Percocet is a prescription medication combining the opioid oxycodone and the medicine cabinet staple acetaminophen in a single pill. While it’s frequently prescribed, often after surgeries and accidents, Percocet can be dangerous and misuse of it can funnel patients into opioid addiction.
- Percocet is a prescription-only drug used to treat moderate to severe pain, usually for a short period of time.
- As with other opioids, abuse of Percocet—using it for pleasant feelings and not pain relief or taking it in ways not prescribed—can lead to addiction, medically known as opioid use disorder (OUD).
- The American Medical Association (AMA) estimates that 3% to 19% of people who take prescription pain medications like Percocet develop an addiction to them.
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What is Percocet?
Percocet is the brand name of a prescription drug that combines immediate-release oxycodone and acetaminophen in fixed doses in a single pill.[1]
Oxycodone is an opioid analgesic (painkiller) around 1.5 to 2 times as strong as morphine.[2]
Opioids are synthetic or semi-synthetic substances that act on opioid receptors in the nervous system and relieve pain by blocking the transmission of pain messages from the body through the spinal cord to the brain.[3] They’re related to opiates such as morphine, codeine, and heroin, which are directly derived from the poppy plant.[4] Oxycodone, for example, is manufactured by modifying thebaine, an alkaloid found in opium.[5]
Acetaminophen, also called paracetamol, is a non-opioid over-the-counter medication that treats mild to moderate pain and reduces fever. You may know it under the brand name Tylenol.[6] Acetaminophen can increase the effectiveness of oxycodone and provide better pain relief.
In 2020, Percocet was the 69th most prescribed drug in the US, with 10 million prescribes issued to 2.7 million patients.[7]
Percocet uses
Percocet is a prescription-only drug used to treat moderate to severe pain, usually for a short period of time.
This includes:
- post-surgery pain
- pain after an injury or accident
- cancer pain
- end-of-life pain
Occasionally it may be used for long-term pain when other analgesics aren’t sufficient.
Percocet is prescribed to treat severe pain that cannot be managed by alternative medications. It is available as a tablet containing varying strengths of oxycodone and acetaminophen, including 2.5mg/325mg, 7.5mg/500mg, and 10mg/650mg. [1]
A typical daily dose of Percocet includes 10-60mg of oxycodone and no more than 4g of acetaminophen per day. Generally, one to two tablets are taken every six hours. [1]
Percocet side effects
Percocet can cause side effects associated with both oxycodone and acetaminophen.
The potential side effects of Percocet include:
- nausea and vomiting
- stomach discomfort
- drowsiness
- dizziness, vertigo, faintness
- headaches
- itchiness or a rash
- chest tightness
- confusion
- constipation
Severe side effects of oxycodone, which require immediate medical attention, include:[8]
- difficulty breathing, slow or shallow breathing
- severe drowsiness, difficulty waking up
- seizures
- allergic reaction, causing: itching/swelling of the face, tongue, and throat; difficulty breathing
Side effects of acetaminophen are rare but include: [9]
- allergic reaction causing rash and swelling
- liver and kidney damage in the case of overdose
Percocet abuse
In addition to its pain-relieving effects, oxycodone in Percocet can cause feelings of relaxation, well-being, contentment, and euphoria in some people. Some people chase this feeling, taking Percocet more frequently than prescribed, at higher doses, or without a prescription.
As the body develops a tolerance to oxycodone, higher and higher doses will be required to achieve this euphoric effect. Users can also develop a physical dependence on oxycodone within just a few weeks of use, leading to unpleasant, painful withdrawal symptoms when they try to quit. To stave off these withdrawal symptoms, users may continue taking Percocet, worsening their dependence.
People who abuse Percocet may crush up the pills and snort the resulting powder or dissolve it in water to inject. These methods deliver a more immediate and intense high and come with serious dangers, including increased risk of overdose, damage to the nasal cavity, abscesses, contraction of blood-borne illnesses such as HIV and hepatitis, and endocarditis (infection of the heart).[10]
What does Percocet feel like?
