Percocet is a painkiller that's part of a group of drugs known as opioids. Some opioids are derived naturally, and others are synthesized in a lab, including hydrocodone and oxycodone. Percocet is the brand name of a drug that mixes oxycodone and acetaminophen, the generic name for the medication Tylenol. Oxycodone is an opioid medication used for the treatment of moderate to severe pain. It is an addictive narcotic and is one of the most commonly abused drugs in the United States. It is available in various formulations by itself, combined with other medications, and immediate-release and controlled-release versions. Because Percocet uses a combination of Oxycodone and Tylenol, it is commonly perceived to have lower abuse potential than drugs like Oxycontin. This leads prescribers to use it more and more people abusing the drug. Even though the Tylenol addition makes it more difficult to inject or snort, especially safely, people do so anyway. This can cause much damage to the body, especially the liver. Even when consumed orally, addiction to Percocet is very harmful for this and many other reasons.
Oxycodone medications are known by several other slang or street names, including:
- Roxy or Roxies
- Hillbilly Heroin
- 5's, 7.5's, or 10's
Other than Percocet, oxycodone is available in prescription forms, including Xartemis XR, Roxicet, Targiniq ER, Percodan, Oxycet, and OxyContin.
The History of Percocet
Oxycodone was first made in Germany in 1916 from thebaine. The United States Food and Drug Administration (FDA) first approved Percocet in 1976. The drug was initially thought to be a safer alternative to more addictive opioids, such as morphine. This proved to be untrue. It is approximately twice as potent as morphine. The stigma associated with morphine is why some patients are reluctant to use it; however, they are comfortable using oxycodone. A systematic review of nine randomized trials compared oxycodone, morphine, and other selected opioids in recreational drug users and people with a history of opioid misuse. It was found that oxycodone was more favored and more likely to be misused than either morphine or hydrocodone.
Percocet is classified as a Schedule II drug by the federal Drug Enforcement Administration, which means it a drug with "a high potential for abuse, with use potentially leading to severe psychological or physical dependence."
The national estimates for drug-related emergency department visits for oxycodone-containing medicines increased from 27.6 per 100 000 people in 2004 to 88.5 visits per 100 000 in 2009. It has been suggested that the high use of oxycodone is partly related to the marketing campaign for OxyContin.
When Purdue Pharma introduced OxyContin to the United States in 1996, it embarked on an expensive marketing and promotion campaign. This created an atmosphere of competition among a relatively stable market, where morphine was the gold-standard for decades. Suddenly, other pharmaceutical manufacturers had to push their oxycodone containing drugs to keep up with sales and avoid bankruptcy. The addiction caused by this created its self-perpetuating demand for opioids like Percocet.
The national opioid epidemic has ravaged the country. After a steady increase in the overall national opioid prescribing rate starting in 2006, the total number of prescriptions dispensed peaked in 2012 at more than 255 million and a prescribing rate of 81.3 prescriptions per 100 persons. The consequences have transcended prescription drug abuse. Opioids have now become America's drug of choice, and efforts to control the damage from overprescribing has led to a worsening of the illicit drug market for heroin and fentanyl. Overdose deaths involving prescription opioids were more than four times higher in 2018 than in 1999.
What does Percocet look like?
Percocet is usually available as a generic medicine in dosages of oxycodone mg/acetaminophen mg 5/325, 5/500, 7.5/500, and 10/325. It is usually white, peach, or blue.
Effects of Percocet
Percocet is an opioid, so it produces the classic opioid effect of depressing the central nervous system. This means that the drug slows down that part of the brain and spinal cord that regulate essential involuntary functions like breathing, heart rate, blood pressure, and digestion, to name a few. But its primary use to dull pain, which it accomplishes by blocking the signal of pain to the brain. Opioids attach to pain receptors throughout the system and cause a massive release of dopamine, a chemical that causes sensations of pleasure and reward. The euphoria produced is the "high" that the user is continually trying to recreate by taking the drug.
One way to spot Percocet abuse is in detecting some of the side effects manifesting in those using the drug. Some of the most common side effects of Percocet use include:
- Slow breathing
- Vomiting and nausea
- Dry mouth
- Pinpoint pupils
- Constant itching
Percocet abuse can lead to dependence and addiction. As one struggles with opioid addiction, compulsive misuse of the drugs can cause:
- Physical damage to your body, such as liver failure from too much acetaminophen.
- The onset of withdrawal symptoms when drug effects wear off, further compelling continued misuse.
- An overdose can result in death.
