Do I need a prescription for oxycodone?

Oxycodone, sold under the brand name Roxicodone and OxyContin

Oxycodone

Oxycodone, sold under the brand name Roxicodone and OxyContin (which is the extended-release form) among others, is a semi-synthetic opioid used medically for the treatment of moderate to severe pain. It is highly addictive and is a commonly abused drug. It is usually taken by mouth, and is available in immediate-release and controlled-release formulations. Onset of pain relief typically begins within fifteen minutes and lasts for up to six hours with the immediate-release formulation. In the United Kingdom, it is available by injection. Combination products are also available with paracetamol (acetaminophen), ibuprofen, naloxone, naltrexone, and aspirin.

Common side effects include euphoria, constipation, nausea, vomiting, loss of appetite, drowsiness, dizziness, itching, dry mouth, and sweating. Side effects may also include addiction and dependence, substance abuse, irritability, depression or mania, delirium, hallucinations, hypoventilation, gastroparesis, bradycardia, and hypotension. Those allergic to codeine may also be allergic to oxycodone. Use of oxycodone in early pregnancy appears relatively safe. Opioid withdrawal may occur if rapidly stopped. Oxycodone acts by activating the μ-opioid receptor. When taken by mouth, it has roughly 1.5 times the effect of the equivalent amount of morphine.

Oxycodone was originally produced from the opium poppy opiate alkaloid thebaine in 1916 in Germany. One year later, it was used medically for the first time in Germany in 1917. It is on the World Health Organization’s List of Essential Medicines. It is available as a generic medication. In 2023, it was the 49th most commonly prescribed medication in the United States, with more than 13 million prescriptions. A number of abuse-deterrent formulations are available, such as in combination with naloxone or naltrexone

Medical uses

Oxycodone is used for managing moderate to severe acute or chronic pain when other treatments are not sufficient. It may improve quality of life in certain types of pain. Numerous studies have been completed, and the appropriate use of this compound does improve the quality of life of patients with long term chronic pain syndromes.

Oxycodone is available as a controlled-release tablet. A 2006 review found that controlled-release oxycodone is comparable to immediate-release oxycodone, morphine, and hydromorphone in management of moderate to severe cancer pain, with fewer side effects than morphine. The author concluded that the controlled-release form is a valid alternative to morphine and a first-line treatment for cancer pain. In 2014, the European Association for Palliative Care recommended oxycodone by mouth as a second-line alternative to morphine by mouth for cancer pain.

In children between 11 and 16, the extended-release formulation is FDA-approved for the relief of cancer pain, trauma pain, or pain due to major surgery (for those already treated with opioids, who can tolerate at least 20 mg per day of oxycodone) – this provides an alternative to Duragesic (fentanyl), the only other extended-release opioid analgesic approved for children.

Oxycodone, in its extended-release form or in combination with naloxone, is sometimes used off-label in the treatment of severe and refractory restless legs syndrome.

Available forms

See also: Oxycodone/paracetamol, Oxycodone/aspirin, Oxycodone/ibuprofen, and Oxycodone/naloxone

Both sides of a single 10mg OxyContin pill.
Oxycodone is available in a variety of formulations for by mouth or under the tongue

Immediate-release oxycodone (OxyFast, OxyIR, OxyNorm, Roxicodone)
Controlled-release oxycodone (OxyContin, Xtampza ER) – 10–12 hour duration
Oxycodone tamper-resistant (OxyContin OTR)
Immediate-release oxycodone with paracetamol (acetaminophen) (Percocet, Endocet, Roxicet, Tylox)
Immediate-release oxycodone with aspirin (Endodan, Oxycodan, Percodan, Roxiprin)
Immediate-release oxycodone with ibuprofen (Combunox)
Controlled-release oxycodone with naloxone (Targin, Targiniq, Targinact) – 10–12 hour duration
Controlled-release oxycodone with naltrexone (Troxyca) – 10–12 hour duration

A liquid solution containing 10mg of oxycodone per 1ml
In the US, oxycodone is only approved for use by mouth, available as tablets and oral solutions. Parenteral formulations of oxycodone (brand name OxyNorm) are also available in other parts of the world, however, and are widely used in the European Union. Spain, the Netherlands and the United Kingdom, oxycodone is approved for intravenous (IV) and intramuscular (IM) use. When first introduced in Germany during World War I, both IV and IM administrations of oxycodone were commonly used for postoperative pain management of Central Powers soldiers.

Why Does Oxycodone Lead to Addiction?

Oxycodone is a narcotic analgesic (painkiller) used to treat severe pain that is classified as a Schedule II controlled substance by the U.S. Food and Drug Administration.

Opioids like oxycodone are highly addictive. Oxycodone has brand names such as OxyContin, Oxypro, Longtec, Reltebon, and Zomestine. Slang terms are also used such as oxy and hillbilly heroin.

Addiction is a higher risk with opioids in comparison to other substances because of the way they work. Oxycodone helps block pain signals from your central nervous system and brain by binding to opioid receptors in the brain.

Opioids mimic endorphins – natural chemicals in your body that produce pleasurable sensations. This can make the feeling of taking oxycodone very pleasurable, which people become addicted to and may start to rely on to feel “normal.”

While oxycodone addiction is a high risk for anyone using the drug, some people can become addicted faster if they have risk factors for opioid use disorders. We’ll cover more about addiction risk factors later on.

Oxycodone Abuse vs. Oxycodone Addiction

It’s important to understand the difference between oxycodone abuse and oxycodone addiction. Oxycodone is a prescribed drug, so it’s possible to use the medication without abusing it.

Oxycodone abuse refers to any misuse of the drug. This can include taking higher doses than prescribed, taking it more frequently than prescribed, or taking it without a prescription. While opioid abuse is different than addiction, it often leads to addiction.

Oxycodone addiction occurs when someone begins to rely on oxycodone to function. People begin to feel incapable of getting through the day without taking oxycodone.

Some people may abuse oxycodone on occasion or use it recreationally, but this can get out of hand quickly due to increased drug tolerance, and oxycodone dependence (“addiction”) can eventually occur. Recreational use can quickly develop into compulsory drug seeking, which can involve doing anything, even engaging in risky, out-of-character behavior to obtain more oxycodone.