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Percocet is the most famous and popular brand name for a prescription pain medicine that combines oxycodone and acetaminophen. This combination of painkillers relieves more symptoms for longer in people who have moderate to severe struggles with pain after surgery or an injury. The opioid in Percocet binds to the opioid receptors in the central nervous system (CNS) to relieve the most severe pain while the nonsteroidal anti-inflammatory drug (NSAID) acetaminophen manages other pain relief. When monitored by a prescribing physician and taken as directed, Percocet is a very effective painkiller that can gradually be tapered off when it is no longer needed.
Percocet is not intended as long-term pain relief, although some people who have chronic pain conditions receive “as-needed” prescriptions to manage pain not controlled by longer-lasting medication. The drug was approved by the Food and Drug Administration (FDA) for prescription use in 1976 but did not become popular until the late 1990s when prescribing rules around treating pain changed. After that, Percocet became one of the most widely abused narcotic prescriptions in the United States, to the point that in 2009, a government advisory panel recommended that the FDA pull the drug from the market. Like other narcotic painkillers, including morphine and heroin, Percocet acts on the brain’s reward center, so some people may rapidly develop an addiction to this substance.
One of the major risks of abusing a potent drug like Percocet is overdose and death. In the case of this medication combination specifically, overdose and organ failure can be caused by either the opioid or acetaminophen. It is important to know the signs of a potential overdose on either drug, so the person can get emergency medical attention as soon as possible. Call 911 immediately if someone displays these symptoms.
After numerous acetaminophen overdoses, doctors have found that the body experiences toxicity after consuming 4,000 mg (or 4 grams) of acetaminophen in one day.
Physicians calculate appropriate doses of narcotic painkillers like the oxycodone found in Percocet by measuring morphine milligram equivalents (MME). There is a standard safe dose of MME per day, although this can be adjusted depending on body weight, age, other medications being taken, and tolerance developed to other opioid prescriptions in the past. Doses of 50 MME per day have been found to double the risk of overdose without providing significant pain relief. The Centers for Disease Control and Prevention (CDC) found that 33 mg of oxycodone per day is the equivalent of 50 MME, so it is roughly 1.5 times the equivalent potency of morphine.
While few people take NSAIDs every day for pain, people who take Percocet and related medications will. This means that taking an over-the-counter medication, like a cold or flu drug or even just a mild medication to relieve a headache, can be dangerous. After numerous acetaminophen overdoses, doctors have found that the body experiences toxicity after consuming 4,000 mg (or 4 grams) of acetaminophen in one day. Taking less than that is extremely important, but that means monitoring how much acetaminophen is in a daily dose of Percocet and limiting over-the-counter drugs, which often contain that NSAID to manage pain relief. To reduce the risk of an acetaminophen overdose, the manufacturers of Percocet have now limited the amount of the NSAID per dose to 325 mg.
Signs of an overdose on oxycodone, which is found in Percocet, include:
The amount of oxycodone consumed increases the risk of an overdose, especially among people who abuse Percocet, as they may take more than the prescribed dose. Oxycodone stays in the body for 4-6 hours, and the half-life is between 1.25 and 3 hours. Taking another dose before the first dose has completely metabolized out of the body will increase the risk of death.
Opioid overdoses can be temporarily reversed with naloxone, a medication that kicks opioids off the opioid receptors. However, this drug does not work for other drugs, like acetaminophen.
Tylenol is the most famous brand name of acetaminophen, although generic versions of this NSAID can be found in many other medications. This increases the risk of an accidental overdose on the substance. The main harm caused by an acetaminophen overdose is liver failure, which can lead to chronic health problems if the person survives the damage to this organ.
Signs of an acetaminophen overdose include:
There are no medications that reverse an acetaminophen overdose. If this drug is combined with an opioid painkiller, overdose symptoms may be complex. The risk of death increases substantially when drugs are combined.
There are several risks, both short-term and long-term, to abusing Percocet.
Signs that Percocet abuse may be a problem include:
Short-term side effects caused by Percocet may include:
If someone abuses Percocet for a long time, they may develop chronic problems, including:
Percocet abuse can cause serious harm on a long-term basis, and it increases the risk of overdose and death. In addition, ongoing, untreated Percocet abuse increases the risk of other drug-seeking behavior, including buying drugs illicitly. Purchasing drugs online or through other illicit means puts the person at risk of consuming something that is not what they expect. Thousands of people in the US have overdosed and died because fentanyl, carfentanil, heroin, and other potent opioids were sold to them instead of the drug they expected. In 2017, a rash of overdoses involving fake oxycodone led the numerous deaths, as people sought opioids after they could no longer get a prescription through their doctor.
Even people who take opioids as prescribed may need help tapering off this medication safely. People who struggle for a long time with addiction to narcotics need medical supervision and may need prescription help from a drug like buprenorphine to safely manage the detox process. Trying to quit “cold turkey” does not work with opioid addiction; in fact, it increases the risk of intense cravings, relapse, and overdose on drugs like Percocet. Medical detox coupled with comprehensive evidence-based rehabilitation treatment forms the foundation of successful addiction recovery.
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