Oxycodone (OxyContin, Percocet) tolerance is a gradual process that may start with legitimate use of the prescription drug for severe or chronic pain.
This opioid is in the same pharmacological family as fentanyl, codeine, hydromorphone, and hydrocodone, known as opioid analgesics.
All of these drugs have antinociceptive effects, meaning they block the transmission of pain signals to your brain.
Unfortunately, your brain’s natural ability to adapt means that opioid analgesics will gradually lose their efficacy, requiring a higher dose for the same effect.
How Oxycodone Tolerance Develops
Oxycodone tolerance develops as a result of your brain’s natural ability to adapt. When you use oxycodone, the drug binds to opioid receptors, causing two major changes.
First, it blocks pain signals from reaching your brain. This process is known as analgesia. Second, it causes the release of dopamine from your brain’s reward center.
In a healthy brain unaffected by opioid use, these processes would be governed by the endogenous opioid system.
Your brain would try to manage the pain, and it would release small to moderate amounts of dopamine to cause feelings of pleasure in response to stimuli.
Opiates like oxycodone push these responses into overdrive, fundamentally changing what your brain perceives as normal.
Your endogenous opioid system regulates behavior related to pain, reward, and addiction.
When you use a prescription opioid like oxycodone, the chemicals in the drug bind with these receptors.
The primary purpose of this interaction is to block pain that is unmanageable through other means, but it also affects other parts of the brain.
Together, these effects of opioids increase the risk of physical dependence and eventual addiction.
Opioid Use For Pain Management
Since the Federal Drug Administration’s discovery of the opioid crisis and the role of oxycodone, the drug has been almost exclusively reserved for severe, chronic pain. Cancer pain is one of the most common applications.
However, there are other opioids with a somewhat lower risk of drug abuse. These options are generally used in other applications that do not respond to other kinds of painkillers.
All opioid analgesics work by binding with opioid receptors, causing a series of chemical changes. The degree of changes will depend on the specific drug.
Opioid drugs calm the activity of neurons in parts of the brain governing pain.
They also cause a mild to extreme release of dopamine, which causes the euphoric side effect often responsible for opioid abuse.
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Factors That Influence Opioid Tolerance
There are a number of factors that could influence your opioid tolerance. They may be limited to your individual situation or related to opioid abuse.
Chronic Or Severe Pain
Having chronic or severe pain are major factors in opioid tolerance. Both may cause you to take high doses of oxycodone, which will increase your general risk.
Analgesic tolerance is a reduction in the effects of oxycodone. This tolerance is usually caused by long-term use, but the definition of long term depends on the specific painkiller.
If you develop analgesic tolerance, you will generally move from a low dose to a higher dose to get the same pain relief.
This condition should be a signal for a healthcare intervention to prevent the continued development of tolerance.
Chronic Opioid Use
Chronic opioid use may continue past legitimate use. You will almost certainly develop analgesic tolerance, requiring more and more oxycodone to get the same effect.
Over time, chronic opioid abuse will dramatically increase your risk of opioid overdose.
How Long Does It Take For Oxycodone Tolerance To Form?
Oxycodone tolerance can form in as little as a few days.
The length of time depends on your individual case and dosage. However, it is clear that oxycodone tolerance occurs uncommonly fast.
Noticing an initial tolerance should not be a signal to panic. Tolerance can be reversed, but it is something you will want to discuss with your doctor.
Together, you can find a non-opioid pain management program that will help prevent dependence.
How OxyContin Tolerance Leads To Addiction
OxyContin is the brand name of oxycodone. Oxycodone tolerance may contribute to addiction by causing a person to increase use of the drug. Tolerance also normalizes changes in your brain chemistry.
According to neuroscience, and the pharmacokinetics of opioids, continued use of oxycodone will cause your brain to gradually adapt to the changes triggered by the drug.
Part of this adaptation includes the reduction in the release of neurotransmitters like dopamine.
As your tolerance builds and addiction sets in, your brain will essentially only function in a semi-normal capacity when you’re using oxycodone.
You will start engaging in addictive behaviors just to avoid intense physical and psychiatric opioid withdrawal symptoms.
Are There Risks With Oxycodone Tolerance?
Oxycodone tolerance is dangerous because it pushes you to take a higher opioid dose to get the same effect.
In higher doses there is a risk of:
- respiratory depression
- morphine tolerance
- psychiatric distress
- opioid overdose
Treatment Options For Opioid Addiction
The sheer number of overdose deaths related to opioid addiction are reason enough to seek professional help.
Medical detox, including the use of buprenorphine, methadone, or naloxone, will provide safety during withdrawal.
From there, you will still likely need the help of professional psychiatry through a long-term program in an inpatient or outpatient capacity.
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Published on July 6, 2022
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- Frontiers in Pharmacology — Opioid Center Desensitization
- National Library of Medicine — Medication-Assisted Treatment for Opioid Addiction
- National Library of Medicine — The Neurobiology of Opioid Dependence