Percocet is trade name for a fixed-dose combination of the pain medications acetaminophen, or Tylenol, and oxycodone. Oxycodone is a type of opioid or narcotic, and as such had a high potential for abuse. Because Percocet is one of the most prescribed medications for moderate pain, Percocet abuse is a common problem, with many abusers taking extremely high doses. Oxycodone is a fairly safe drug for long-term use in high doses, although it does cause a few problems, but acetaminophen in high doses is quite dangerous.
Short vs. Long Term Effects
Oxycodone, like all opioids, has some extremely dangerous short-term effects. The most serious of these effects is a decrease in the drive to breathe, which is known as respiratory depression. Respiratory depression can be fatal and is in fact the cause of death in narcotic overdoses. However, tolerance quickly develops to most of the short-term effects of oxycodone, including respiratory depression. There is little risk of dangerous respiratory depression in a long-term user of Percocet, unless the dose is suddenly drastically increased or it is combined with another substance that also slows breathing, such as alcohol.
Constipation is one of the few effects of oxycodone for which long-term users do not develop a significant tolerance. As a result, most long-term users of significant doses of Percocet develop some degree of chronic constipation. Severe chronic constipation can be a fairly serious problems if left untreated, potentially leading to anal fissures, intestinal obstruction or diverticulitis. Fortunately, the chronic constipation of long-term opioid use is easy to treat and usually responds well to mild medications and changes in exercise patterns and fluid and fiber consumption.
The most dangerous effects of long-term Percocet use come from the acetaminophen rather than the oxycodone. Acetaminophen can cause liver damage in large doses, and even a single large dose can be enough to cause acute liver failure. A paper published in the December 2005 issue of the journal "Hepatology" found a median dose of 24 grams, 48 extra-strength tablets, in patients who developed acute liver failure as the result of a single large dose of acetaminophen. Of the patients who were not intentionally overdosing, 63 percent reported taking the acetaminophen in the form of narcotic-containing pain preparations, such as Percocet.
Even a regular, long-term acetaminophen dose of greater than four grams per day, eight extra-strength tablets, can lead to chronic liver diseases, such as cirrhosis, particularly if used along with other substances with potential liver toxicity, such as alcohol. Abusers of medications such as Percocet frequently end up taking large daily doses of acetaminophen in order to keep getting the euphoric effects of the oxycodone.
- "Principles of Pharmacology"; David E. Golan, et. al.,( eds).; 2005
- "Harrison's Principles of Internal Medicine 16th ed."; Dennis L. Kasper, et al. (eds.); 2005
- "Hepatology"; "Acetaminophen-Induced Acute Liver Failure: Results of a United States Multicenter, Prospective Study"; AM Larson, et al.; December 2005