From 1999 to 2018, more than 232,000 people died in the United States from overdoses involving prescription opioids. They are one of the most deadly drugs in existence because of how they kill. The person who abuses opioids will commonly become unconscious or "nod-off," a classic side-effect. Very high doses of opioids will cause this without overdose or killing the person. So, when too large of a dose is consumed, the user is usually unaware that they will die without help. They quickly become unconscious and can do nothing to save their own life or get help. Symptoms of an overdose are given so that anyone who discovers someone overdosing can know to intervene.
They can include:
- Profound sleepiness
- Muscle weakness
- Markedly constricted pupils
- Difficulty breathing
- Respiratory failure
- Cyanosis (blue-tinged skin, fingernails, or lips)
- Cold, clammy skin
- Loss of consciousness
Perhaps the only saving grace is that those who are not found before it's too late hopefully do not suffer.
Another silver lining from the opioid epidemic is that the amount of attention to the situation has created change. Much progress has been made in understanding opioids and how to treat an overdose. This has led to a fantastic drug, naloxone. Naloxone is a medication designed to reverse opioid overdose rapidly. It is an opioid antagonist, meaning that it binds to opioid receptors and can reverse and block other opioids' effects. It can quickly restore normal respiration to a person whose breathing has slowed or stopped due to overdosing on heroin or prescription opioid pain medications.
The liquid for injection is commonly used by paramedics, emergency room doctors, and other specially trained first responders. To facilitate ease of use, NARCAN® Nasal Spray is now available, which allows for naloxone to be sprayed into the nose. Depending on the state you live in, friends, family members, and others in the community may give the auto-injector and nasal spray formulation of naloxone to someone who has overdosed. Some states require a physician to prescribe naloxone. In other countries, pharmacies may distribute naloxone in an outpatient setting without bringing a prescription from a physician. Naloxone is an extremely safe medication that only has a noticeable effect on people with opioids in their systems. Naloxone can (but does not always) cause withdrawal symptoms, which may be uncomfortable but are not life-threatening; on the other hand, opioid overdose is extremely life-threatening. Withdrawal symptoms may include headaches, blood pressure changes, rapid heart rate, sweating, nausea, vomiting, and tremors.
This should discuss the cycle of addiction and specific statistics about drug use. It should go to explain different scenarios that can lead to addiction.
Addiction to Percocet can occur easily and rapidly. Addiction is defined as a primary, chronic, and relapsing brain disease characterized by an individual pathologically pursuing reward or relief by substance use and other behaviors. Of the 20.5 million Americans 12 or older with a substance use disorder in 2015, 2 million had a substance use disorder involving prescription pain relievers, and 591,000 had a substance use disorder involving heroin.
As with any addiction, it begins with a problem. The drugs are not the problem initially, but rather a "solution" that the person uses to handle the situation. It could be anything from physical pain to any unwanted feeling, emotion, or life circumstance. Whatever it is, the person somehow discovers that the drug gives them relief or escape from the problem for some time. As they continue to pursue this reward, they begin a downward spiral of physical, mental, and moral deterioration. To protect their addiction, they must lie to anyone who would try to get them to stop, usually the people who care about them the most. All of these issues compound to form a situation where the person can become quite ill. They will incur a host of other problems, including legal, financial, and many more issues.
Soon, the drugs are a problem and the only momentary escape from an unbearable existence. Without improvement, this conundrum will kill the person. It can happen to anyone. Now that we know more about prescription opioids like Percocet, it is less excusable but is still occurring regularly. But in the late 1990s and early 2000s, we didn't know what we do now.
Even worse, opioids like Percocet were promoted as safer alternatives to more addictive opioids. Many people became unwittingly addicted to opioids because of this. Unethical doctors even went as far as to set up fly-by-night clinics and other walk-in facilities where they could quickly see multiple patients for cash-only transactions. Many of these were eventually shut down.
At that time, a person struggling with real pain faced a predicament and didn't even know it. Just seeing a healthcare professional about it put one at risk of being deceived and pushed addictive pills.
Often, these doctors thought they were doing what was best for their patients. Imagine struggling with chronic back pain after a car accident. Suddenly, your life is altered drastically, and you can find no relief. Your job is in jeopardy, and you cannot support your family on disability. Perhaps you are struggling a bit financially, so you cannot afford to go to a specialist or an Emergency Room. You choose a cheap doctor's office around the corner that accepts $40 cash-only payments. In 1999 this was not suspicious. Perhaps you won't get top-notch care, but you don't expect to be lied to.
Having just finished medical school, the doctor has children and a massive debt from her education. She is the sole provider and just took out a loan to open this small clinic after finding it difficult to get a job even after all of her hard work completing her degree. But thankfully, she was approached by representatives from a major pharmaceutical company who have told her all about their new medication, which is much more effective for pain management than morphine and carries far less risk for addiction. These are lies, but the doctor believes the giant, reputable company and their research statistics. The doctor is promised compensation for prescribing this drug, with incentives to write more and more prescriptions. She's finally making money and laying her debt off, and the patients are grateful and thank her.
