Roxicet is one of the many brand names for a prescription painkiller that features a specific combination of oxycodone and acetaminophen. As an opioid-based painkiller, Roxicet is designed to relieve moderate to severe pain, usually after an injury or surgery. It is supposed to serve as temporary pain relief, with users stepping down the dose after a few months; however, for too many people, Roxicet becomes a drug of abuse.
Because the drug was readily prescribed and widely available for diversion, Roxicet is one of the prescription narcotics that have contributed to the epidemic of opioid addiction and overdose in the United States. According to the Centers for Disease Control and Prevention (CDC), this epidemic currently leads to the overdose deaths of 91 people every day in the United States.
How Roxicet Works
As a prescription medication, Roxicet is similar to Percocet, which combines an opioid analgesic, oxycodone, with a nonsteroidal anti-inflammatory drug (NSAID), acetaminophen. By combining these two kinds of painkillers, Roxicet was designed to be more effective at relieving pain, aches, and even fever, by targeting more than one area of the brain to ease pain.
The more potent of the two painkillers, oxycodone, targets opioid receptors in the brain. These receptors are involved in moderating how the brain interprets pain signals from the body; at times, the brain will release its own endogenous opioids. However, the brain’s opioid receptors are also associated with breathing rate, which is why opioid drugs can depress breathing, as well as the brain’s reward center, which releases neurotransmitters associated with mood, including dopamine and serotonin. This association with the reward center and mood-elevating neurotransmitters can make oxycodone and other opioids addictive.
Acetaminophen has little to no addiction potential, and it is included in dozens of over-the-counter pain relievers, cold medicines, and other medications to reduce fever and relieve pain. Unfortunately, it is possible to overdose on acetaminophen and severely damage the liver. While safe doses of acetaminophen are found in OTC medicines and prescription drugs like Roxicet, combining different sources of acetaminophen, or taking larger than recommended doses of these drugs, can lead to overdose. The recommended maximum daily dose of acetaminophen is 4,000 mg; there are 325 mg of acetaminophen per dose of Roxicet.
Roxicet is a short-acting opioid drug, which lasts for six hours to relieve pain. However, people who become addicted to the oxycodone in the drug may take much more than the prescribed dose. They may mix Roxicet with other intoxicating drugs, like alcohol, benzodiazepines, or other opioids. Physicians typically try to prescribe the lowest possible dose of opioid medications, to reduce the risk of addiction, but this approach does not work for every patient.
A recent study that followed up with 36,177 privately insured patients who had undergone minor or major elective surgeries and received opioids for post-surgical pain management found that 6 percent of those who took these medications continued to abuse the drugs for 90 days after surgery, suggesting they maintained consumption well after they needed the drugs for pain treatment. The study concluded that one of the most serious post-surgical risks to patients in the United States was opioid addiction and abuse.
Signs of Roxicet Abuse
While most people take prescription narcotics safely with the oversight of a medical professional, many begin to abuse these medications and ultimately struggle with opioid abuse. This condition is referred to as opioid use disorder, and it has similar characteristics to other addictive disorders, like alcohol use disorder. Signs that a person may struggle with opioid use disorder include:
- A strong desire to take opioid drugs
- Difficulty controlling or reducing use of the drugs
- Struggling to meet work or social obligations because of drug abuse
- Experiencing legal trouble because of drug use
- Spending a lot of money or time acquiring drugs
- Developing a physical tolerance to the drugs, so needing to consume more of the substance to achieve the original effects
- Experiencing withdrawal symptoms when attempting to end drug abuse
If a person’s behavior and appearance change, they may struggle with substance abuse. If this occurs after an injury or surgery, they may struggle with their prescription narcotics, such as Roxicet.
Side Effects and Health Risks from Roxicet Abuse
Potent drugs like Roxicet can lead to several short-term and long-term side effects. Short-term, a person may experience side effects like:
- Abdominal cramps
- Appetite changes
- Nausea or vomiting
- Drowsiness or sleepiness
- Changes in blood pressure
These side effects can occur in people who take doses as prescribed with a doctor’s oversight; however, they are more likely to occur in a person who abuses these drugs and takes too much oxycodone.