Users say that Percocet makes them feel:[11][12]
- relaxed
- euphoric
- stress-free
- a sense of well-being
- “That all was right with the world”
- “That I could function at a higher level”
However, opioids like Percocet don’t elicit pleasant effects in everyone. Many people who are given opioids for acute pain may find them unpleasant and report dizziness, nausea, and negative feelings. Whether someone finds opioids pleasant likely depends on their mood, previous drug exposure, metabolism, and genetics. Those who do find opioids like Percocet euphoric or relaxing are at higher risk of abusing them and becoming addicted.[13]
Percocet addiction
As with other opioids, abuse of Percocet—using it for pleasant feelings and not pain relief or taking it in ways not prescribed—can lead to addiction, medically known as opioid use disorder (OUD).
Many people’s addiction to opioids begins with a legitimate prescription for Percocet or similar drugs like OxyContin (extended-release oxycodone) or Vicodin (hydrocodone and acetaminophen), often for post-surgical pain.
Some may continue taking these pills after this initial prescription has lapsed. They may visit multiple doctors complaining of pain to receive prescriptions or visit unscrupulous doctors who hand out prescriptions for opioids for pay. They may buy Percocet—colloquially known as Percs—on the street, where the pills may be counterfeit or cut with dangerous substances such as fentanyl.
When they can’t acquire prescription opioids, users may escalate to street opiates, such as heroin. Around 80% of heroin users report that they used prescription opioids before beginning heroin.[14]
Signs of Percocet addiction
You may believe you can’t be addicted to a drug that has been legitimately prescribed to you. But however beneficial it can be for short-term pain relief, Percocet has a high potential for abuse and addiction. The American Medical Association (AMA) estimates that 3% to 19% of people who take prescription pain medications like Percocet develop an addiction to them.[15]
You may be addicted to Percocet if:[16]
- You take Percocet to relax, have fun, or escape your problems.
- You’re running through your prescriptions quickly and asking for early refills.
- You’re seeking out other prescriptions.
- You’ve started taking other opioids, maybe borrowing or stealing them from family and friends.
- You’re snorting or injecting the substance.
- You have cravings and withdrawal symptoms when you’re not using Percocet.
- Your loved ones have suggested you try to cut back or stop using Percocet.
The sooner you identify a Percocet addiction, the sooner you can get treatment. With rapid treatment, you can avoid the most severe withdrawal symptoms and escalate to even more dangerous street drugs.
Percocet withdrawal
You can develop a physical dependence on oxycodone in Percocet after just a few weeks of use. Stopping taking Percocet or even reducing your dose can result in unpleasant symptoms of Percocet withdrawal.
Even people taking opioids for short-term pain relief and who have used them strictly as prescribed may need to be tapered off them to prevent withdrawal.[17]
Users often compare opioid withdrawal to a severe bout of the flu, with symptoms including:[18]
- severe anxiety
- insomnia
- nausea and vomiting
- diarrhea
- muscle aches
- sweating
- fever
- hot and cold flashes
- watery discharge from the eyes and nose
Percocet withdrawal timeline
The onset and duration of the withdrawal symptoms depend on how much Percocet you were taking and if you were also abusing other opioids.
Oxycodone is a short-acting opioid with a half-life of just four hours. That means a more rapid onset of withdrawal symptoms—heavily-dependent users may begin experiencing symptoms in just four hours—but a shorter duration overall (4 to 10 days).[18]
Everyone’s journey through opioid withdrawal will be different but might follow this timeline:[19]
- 8 to 12 hours after the last dose of Percocet, or 4 hours for heavily dependent users: the first symptoms emerge, usually anxiety and cravings for the drug.
- Patients then develop an increased respiratory rate, excessive sweating, yawning, teary eyes, runny nose, dilated pupils, and stomach cramps.
- 24 hours in: symptoms are at their peak. Patients develop gooseflesh, tremors, muscle twitching, elevated heart rate and blood pressure, fever and chills, lack of appetite, nausea, vomiting, diarrhea, and insomnia.
- Within a week: physical symptoms of withdrawal subside and cravings become less intense.
Percocet detox
Opioid withdrawal isn’t usually dangerous, but it can be very unpleasant and push people to continue using even when they want to quit. That’s why many people undergo medically-supervised withdrawal, also known as detoxification or detox. During detox, patients receive medication and fluids to ease the worst symptoms and have their vital signs regularly monitored to identify complications.
