Oxycodone

Effects of oxycodone

The use of any drug can have risks. It’s important to be careful when taking any type of drug.

Oxycodone can affect everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the environment (where the drug is taken).

Onset and duration of effects

How fast a drug takes effect and how long it lasts can vary depending on how it's taken - for example, whether it's snorted, swallowed, or injected.⁹

• If swallowed: effects can be felt within 10 – 30 minutes, and can last for 4 – 8 hours for short acting oxycodone, or around 12 hours for controlled-release oxycodone (e.g. OxyContin®).
• If snorted: Do not snort controlled-release/long-acting oxycodone tablets. Effects for short-acting oxycodone may be felt within 10 minutes and can last for 3 – 5 hours.
• If injected: effects can be felt immediately and can last for 3 – 5 hours.¹⁰

Effects

Effects can include:

• pain relief
• drowsiness
• euphoria (happiness) or changes in mood
• dizziness
• confusion or difficulty concentrating
• restlessness
• stiff muscles
• constipation
• stomach pain
• nausea
• dry mouth
• difficulty urinating
• slow pulse
• excess sweating, flushing and itching
• mild allergic rash or hives.^{2, 11}

If you experience side effects or are concerned about your oxycodone use, speak with your doctor.

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’): 

• Set: a person’s state of mind, previous encounters with the drug, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using oxycodone may result in an unpleasant experience and make those feelings worse.
• Setting: the physical and social environment where you take oxycodone – whether it’s known and familiar, who you're with, if you're indoors or outdoors, the type of music or sounds, and lighting. The ideal setting to take oxycodone will vary based on the individual and drug they’re using.¹²

Being in a good state of mind, with trusted friends and a safe environment before taking oxycodone reduces the risk of having a bad experience.¹²

Overdose

If you take a large amount of oxycodone or use a strong batch, you could overdose.

Your risk of overdose can also increase if you mix oxycodone with alcohol or other drugs, including medications.

Oxycodone overdose can cause death.¹³

Call triple zero (000) and request an ambulance if you or someone else has any of the following symptoms (emergency services are there to help and can provide more instructions).

Signs of opioid overdose can include:

• unconscious or non-responsive
• slow breathing, abnormal breathing, or not breathing at all
• slow or no heartbeat and pulse
• choking or gurgling sounds
• skin colour changes, especially lips and fingernails
• bluish-purple skin for people with lighter complexions
• greyish or ashen skin for people with darker complexions
• vomiting
• cool or clammy (wet and sweaty) skin
• small ‘pinpoint’ pupils.^{14, 15}

Note: If possible, have the medicine with you so the ambulance officers know what has been taken.

Learn more on overdose and drug-related emergencies

Naloxone

Naloxone (also known as Nyxoid®/Narcan®) temporarily reverses the effects of opioid overdose (including oxycodone). It’s available for free over the counter from most local pharmacies and can be administered by anyone, including family or friends and bystanders.¹⁶

If a person does not respond to the first dose after 3 minutes, give them a second dose. This can be repeated until the ambulance arrives.^{17, 18}

Mixing with other drugs

Mixing oxycodone with other drugs can have unpredictable effects and increase the risk of harm.

Mixing includes using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

• Oxycodone and alcohol /opioids/benzodiazepines/ GHB/GBL/ ketamine/MXE: high risk of overdose, slow/no breathing, slowed/stopped heart rate, loss of consciousness, and death. 
• Oxycodone and ice/cocaine/amphetamine: strain on heart and kidneys, increased risk of overdose. 
• Oxycodone and some antidepressants (monoamine oxidase inhibitors – MAOIs): can cause delirium, convulsions, respiratory failure, coma and death. Increases risk or serotonin syndrome.^{11, 19}

Using more than one drug or type of drug at the same time is called polydrug use.¹⁵

Reducing harm

There are ways you can reduce the risk of harm when using oxycodone:

• If you have a prescription, take oxycodone as advised. Don’t stop using your medicine or lower the dose without checking with your doctor.
• Start low, go slow – try a little bit first to see how you feel. Wait at least 5 hours before deciding whether to take more.
• Keep naloxone nearby – in case of an overdose.
• Don’t mix oxycodone with alcohol or other drugs to reduce risk of overdose.
• Test your drugs – if there is an available drug checking (pill testing) service near you, to find out what the drugs contain and how strong they are.
• Don’t operate machinery, drive, or swim.^{5, 11, 20}

If snorting

• Don’t crush or break slow-release tablets – this can release the entire dose at once, significantly increasing the risk of overdose.
• Crush immediate-release tablets into a fine powder, as crystals can cause cuts.
• Rinse your nose with water before and after to protect your nose from irritation.
• Use your own straw, or a disposable one, and avoid money notes to reduce the risk of infections or transmission of viruses like HIV or Hep C.
• Switch nostrils and take breaks to avoid nasal damage.^{21, 22}

If injecting

• Always use new needles – never share needles or other injecting equipment. Use your own spoon/cup and tourniquet. Use new barrels, filters, sterile water, and swabs. Safely dispose of used equipment.
• Visit a needle and syringe program for sterile equipment, disposal of used equipment, and expert medical advice.^{23, 24}

Tramadol sold as oxycodone:

• ‘Start low, go slow’, pace yourself by taking a small amount to start with, and leave time between doses. 
• Never use alone, make sure someone nearby has naloxone on hand and a phone to call for help if needed. 
• Check for drug alerts and use drug checking (pill testing) services, where available.

