Percocet is commonly prescribed to patients suffering from pain, whether from a cesarean section or a broken bone. Opioids vary in the length of time between when they are taken and when the user feels an effect. Oxycodone, the opioid in Percocet, is relatively fast-acting.
As is true of all medicines, opioids are not inherently good or bad, said Dr. Caleb Alexander
, an associate professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health and the co-director of the school's Center for Drug Safety and Effectiveness.
"The value of Percocet or any medicine depends upon how its applied, how it's used," he said. "And so, for the right patient at the right time, it's a remarkable medicine. But unfortunately, it's been vastly overused, as have all opioids."
Percocet side effects
Those who take the drug may experience both short- and long-term effects. In addition to euphoria and pain relief, Percocet may cause drowsiness, constipation, depression, memory problems, decreased testosterone, cardiac problems, bone problems, addiction and death.
Percocet is classified as a Schedule II drug by the federal Drug Enforcement Administration
, which means it a drug with "a high potential for abuse, with use potentially leading to severe psychological or physical dependence."
Alexander said it is difficult to obtain accurate statistics on the number of people misusing Percocet because it not uncommon for individuals with an addiction to switch between opioids.
"The opioids as a class are more similar than they are different," he said.
Dr. Sarah Wakeman
, the medical director of the Substance Use Disorder Initiative at Massachusetts General Hospital, said national drug surveys often lump prescription drugs into one category rather than separate them by brand name.
According to the National Institute on Drug Abuse
, an estimated 54 million people in the United States have used prescription drugs for nonmedical reasons at least once.
The simplest definition of addiction is use despite consequences, Alexander said.
And while Percocet and other prescription opioids are highly addictive, individuals can have varying risks of addiction based on hereditary and environmental factors, said Dr. Anna Lembke
, an associate professor and the chief of addiction medicine at the Stanford University School of Medicine.
Risk factors for addiction
Some hereditary risk factors include personal or family history with addiction to either opioids or other substances, including alcohol, and co-occurring mental illness, while environmental risk factors include early childhood trauma, poverty and unemployment.
"One of the biggest risk factors for addiction that's often overlooked is simple access," Lembke said. "If you have more access to a drug, for example to a doctor's prescription, you are more likely to be exposed to that drug and more likely to get addicted."
Nevertheless, individuals who have none of these risk factors may still become addicted, she added.
Dependence and withdrawal
Not everyone who uses Percocet becomes addicted to the drug; however, anyone who takes it for an extended period of time will eventually develop dependence, a term that refers to specific physiological changes in the brain, Alexander said. Only a subset of dependent people will become addicted, for reasons scientists do not completely understand, he added.
Dependence is not necessarily a lifelong condition, but if an individual dependent on Percocet stops taking the drug, they may experience withdrawal symptoms. People addicted to opioids may also experience these symptoms if they attempt to suspend use.
Withdrawal symptoms include craving the drug, upset stomach, restlessness, anxiety or irritability, rapid heart rate, sweating, aches or pains and dysphoria, a state of unease.
Misuse and abuse
Abuse and misuse of Percocet may look different for different people, but the definition of misuse is using the drug not as it is prescribed, in this case as a treatment for pain. Examples of misuse include taking the drug recreationally, changing the delivery method by crushing and snorting it, and hoarding and binging pills. Lembke said that going to multiple doctors for the same or a similar prescription, a practice known as "doctor shopping," constitutes another form of misuse.
Because Percocet contains two drugs, there are two potential ways to overdose, Wakeman said.
The first is by overdosing on oxycodone, the opioid component of Percocet. The drug affects the part of the brain stem that controls the urge to breathe, so an overdose results in slowed or stopped breathing. Without enough oxygen, your body's tissues and organs will become damaged. Ultimately, this kind of damage to the brain is what results in death.