There are very serious side effects associated with Roxicet, which can cause long-term harm. Overdose is one of the most serious; a person can overdose on either the opioid or acetaminophen. Signs of an opioid overdose include:
- Changes in consciousness or awareness
- Extreme sleepiness
- Falling unconscious and unable to be roused
- Low blood pressure and weak heartbeat
- Depressed, slowed, shallow, irregular, or stopped breathing
- Bluish tint on the skin or lips
- Cold, clammy skin
The primary symptom of acetaminophen overdose is liver damage. This can take time, but a person may develop jaundice; this involves yellowing of the eyes and skin, which indicates the liver is no longer filtering toxins out of the body. This can lead to damage to other organ systems and eventual death. The presence of a potent drug like oxycodone can accelerate liver damage.
Treatment to End Roxicet Addiction
Because so many people in the United States are affected by opioid addiction, medical researchers have worked hard on developing effective, evidence-based treatments. The National Institute on Drug Abuse (NIDA) is clear in their Principles of Effective Treatment that no single path works for everyone; however, a general treatment protocol for opioid addiction has been developed, which can be adjusted to help most people struggling with opioid use disorder.
First, a medical professional should meet with the individual. It is important to find a physician who can help with the detox process. Although opioid withdrawal is not life-threatening, it is uncomfortable, and without medical oversight, the individual is at risk of relapsing, which puts them at a greater risk for overdose.
Safe detox may involve medication-assisted treatment (MAT). The physician will use the Clinical Opiate Withdrawal Scale (COWS) to determine how serious their patient’s withdrawal symptoms are. If they are intense enough, the physician may prescribe withdrawal medications like buprenorphine. Then, the physician will begin to taper the patient off buprenorphine, which reduces the severity of withdrawal symptoms, and the individual will focus on therapy to change behaviors around addictive substances.
Withdrawal symptoms associated with opioid abuse have two basic stages that involve earlier and later symptoms. Initial symptoms, during the first 2-3 days after the individual stops taking Roxicet, include:
- Muscle aches
- Watery eyes
- Runny nose
- Excessive sweating
- Trouble sleeping or insomnia
- Excessive yawning
Peak withdrawal symptoms typically begin within 3-7 days, depending on how much Roxicet the person took. They are most likely to peak at 3-4 days after the final dose.
These and later stage withdrawal symptoms include:
- Abdominal cramps
- Nausea and vomiting
- Dilated pupils
- Changes to vision, including blurry vision
- Rapid heart rate
- Increased blood pressure
- Physical discomfort
- Symptoms that are similar to those experienced with a cold or the flu
By tapering a prescription therapy like buprenorphine, the individual can reduce the impact of these withdrawal symptoms on daily life. Another prescription drug, naltrexone, may help individuals to maintain sobriety after safe withdrawal by reducing cravings for Roxicet.
Long-term treatment is very important. NIDA recommends that people struggling with any addiction, including opioid use disorder, remain in rehabilitation for at least 90 days, or three months. This is enough time for the person to understand the root causes of their addiction and change their behaviors around substances. However, even after 90 days, ongoing support and treatment are needed to maintain sobriety.
For example, peer support groups have helped many people talk through ongoing issues like cravings or stress, and receive emotional support to stay accountable for their actions. Additional treatment may include regular checkups with a physician, especially if the person has long-term health issues like liver damage.
Ongoing individual therapy is useful for people with co-occurring disorders – a concurrent mental health problem and substance abuse problem, which both require treatment. Conditions like anxiety, depression, bipolar disorder, schizophrenia, and even insomnia or other sleeping disorders may require ongoing therapy for years, to help the person stay away from self-medicating with drugs or alcohol.
Although Roxicet has been useful for many people as a temporary form of pain management, too many individuals have taken the drug and then struggled with substance abuse and addiction. With the serious, deadly opioid abuse epidemic sweeping the world, not just the United States, effective, evidence-based treatments are vital.
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