Coming down

Oxycodone is not known to cause comedown effects.

Long-term effects

Long-term effects can vary depending on how much, how often and how oxycodone is consumed. 

Regular use may eventually contribute to:

• increased tolerance and dependence
• reduced bone density and higher risk of fractures
• increased risk of infection
• impacts on hormone levels, leading to reduced sex drive, erectile dysfunction, or menstrual cycle changes.
• sleep problems.^{2, 11, 25}

Oxycodone and mental health

Research has found a link between some mental health conditions and the risk of opioid overdose, including oxycodone.^{26, 27}

There is evidence that as many as 1 in 3 people with an opioid use disorder also have post-traumatic stress disorder (PTSD).²⁸

People experiencing mental health concerns such as depression, anxiety, PTSD, psychosis, or bipolar disorder are also more likely to experience an opioid overdose compared to those without these conditions.²⁶

This association has been seen across different groups, including people in emergency departments, veterans, and those in prison settings.²⁶

Tolerance

Regularly taking oxycodone can lead to developing a tolerance, which means you need to take larger amounts to get the same effects.^{2, 10}

Tolerance to oxycodone also affects other opioids (known as cross-tolerance). For example, tolerance to oxycodone will also result in a higher tolerance to heroin or fentanyl.^{29, 30}

Tolerance should return to normal within 1 – 2 weeks of not using opioids.30

People taking opioid medications long term may be switched by their doctor to a different opioid to reduce the amount of medication they need to take. This is known as opioid rotation.²⁹

Dependence

People who regularly use oxycodone may become dependent. They may feel they need to use oxycodone to go about usual activities like working, studying and socialising, or just to get through the day.2

Withdrawal

Withdrawal refers to the symptoms that can occur when someone who is dependent on a drug, or who has been using it regularly over time, stops or reduces their use.³¹

Withdrawal can include physical symptoms (such as headaches, or nausea) and psychological symptoms (such as anxiety, or depressed mood).³¹

Symptoms - including how strong they are and how long they last - will vary depending on the type of drug and a person’s history of use.³¹

Withdrawal from oxycodone can be potentially life-threatening.³²

If you, or someone you care about, is planning to stop taking oxycodone after using it for a long time, it’s important to speak with a medical professional for guidance and supervision. 

Withdrawal symptoms

Reducing, or stopping using oxycodone after a period of regular use can lead to withdrawal symptoms, including:

• hot and cold flushes, sweating and 'goosebumps'
• feeling anxious or irritable
• cravings for oxycodone
• nausea, vomiting, diarrhoea and lack of appetite
• tremors or shaking
• watery eyes, runny nose and sneezing
• trouble sleeping
• increased heart rate
• joint, bone or muscle pain, abdominal (stomach area) pain or headaches.^{2, 33}

Withdrawal symptoms may be experienced 6 to 12 hours after taking your last dose, peak around 2 days after stopping, and settle down after around a week.³³

Reduced tolerance and overdose risk

After withdrawing from opioids such as oxycodone, your body is no longer used to it and your tolerance drops.³⁰

This means if you use the same amount as before, it can be too much for your body and cause an overdose.³⁰

Always start with a lower dose after a break from oxycodone or other opioid drugs.³⁰

Pregnancy and breastfeeding

Before pregnancy

Opioid drugs, including oxycodone, can impact fertility.

Opioids can:

• affect menstrual cycles
• lower sex drive.
• lower testosterone levels
• reduce sperm quality and movement
• cause erectile dysfunction.^34-36

If you’re trying to conceive and are dependent on illegally made opioids, speak to your doctor about opioid pharmacotherapy and other withdrawal management plan to help you reduce or stop use. While there are benefits at any time in pregnancy, the safest and most effective time to stop is before. 

During pregnancy

If oxycodone is needed for pain relief, your doctor will aim to prescribe the lowest effective dose for the shortest possible time.³⁷

Opioids can cross the placenta and may affect your baby’s growth and development and result in a premature (early) birth.^{37, 38}

If you’re dependent on oxycodone, don’t suddenly stop taking it suddenly. Withdrawal can be harmful to both you and your baby. Your doctor can help you to safely reduce your use.³¹

Illegal or counterfeit (fake) oxycodone may contain other substances that can have unpredictable effects on your baby or pregnancy.³⁹

If you’re injecting opioids, it’s important to not share injecting equipment with other people. This protects you and the baby from bloodborne viruses such as HIV and hepatitis C.⁴⁰

After pregnancy

Opioid use during pregnancy can sometimes cause withdrawal symptoms in babies after birth. This is known as neonatal opioid withdrawal syndrome (NOWS).^{37, 41}

NOWS is easily diagnosed and treated, and not all babies will experience symptoms.⁴¹

Breastfeeding your baby while using opioids in high doses is not recommended, as the drugs can be present in breastmilk and affect the baby.^{38, 41-43}

If you’re planning to breastfeed, make sure you talk with your midwife or doctor about your use of opioids.³⁷

Getting help

If your use of oxycodone is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone, there is help and support. 

• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs.
• Search our Help and Support directory to find your preferred support, by adding your location or postcode and filtering by service type.