For mild opioid withdrawal, patients may receive:
- Fluids, to ensure they’re replacing what they lose through sweating and diarrhea
- Vitamin B and vitamin C supplements
For more severe opioid withdrawal, patients may receive clonidine, an alpha-2 adrenergic agonist that relieves many of the physical symptoms of withdrawal, including diarrhea, vomiting, abdominal cramps, insomnia, tremor, chills, sweating, and anxiety. Clonidine will not be given at the same time as opioid substitutes.
Opioid substitutes used in withdrawal management include:
- Buprenorphine: a partial opioid agonist, which binds to opioid receptors but less strongly than full agonists such as oxycodone and therefore doesn’t create pleasurable effects but does reduce withdrawal symptoms.
- Methadone: a full opioid agonist that binds to receptors but slowly and therefore doesn’t produce rewarding effects.
These opioid replacements can be taken long-term for patients at high risk of relapse.[18]
Percocet addiction treatment
Overcoming an addiction to an opioid such as Percocet is difficult but achievable. A comprehensive opioid addiction treatment plan, including medication, therapy, and holistic treatment, can help you heal both your body and mind and rebuild your life.
Medication
Medication used in the treatment of addiction to Percocet and other opioids includes:[20]
- Methadone: an opioid substitute that reduces cravings and can be taken long-term.
- Buprenorphine: an opioid substitute that reduces cravings and is taken daily or administered as a monthly injection or 6-month subdermal implant.
- Naltrexone: an opioid antagonist that blocks the activation of opioid receptors so opioids don’t produce rewarding effects. Patients who struggle to comply with daily dosing can be given an injectable, long-acting form.
- Antidepressants: Many people self-medicate for depression and other mental health conditions with opioids. Treating these conditions can reduce the risk of relapse.
Therapy
Therapy for Percocet addiction will depend on your history, co-occurring mental health conditions, availability in your local area, and your insurance but may include:
- motivational interviewing (MI)
- cognitive behavioral therapy (CBT)
- dialectical behavioral therapy (DBT)
- group therapy
Treatment settings
Treatment for Percocet and opioid addiction can be accessed in a number of settings. The one you select will depend on the severity of your dependence, local availability, your insurance, and your lifestyle. A doctor or addiction specialist can suggest what style of treatment might be best suited to you.[21]
- Inpatient treatment: a short-term stay in a hospital, usually to oversee detoxification.
- Partial hospitalization programs (PHP): a treatment program in which a patient attends a hospital part-time, usually during the day, to access counseling, group sessions, and medical care.
- Outpatient programs (IOP): in which the patient attends regular appointments while not staying in the hospital or rehab facility. Outpatient programs vary in intensity, depending on the provider and the patient’s needs.
- Residential treatment: treatment accessed during a stay in a rehabilitation facility. These facilities offer 24-hour supervision but not the same level of medical monitoring and staffing as a hospital. During residential treatment, patients access counseling and group sessions and will be medically checked out by a doctor at admission and on an intermittent basis.
Percocet FAQs
Here are some of the most commonly asked questions about Percocet.
How long does Percocet stay in your system?
Usually, it’s eliminated from users’ bloodstreams within 24 hours, but metabolites can linger in saliva and urine for two to four days and can be detected by hair follicle testing for three months. Read here to learn more about how long Percocet stays in your system.
What is the right dosage of Percocet?
Percocet dosage varies depending on the pain being treated. However, most doctors and medical professionals try to keep prescriptions on a low dose with a short duration to avoid abuse and dependence. Read here for more information on Percocet dosage.
What's the difference between Percocet and other opioid painkillers?
Percocet is just one of many forms of opioid painkiller available for treatment. Some have subtle differences and are used to treat differing levels of pain. Some also have a greater likelihood of abuse and developing substance use disorder. Read here to learn more about the differences between Percocet and other painkillers.
What are fake Percocet and what do they look like?
The illicit drug market is now flooded with counterfeit prescription pills, often painkillers such as Percocet laced with the super-strength opioid fentanyl. The fakes are often convincing: the same color and shape as real Percocet and stamped with the same imprint code. Read our guide to learn more about fake Percocet and how to identify counterfeit pills.
