Percocet is the brand name for a drug that combines oxycodone and acetaminophen. This same combination but in different strengths can also be found in the brand name drugs, Roxicet, Tylox and Endocet, but Percocet is by far the most popular prescription painkiller.

Unfortunately, it’s pretty easily prescribed: get a tooth pulled at the dentist or a couple stitches at the doctor’s office and head home with a bottle of Percocet (or at least a script for one). Take them for too long and you end up with something much worse than that: a physical dependence upon Percocet, otherwise known as Percocet addiction.

Now, the acetaminophen in Percocet is relatively innocuous. Though you can overdose on the drug and it can kill you, my understanding is that it would take a couple of weeks and it’s a long, slow, painful death. The oxycodone in Percocet, on the other hand, can end your life with a single overdose depending upon your tolerance. It also impairs your ability to think clearly, to make good decisions and your hand-eye coordination. Driving is extremely dangerous under the influence.

So what’s it like to go through a Percocet withdrawal? Not fun. Just like all opiate painkillers, your body comes to depend upon a certain amount of the drug in your system at all times. When you stop taking it without warning, your body kind of goes into shock, which translates into withdrawal symptoms that are nothing nice. It’s like the flu with fever, sweating and chills, runny nose and eyes, anxiety, nausea, stomach cramps, diarrhea…. I could go on and on. In short, it’s not fun. But there are ways to get off the Percocet without experiencing the withdrawal symptoms that go along with a cold turkey Percocet detox.

Taking advantage of buprenorphine in the form of Suboxone and Subutex is one way to bypass the most fierce symptoms and, in some cases, avoid them altogether. Depending upon what dose you are at and how long you have been maintaining your Percocet addiction, your Suboxone detox will be shorter or longer. With a treatment plan, you can be off it and complete drug-free in as few as six weeks. Check it out!

There seems to be a little confusion about the difference between the two “nal-xone” drugs, naltrexone and naloxone. Two very different drugs, the similar names are confusing but what makes it worse is the fact that both are related to the treatment of drug and alcohol abuse. Hopefully this will clear up the misconceptions.

Naltrexone

Naltrexone, like naloxone, is an antagonist that binds to opioid receptors and blocks the effects of opiates. However, naltrexone is used primarily in the treatment of alcohol addiction in an effort to reduce the craving to drink. Its generic name is naltrexone hydrochloride, but it’s sold under the brand names Revia and Depade. An extended release formula is also sold as Vivitrol.

After detox off of opiates or alcohol, naltrexone may be prescribed to help people stay off the sauce—in any form. It effectively blocks any opiates from binding to your opiate receptors so if you do try to get loaded while you’re taking it, it won’t work. You won’t get high at all. But for some reason, it’s rarely prescribed to people who suffer solely from opiate dependence but rather to those who need help fighting the urge to drink. With studies to back it up, it works well to prevent relapse and decrease the severity of relapse when it does occur. For those who need help with opiate addiction, a better medication is Suboxone, which combines buprenorphine and naloxone.

Naloxone

Sold under the brand name Narcan, naloxone is injected into a muscle when overdose on an opioid-based drug occurs. Whether you overdose on a prescription painkiller like Fentanyl, Vicodin, Dilaudid, Darvon or Darvocet, Norco or OxyContin or you overdose on a street drug like heroin or morphine, naloxone stops the overdose dead in its tracks (no pun intended).  It works by heading straight to the opiate receptors and knocking off any opiates that are there, which stops the respiratory depression they cause and the subsequent overdose. It doesn’t work for benzodiazepines like Valium, Xanax, Valium, or Klonopin, nor does it work for stimulants like methamphetamine and cocaine.

Naloxone stays active in the system, blocking opiates from binding to your opiate receptors for 30 minutes to 90 minutes. When it wears off, the opiates that caused the overdose are still in your system and their effects will kick in again and, possibly, slam you right back into an overdose. This brief reprieve, however, can be what you need to keep you from dying before you get emergency medical help.

A few things you should know:

- Naloxone won’t let you give a clean drug test.
- Naloxone is effective in fighting an overdose even if you hit a vein.
- Naloxone is ONLY meant to be delivered with a needle in the event that someone is dying.

Suboxone

If you are addicted to opiates and taking Suboxone to detox off of your drug of choice, then you are taking naloxone. Suboxone is a combination of buprenorphine and naloxone, and it comes in a pill that you take by dissolving it beneath your tongue. The naloxone remains dormant unless you should try to abuse the Suboxone by dissolving it in water and inject it. If you do this, the naloxone will kick in and prevent you from experiencing any of the relief that the buprenorphine provides for those trying to avoid withdrawal symptoms.

So hopefully that clears that up! Any questions?

Now, I really mean it this time: this is the last I’m going to say about overdoses for awhile. I thought I’d pretty much gotten it out of my system with the urban myths about overdoses and the tips on how to avoid an overdose and how to know one when you see it. But yesterday, someone I know quite well overdosed unintentionally. They have had a lifetime methadone maintenance slot for years now, and if ever there was a success story to support methadone maintenance, he was it: after a lifetime of being a street junkie addicted to heroin and doing crimes to pay for his habit, he’s managed to hold onto the same job (even move up in the company), married a great gal and had a baby with her. Then yesterday, he had a migraine, happened to run into an associate from the old days who offered him a pill to wipe out the headache. He went home, had a couple of beers and woke up this morning in the hospital having suffered an overdose.

It’s that quick, and it’s that unexpected. Don’t think that because you have two, three, 10 or 20 years invested in a methadone maintenance program that you are immune to overdose. Sometimes all it takes is a one too many alcoholic drinks or one pill that unexpectedly mixes with your daily methadone dose to create an overdose situation. Maybe he hadn’t eaten very much that day or maybe he’d just come up or down a few milligrams on his methadone dose through the clinic. Maybe neither. Your body’s chemistry changes as you grow older and if you don’t get to the doctor for your regular checkups, you may not know when you’re developing a chronic issue that will affect how your body processes your methadone dose.

If your methadone dose is 30 milligrams or lower, you can switch to a Suboxone detox. Avoid the daily trip to the clinic, the liver damage associated with long-term methadone use and the possibility of overdose as you work your way toward a drug-free life. In the meantime, be aware of your body and if you are suddenly overwhelmingly tired, having difficulty breathing, have cold and clammy skin or muscle spasms. Any of these or a combination can indicate an overdose and it’s imperative that you get medical assistance while you still can or make sure that there is someone in the house with you who can watch over you and make sure that you’re okay.