Roxanol Addiction: Understanding Side Effects, Symptoms and More

Disclaimer: This article is for educational purposes only and does not replace expert medical or mental health advice. So, always refer to a board-certified physician or a licensed mental health specialist to understand the benefits and complications of Roxanol use.

Roxanol (morphine sulfate) is an opiate used to manage pain and end-of-life care. It is also known as liquid morphine. While highly effective when taken as prescribed by the doctor, as an opiate, it can become addictive and lead to dependence. In this article, we will explore how you can identify Roxanol addiction in yourself or a loved one so that you can make informed decisions for your safety and well-being.

Roxanol is the brand name for morphine sulfate. Now, it has been discontinued in the U.S., but other generic variations are still available.

Roxanol is used to treat pain and is highly regarded in palliative care systems. However, it is a very strong pain medication that comes with a high potential for misuse and dependence.

Roxanol is far more concentrated than standard oral morphine solution. A dose measured as though it were the standard strength can be a large overdose. Concentration mix-ups with oral morphine solutions are a documented cause of fatal overdose, and the U.S. Food and Drug Administration (FDA) has issued warnings about confusion between concentrations. Always measure Roxanol with the supplied dosing device, never a household spoon, and confirm the strength and volume with your doctor and pharmacist each time you refill.

Dr. Ryan Peterson, a highly experienced physician at the NuView Treatment Center, says, “When Roxanol is used as prescribed and instructed by your doctor, it can be safe and effective. However, as a derivative of morphine, it does come with some side effects. Some side effects are common and expected, but when you experience fatigue, dizziness, or breathing troubles, it is time to seek medical care immediately.”

If you or a loved one has been prescribed Roxanol, here are some precautions you need to take:

• If you are allergic to Roxanol or morphine, or any other kinds of substances, be open with your doctor.
• If you struggle with lung or breathing difficulties, be open with your doctor.
• If you are pregnant or breastfeeding, tell your doctor. Roxanol can lead to withdrawal symptoms in the child after birth, which can, in turn, lead to behavioral changes, seizures, and other complications.
• If you are taking medication for major depressive disorder or Parkinson’s disease, inform your doctor beforehand.
• If you are taking any of these substances, like buprenorphine, butorphanol, linezolid, methylene blue, nalbuphine, or pentazocine, inform your doctor beforehand.
• Even a small dose of Roxanol can be lethal for children, so keep it away from the reach of children and others who may misuse it.

In a nutshell, as a precautionary measure, if you have any pre-existing allergies or conditions, or are taking any psychoactive substances, medications, or even supplements, inform your doctor.

Some of the short-term effects of Roxanol are as follows:

• Drowsiness
• Heightened sense of well-being
• Weight loss
• Cramps
• Bowel movement difficulties
• Changes in vision
• Uncontrolled eye movements
• Dry mouth
• Indigestion
• Floating feeling
• Halo around lights
• Night blindness
• Irregular menstrual periods
• Loss of sex drive
• Breathing difficulties.

Meanwhile, chronic use of Roxanol can lead to severe, long-term effects, such as:

• Blurred vision
• Pounding in the ears
• Pins and needles sensations on the skin
• Chills
• Sweating
• Vomiting
• Slowed heartbeat
• High level of serotonin in the body (serotonin syndrome)
• Adrenal insufficiency
• Allergic reactions, like itching, wheezing, and breathing difficulties, must be treated as an emergency.

While some side effects are common, if they begin to worsen or you experience other severe side effects like shallow breathing, trouble swallowing, or swelling of your limbs - call your doctor immediately!

The reason why Roxanol is addictive is that it is an opioid, so it binds to the opioid receptors in your brain to relieve pain. Especially moderate to severe pain, like with surgery or chronic illness-related pain. However, it also gives rise to euphoria even among those who use it as a pain reliever.

This is what makes Roxanol very addictive. Hence, it is crucial that you take it only as it is prescribed by your doctor. If you feel like you need changes, contact your doctor immediately.