So when the doctor starts you on Percocet, you both think that this is the answer. The drug works very well, and not only is the pain gone, but you feel great. You can work smoothly, the time flies, and you have an unusually optimistic attitude. You sleep wonderfully for the first time since the accident and feel like your old self again. People even comment that you're looking good and how great it is to see you smile.
Percocet is now a solution to your problems. So when it stops working as well, taking more is the natural progression. Since the doctor continues to write the prescriptions so long as you have the cash, the problem grows out of control rapidly. At first, no one thinks they are doing anything wrong, but it soon becomes apparent that you've become addicted and go through the pills way too fast. But neither of you say anything because the situation is mutually beneficial, at least in its apparency. So, the doctor gives you a higher dosage and more pills, which you do not complain about.
This exact scenario happened to countless people who became addicted to prescription opioids. Subsequent efforts to curb the damage by restricting the drugs only gave rise to a massive heroin problem in the U.S. Everyone was already addicted. And when doctors like the one described above were shut down or arrested, their patients were left with severe addictions and nowhere to go.
How to help a loved one addicted to Percocet
If your loved one is addicted to Percocet, you should not hesitate to intervene. Intervention does not always have to look like it does on television. To intervene simply means to get in-between someone and something else and change the outcome. Usually, this means preventing harm, and in the case of Percocet addiction, the harm is further addiction and death.
Intervening can be as simple as sitting down with the person and confronting them about what you’ve observed. If they’re hiding their addiction from you, this can be tricky. Do not give them the opportunity to lie to you. Tell them what your concern is and let them know that you are not upset and you want to help. It is vital that you do not become angry with them. They have not told you yet because they expect this. Instead, listen and be understanding. They may lie or blame you for everything that’s wrong in their life, but just do not get angry.
If you already know that they are using drugs and they’ve confirmed this, it’s time to get them into treatment. This can be as simple as calling us at the number on this page and finding the best fit for them and getting them started. Or they may not want treatment. In this case, or in the case of the person who is lying and denying drug use but is obviously addicted to drugs, a more advanced form of intervention may be needed.
This type of intervention requires strategizing and more closely resembles what we think of when the term “intervention” is used. In the cases where the person is actively using drugs and is defiant, a professional service may be your best chance of helping them.
Professional interventionists will discuss the situation with you and come up with a game plan. This may involve using tactics that some are uncomfortable with, such as not giving them a place to live or financial help to encourage them to get help. While it may be debatable to make threats or give ultimatums when someone’s life is on the line, a professional interventionist will guide you to doing what will have the best possible outcome for your loved one.
Never just ignore signs of drug use, hoping that they will come to their senses one day. Drugs could affect judgment and dull the senses, so they aren’t going to have improved cognition as their addiction progresses. Act before it is too late.
Percocet addiction is beatable. One of the most effective methods is substance abuse treatment. Treatment for any addiction falls into three categories. Inpatient drug treatment is the most common form in the country and is also the most effective. It is considered the gold standard for rehabilitation because of the many advantages it provides. The person lives at the facility, staying there for the duration of their treatment. This allows them to focus entirely on their recovery and not have outside distractions, stressors, or temptations. They cannot get drugs just because they are craving them. They would be required to discharge from treatment in most cases to relapse. Most inpatient programs are around four weeks long.
Outpatient treatment is the second form. This is where the person lives at home but travels to the facility for treatment sessions. These sessions may be as frequent as daily at first, becoming less frequent as they progress and gain confidence in their recovery. The benefits of this form are that the person can continue to handle obligations that may have prevented them from getting treatment.
Telemedicine is the third and newest form of treatment for substance abuse. It is just now being piloted by many treatment facilities and insurance providers. This change was caused in part by the COVID-19 pandemic and its effects on the treatment industry. There are many different styles of treatment within the formats discussed above. Any substance abuse treatment should provide a chance at recovery from Percocet addiction. Specifically, Medication-Assisted Treatment, or MAT, was developed to treat opioid use disorder. MAT utilizes opioid narcotics to treat opioid addiction, a controversial approach. It originated as a harm-reduction strategy known as "maintenance," where the addict was placed on prescription opioids to prevent the risks associated with illicit drug use. Ideally, this discourages things like needle sharing, theft, and overdose. Due to the opioid epidemic's impact, it has become a primary approach used by many to save lives. As time passes, we'll see the long-term results and effects of MAT. Another form of treatment worth mentioning is holistic rehabilitation. This model generally supports a drug-free approach to treatment and focuses on nutrition and addressing addiction's core issues. While these programs can be more difficult to find in a growing sea of medication-assisted models, they are among the most effective programs and one of the only routes to recovering a completely drug-free life.
