the second or third day of abstinence. This period is referred to as the acute withdrawal. At this stage the symptoms are physical as well as psychological, lasting one to two weeks. In extreme cases the symptoms may last even longer, leading to the post-acute withdrawal syndrome or PAWS.

Easing Withdrawal Symptoms

To avoid severe withdrawal symptoms, users are advised to seek professional help and allow doctors to plan a weaning schedule. This way, the patient will not have to suffer the agonizing and life-threatening symptoms of Oxycodone withdrawal. Doctors may also choose to prescribe Methadone, a partial opioid agonist which is often used to treat opioid-related addictions.

Overall, Oxycodone should only be taken under professional supervision, and should only be obtained with a doctor’s prescription.

Potential users are strongly advised against self-administration and recreational use of Oxycodone.

Oxycodone Detox Centers

The best way to avoid the nasty symptoms of Oxycodone withdrawal is to go through the process with professional help. In specialized medical detox centers, you can begin the process before the withdrawal symptoms have begun, while the drug is still active in your body. This is the ideal way to begin the process. Next, your vital signs will be checked and monitored constantly for around a week. In extreme cases, of long periods of addiction, of a history of substance abuse or heavy dependence on Oxycodone, this period can be extended to 10 days. Medication can be helpful to cope with the harder withdrawal symptoms. This is the first step towards moving to a full recovery in substance abuse treatment programs. Medical Oxycodone detox is often a requirement for entering a recovery program so that the patient can concentrate with a clear mind on learning new coping skills, and adapting to a drug-free life.

Preventing Relapse

For full recovery to be possible and maintainable it is important that after the initial detox, you are not set free to your own devices. A comprehensive substance abuse treatment program not only lays down the foundations for recovery but can also provide medication to help prevent relapse.
Oxycodone relapse can be especially dangerous, and potentially life-threatening. This is because during continual use of a drug your body builds up a tolerance towards it, requiring larger amounts of the drug to achieve the desired effect. If someone successfully completes an Oxycodone detox and then returns to using the same amount they did before, their body may not be able to handle it, which can lead to a deadly overdose. This is a real concern, as annually there are an estimated 15,000 deaths related to prescription pain pill overdoses, according to the Centers for Disease Control and Prevention. Medication provided by substance abuse treatment programs can help decrease cravings for the drug and hopefully prevent a someone from returning to Oxycodone in the future.

Page Sources

  1. https://www.drugabuse.gov/publications/misuse-prescription-drugs/overview
  2. https://www.fda.gov/media/86875/download
  3. https://www.cdc.gov/vitalsigns/PainkillerOverdoses/index.html

Published on: November 14th, 2016

Updated on: June 24th, 2020

About Author

Roger Weiss, MD

Dr. Roger Weiss is a practicing mental health specialist at the hospital. Dr. Weiss combines his clinical practice and medical writing career since 2009. Apart from these activities, Dr. Weiss also delivers lectures for youth, former addicts, and everyone interested in topics such as substance abuse and treatment.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.


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