How to Wean off Oxycontin
From a treatment standpoint, individuals who are in recovery from OxyContin or other opioid abuse are uniquely situated. Whereas undergoing a full detox is typically the starting point of treatment option for those who abuse drugs, such as marijuana, cocaine, methamphetamine, and a myriad of other drugs, there are targeted medications that can help either to wean people off OxyContin over time or be used in the long-term as a form of substitution therapy program. In other words, immediate detox may not be the goal with opiates like OxyContin.
The prescription medications that are approved by the U.S Food and Drug Administration (FDA) for OxyContin abuse recovery are methadone, buprenorphine (Suboxone or Subutex), and naltrexone. These medications are different from palliative medications that may be used, as medically necessarily, to address certain withdrawal symptoms.
OxyContin and Weaning
When recovering persons and their treatment teams decide to follow a tapering approach, it is important to keep in mind that there is not a one-size-fits-all method available. According to governmental authority, a main goal of the tapering approach is to minimize the recovering person’s withdrawal symptoms and maintain safe conditions. Typically, withdrawal symptoms will emerge 30-72 hours after the last dose of OxyContin. The withdrawal process, and its attendant side effects, can last at least a couple of weeks.
Tapering occurs in successive stages that involve ongoing clinical evaluation of the efficacy of the treatment and relevant dosing levels. It is most advisable for those who have formed a physical dependence on or addiction to OxyContin to undergo tapering within the context of a structured rehab program equipped to render this medical service. It is also important to note that relying on online literature alone is not recommendable. Some of the literature is geared towards tapering procedures for those who were on OxyContin as part of a pain management plan and who have no history of abuse. For any number of reasons, prescribed users and their doctors may decide to wean off OxyContin, but their process may be different from that of a person with a history of abuse of this opioid.
For example, within the Veteran Affairs medical treatment community, there is a medical advisement that individuals who have regularly been taking a stable level of oxycodone CR as part of a pain management program can be weaned from this drug as follows: decrease the familiar dose 20-50 percent each day until the client is stabilized on 30 mg a day and then decrease the dose by 10 mg every 2-5 days. Treatment of Individuals who have a history of OxyContin abuse involves many different variables, such as volume and length of OxyContin abuse, which can present different challenges in the weaning-off phase. For this reason, a team of treatment professionals will need to work together to determine the right way to induct the recovering person into the tapering process and then progressively and safely decrease the dosage of the maintenance medication.
Some individuals face a more severe withdrawal process called protracted withdrawal syndrome (PAWS). The more common withdrawal symptoms associated with opioid withdrawal include but are not limited to:
- Abdominal cramping
- Muscle spasms and other musculoskeletal symptoms
- Raising heart
- Loss of appetite
- Drug cravings
As the National Institute on Drug Abuse discusses, at present, the use of targeted medications is considered the most effective treatment option for those with a history of opioid abuse. It can help to understand how these medications work. Each FDA approved treatment medication falls into one of three main categories: (1) agonists, (2) partial-agonists, and (3) antagonists. Agonists occupy the same receptors in the brain that an opioid, such as OxyContin, would occupy if present in the person’s body. An agonist medication activates the receptor site but with effects that are safer than the drug of abuse; this explanation makes apparent why the term substitution therapy is used to describe the use of targeted medications. A partial-agonist medication also occupies the brain receptor site but with less intense effects compared to the drug of abuse. An antagonist drug occupies the receptor site and blocks the ability of the drug of abuse to dock there. In this way, an antagonist defends the receptor site and brain from the drug of abuse.
A review of different literature on the topic of OxyContin withdrawal will reveal the general advisement that there is no set weaning-off plan. While this is true, according to research published in the Journal of Addiction Medicine, a taper that lasts one week to one month can be suitable to many recovering persons. However, each tapering process is different, and it can change over time depending on the recovering person’s responses during different stages.
It bears mention that there is some advisement online that those with a history of OxyContin abuse can readily wean themselves off this drug by decreasing dosages slowly over time. However, this approach is not advisable, nor does it appear prudent to rely on a drug of abuse to end one’s abuse. Some sites state that opioids must be reduced by 10 percent each week and then 20 percent every 3-5 days. This information is useful only to express a strong caution that there should never be a sharp decrease in the amount of OxyContin in a short timespan, as this approach can trigger negative health responses.
These at-home detox advisements do not take into account important elements of the tapering-off process that they promote.
For instance, it would be very difficult for a nonprofessional to accurately measure the necessary percentage decreases in OxyContin. The strongest caution that can be made is simply not to approach tapering without the assistance of a medical professional. A treatment program will not use OxyContin to wean a person off OxyContin. When tapering is part of the course of treatment in a medically supervised environment, as stated, targeted FDA-approved medications are used.
It is established in the drug treatment community that tapering off is not enough, even when full detox is achieved. A program with a full continuum of services will provide a host of supportive treatments. Treatment in a structured rehab program provides at least a twofold benefit. First, professional staff can help those with a substance abuse history to establish abstinence (through detox, short-term tapering to detox, or long-term substitution therapy). Second, rehab treatment can help recovering individuals to learn relapse prevention strategies as well as to develop skills to build a new drug-free lifestyle.
The desired outcome of recovery is that it be lasting. Entering a comprehensive rehab program is currently considered to be the most advisable approach to achieve this goal.