Pain and Pleasure: Oxycodone, a Tale of Two Addictions

Article Provided By: Marianne Messina – Editor/Writer for American Addiction Centers.

Somewhere in the background of American life, millions of people are living with chronic pain. 32 million, in fact, report pain that has been with them for more than a year, according to a WebMD report on pain management [1].  Add to that the 50 million or so people recovering from surgeries with acute recuperative pain, and you have a glimpse of how many people come into legitimate contact with the pain medication cycle [2].

Whether treating extreme post-operative pain or chronic pain, the commonly prescribed medication is Oxycodone. In the ideal surgical scenario, surgery patient recovers, pain goes away, and Oxycodone prescription ends before any damage is done. But in less than ideal scenarios, people are left with any number of unpredicted circumstances leading to long-term need for pain medication. And then there’s treatment for chronic conditions like fibromyalgia and rheumatoid arthritis. Many suffering from this type of chronic pain come to see Oxycodone as a blessing.

However, it’s important to remember that like heroin, codeine, and morphine, Oxycodone is an opiate. It has great addictive power rooted in the chemistry of our brains, where these opioids bond with opiate receptors.

People who are taking Oxycodone for pain are usually well aware of its addictive qualities; especially as they watch their tolerances increase. Longtime users dread the day the drug will have no effect; in fact, they may be far more afraid of their growing tolerance for the drug than of addiction itself. Even for people in pain, while much of the substance is busy blocking pain signals, it can also bring the user seductive feelings of well-being. This is how the quest for relief from chronic pain can end up in addiction.

And then, like all addictive substances, Oxycodone is subject to abuse. In the case of these “recreational” users, who are not in pain, the entire dose goes to creating the euphoric effect, increasing the potential for and pace of addiction developing.

As this type of drug abuse has increased, so has the death rate associated with prescription drugs. In addition to side effects such as constipation and dry-mouth, Oxycodone has the added effect of slowing breathing, occasionally to the point of not breathing at all. When taken with alcohol, the risk of a fatal mistake increases exponentially.

Treatment for Oxycodone addiction is very much like treatment for addiction to heroin, morphine, and other opioids. Most successfully, it begins with medical detox, where medical professionals oversee the uncomfortable, several-day process of cleaning the drug out of the system. Medical detox from opiates often involves prescriptions for other substances like Suboxone that fill the opioid receptors in the brain without providing euphoric effects, thus minimizing the more horrific withdrawal symptoms. The goal of this treatment is to deliver the individuals safely to rehab, where they can focus on building their recovery. Detox alone is probably not enough to break an Oxycodone addiction. In fact, the longer these individuals stay in rehab the better their chances of long-term recovery. American Addiction Centers recommends a 90-day in-patient stay. Citing research that connects long-lasting sobriety to longer stays in treatment, the company is unique in offering a treatment guaranty to anyone who has gone through a 90-day rehab in any of its centers. The AAC website explains this 90-day treatment recommendation as follows [3]:

  • Allows for the identification and treatment of co-occurring disorders.
  • Lets new habits take root, increasing the probability of lifelong sobriety.
  • Better chance at employment post-treatment.

Less than a year before his fatal overdose, the well-known actor Phillip Seymour Hoffman had been in rehab. He also left treatment after only 10 days, giving himself barely enough time to detoxify.  Far-flung stashes of heroin and cocaine found by investigators at the time of his death, with multiple drugs in his system, suggest that his “recovery” had been very short-lived.

Equally as sad is the fact that for those facing unremitting chronic pain, our health system offers few alternatives to long-term Oxycodone dependence and the ever-increasing likelihood of addiction. Approaches tailored to very specific situations, such as the hormone nasal spray calcitonin – which works well for back pains due to falls in elderly women – are innovative, but less common in practice.  Research to apply opioid enhancement therapies at the site of the pain (2012) are promising, but as a practical solution it is undeveloped [4].

Acupuncture, among the “alternative medicines” has shown some success in recent studies, especially in cases where there is an emotional component to chronic pain. Though recent studies have shown that acupuncture does have an impact, results are often considered “modest” and more robust successes are highly unpredictable [5].

A different approach to pain comes from the health and wellness field. Physiatrist Julie K. Silver, M.D., says that pain can be minimized by bolstering the body’s numerous natural healing processes [6]. Silver claims that the best way to help ourselves to a quick recovery, minimizing pain, is to eat healing-supportive foods, make a commitment to a full night’s sleep, and find ways to become active.

In addition to the physiatrist approach, holistic practitioners will suggest awareness exercises (meditation) and energetic practices (tai chi, chi gong). Many of these approaches require a daily practice and show effects slowly. It is hard to persist in these against severe pain when relief seems so far away.

While alternative approaches and physiatrists can fall short of the immediate relief of a powerful drug like Oxycodone – which can make even the most severe pain suddenly “bearable” – Silver offers many stories of recoveries that surpassed medical predictions. These are not to be discounted. Work in the field of food-sleep-movement or lifestyle approaches suggests that these approaches can not only shorten the time on pain meds, reducing the risk of addiction, but they may be able to better position the individual for an ideal recovery, a recovery both shorter and closer to their life before illness or surgery.


[1]:  “Chronic Pain and Depression: Managing Pain When You’re Depressed”.

[2]: Centers for Disease Control and Prevention.  “Inpatient Surgery”.

[3]: American Addiction Centers, “Evidenced-based Curriculum”,

[4]: Science Daily.  “Promising new approach in therapy of pain.”

[5]: Time, “Acupuncture May Offer Real Relief for Chronic Pain.”

[6]: Silver, Julie K.  “Super Healing”.  AARP, the Magazine.  November & December 2008.