The best way to get help is to educate yourself on these forms of treatment and choose one that aligns with your beliefs. It is your journey. Then, speak with someone from the facility for a process known as screening. This will ensure that the program is the right fit for your needs medically and that you will be safe. If it isn't, they will help refer you to somewhere that is.
In 2017, however, there were still almost 58 opioid prescriptions written for every 100 Americans.
- More than 17% of Americans had at least one opioid prescription filled, with an average of 3.4 opioid prescriptions dispensed per patient.
- The average number of days per prescription continues to increase, with 18 days in 2017.
Counties with higher prescribing have been shown to have these characteristics:
- Generally smaller cities or larger towns
- Higher percentage of white residents
- Higher number of dentists and primary care physicians per capita
- More people who are uninsured or unemployed
- More residents who have diabetes, arthritis, or a disability
In 2018, an average of 41 people died each day from overdoses involving prescription opioids, totaling nearly 15,000 deaths.
While prescription opioids were involved in 32% of all opioid overdose deaths in 2018, there was a 13.5% decrease in prescription opioid-involved death rates from 2017 to 2018.
- Rates decreased in males and females, persons aged 15–64 years, non-Hispanic whites, Hispanics, non-Hispanic American Indian/Alaska Natives, and across all urbanization levels.
- Rates remained stable in the Northeast and decreased in the Midwest, South, and the West.
- Seventeen states experienced declines in prescription opioid-involved death rates, with no states experiencing significant increases.
After a steady increase in the overall national opioid prescribing rate starting in 2006, the total number of prescriptions dispensed peaked in 2012 at more than 255 million and a prescribing rate of 81.3 prescriptions per 100 persons.
The overall national opioid prescribing rate declined from 2012 to 2018, and in 2018, the prescribing rate had fallen to the lowest in the 13 years for which we have data at 51.4 prescriptions per 100 persons (total of more than 168 million total opioid prescriptions). However, in 2018, prescribing rates continue to remain very high in certain areas across the country.
- In 11% of U.S. counties, enough opioid prescriptions were dispensed for every person to have one.
- While the overall opioid prescribing rate in 2018 was 51.4 prescriptions per 100 people, some counties had rates that were six times higher than that.
More than 750,000 people have died since 1999 from a drug overdose. Two out of three drug overdose deaths in 2018 involved an opioid. Overdose deaths involving opioids, including prescription opioids, heroin, and synthetic opioids (like fentanyl), have increased almost six times since 1999. Overdoses involving opioids killed nearly 47,000 people in 2018, and 32% of those deaths involved prescription opioids.
Common Terminology Surrounding Percocet
|Opioid tolerance||occurs when a person using opioids begins to experience a reduced response to medication, requiring more opioids to experience the same effect.|
|Opioid dependence||occurs when the body adjusts its normal functioning around regular opioid use. Unpleasant physical symptoms occur when medication is stopped.|
|Opioid addiction (Opioid use disorder (OUD))||occurs when attempts to cut down or control use are unsuccessful or when use results in social problems and a failure to fulfill obligations at work, school, and home. Opioid addiction often comes after the person has developed opioid tolerance and dependence, making it physically challenging to stop opioid use and increase withdrawal risk|
|Overdose||Injury to the body (poisoning) that happens when a drug is taken in excessive amounts. An overdose can be fatal or nonfatal.|
|Opiates||refer to natural opioids such as heroin, morphine, and codeine.|
|Opioids||refer to all-natural, semisynthetic, and synthetic chemicals that interact with opioid receptors on nerve cells in the body and brain and reduce the intensity of pain signals and feelings of pain. This class of drugs includes illegal drug heroin, synthetic opioids such as fentanyl, and pain medications legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and many others.|
|Narcotic drugs||Originally referred to as any substance that dulled the senses and relieved pain. Opioid is now the preferred term to avoid confusion.|
|Fentanyl||Pharmaceutical fentanyl is a synthetic opioid, approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine. However, illegally made fentanyl is sold through illicit drug markets for its heroin-like effect. It is often mixed with heroin or other drugs, such as cocaine, or pressed into counterfeit prescription pills.|
|Heroin||An illegal, highly addictive opioid drug processed from morphine and extracted from certain poppy plants.|
|Illicit drugs||The nonmedical use of a variety of drugs that are prohibited by law. These drugs can include amphetamine-type stimulants, marijuana/cannabis, cocaine, heroin, other opioids, and synthetic drugs, such as illicitly manufactured fentanyl (IMF) and ecstasy (MDMA).|