Some of the signs and symptoms of Roxanol addiction, as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), are as follows:

• Strong cravings or urges to use Roxanol.
• Using Roxanol in other ways than prescribed or using others’ prescriptions to obtain and use Roxanol.
• Spending a lot of time acquiring, using, and recovering from Roxanol use.
• Tried to quit Roxanol before, but have been unsuccessful.
• Continue to use Roxanol despite its effects on physical, mental, and social health.
• Prioritizing Roxanol over education, job, family, and other responsibilities and activities.
• Using Roxanol in highly risky circumstances, like driving or operating heavy machinery.
• Developing tolerance for Roxanol - which is when you need it in larger quantities to experience the desired effect.
• Developing withdrawal symptoms in case of reducing or stopping Roxanol use suddenly.

Common Roxanol withdrawal symptoms are:

• Irritability
• Anxiety
• Sleeplessness
• Yawning
• Sweating
• Aches
• Dilated pupils
• Vomiting
• Diarrhea.

If you or someone you know is experiencing any of these symptoms, reach out to your doctor immediately to seek medical care.

Yes, a person can overdose on Roxanol if they take too much of the medication than what is prescribed for them.

Typically, if you struggle with symptoms like:

• Low blood pressure
• Dizziness
• Nausea
• Sweating
• Pinpoint pupils
• Cold or clammy skin
• Blueish lips or fingernails
• Shallow breathing

…these can be the signs of a Roxanol overdose, which is a medical emergency. So, call 9-1-1 (if you are in the U.S.) or your local emergency providers immediately.

Harm Reduction and Safety

• Ask your doctor or pharmacist regarding a naloxone (Narcan) prescription, and make sure those around you know where it is and how to use it.
• Never combine Roxanol with alcohol, benzodiazepines, or other sedatives.

Roxanol addiction is treated with medically supervised detoxification and psychotherapy in both residential and outpatient settings:

• Detox: Medically supervised detox removes or slowly tapers off Roxanol levels from your body to minimize and manage cravings and withdrawal symptoms.
• Therapy: Therapeutic models like motivational interviewing, cognitive behavioral therapy, contingency management, and 12-Step facilitation therapies are used to identify the patterns leading to Roxanol misuse and equip you with productive coping skills.
• Medication: Medication-assisted treatment can also be used to treat Roxanol addiction. This combines both medication and therapy for the best recovery outcomes.
• Holistic Practices: Holistic practices like nutrition, sleep, exercise, meditation, and mindfulness are used to complement traditional therapies.
• Aftercare Planning: Ongoing counseling, relapse prevention, peer support, lifestyle modifications, and sober living are recommended to sustain your recovery.

Dr. Peterson says, “While opioid misuse is a chronic condition that needs to be controlled, a significant majority of those who seek treatment achieve meaningful recovery. This is why early diagnosis and intervention are highly recommended, as they lead to the best outcomes.”

If you or a loved one is struggling with Roxanol use, do not hesitate to reach out to NuView today. We provide a safe setting, strengthened by the sense of family and community, so that you can achieve full recovery and lead a healthier, meaningful life.

Please contact us at (323) 307-7997 to begin healing now!

1. What should I do if I miss a dose or feel the urge to take extra Roxanol?

Do not double doses or self-adjust if you miss a dose or feel the urge to take more than what is prescribed. Contact your doctor immediately to avoid overdose or dependence.

2. Can Roxanol addiction develop even when taken exactly as prescribed?

Chronic prescribed use can still lead to misuse and dependence, especially with higher doses or extended use.

3. What makes Roxanol misuse harder to recognize than other opioids?

As Roxanol is often prescribed for severe pain or end-of-life care, misuse can be mistaken for a legitimate medical need rather than misuse or dependence.

4. Is Roxanol more dangerous when mixed with alcohol or other substances?

Combining Roxanol with alcohol, other substances, or even other prescription medications can be dangerous. This is why you need to be open with your doctor.

5. Can someone relapse after detoxing from Roxanol?

Detox alone does not treat Roxanol addiction, which is why therapy and aftercare are crucial to reduce relapse risk.

6. Why is measuring so important with Roxanol?

As it is highly concentrated, a small measuring error can lead to a serious or fatal overdose. Use only the supplied device, and call your doctor or pharmacist if you are unsure of the strength or volume.