While oxycodone can relieve the symptoms of anxiety temporarily, the use of this opioid comes with many adverse side effects.

The popularity of oxycodone as a prescription painkiller persists even as the opioid epidemic worsens and more people die from overdoses of opioid medication every year. There may be a hidden factor behind this popularity: people with anxiety or mood disorders account for over half of opioids prescribed in the United States. The most likely reason for this is that opiates can alleviate mental as well as physical discomfort. Even though opioid drugs are not approved for the treatment of anxiety by the Food and Drug Administration, they often end up being used for that purpose by people with anxiety who are prescribed opioids for another reason.

Unfortunately, the relationship between oxycodone and anxiety is not a good one. Like any other opioid, oxycodone is highly addictive. While some people can take it as prescribed and stop using it when their doctors stop prescribing it, others find themselves taking oxycodone in larger amounts and over longer periods than intended. As use progresses to misuse and dependence, people face serious risks of medical complications, overdose and social and legal problems. Perhaps the most insidious side effect of regular oxycodone use for people with anxiety disorders is that it can worsen anxiety symptoms over time.

Does Oxycodone Cause Anxiety?

Research has revealed that people with anxiety disorders are more likely to develop opiate use disorders. Is this only because people with anxiety are drawn to opioids like oxycodone for their ability to alleviate anxiety? Or can oxycodone cause anxiety? While this question has not been answered definitively, research suggests that the answer is “yes.”

Endorphins are endogenous opioids or opiates produced by the human body. They are central to natural processes that modulate anxiety and help people regain their composure after facing a threat. Opioid drugs work by mimicking natural opiates and linking to the same receptors in the brain, meaning that their immediate effect is to reduce anxiety in the same way that endorphins would. However, this effect is short-lived. As tolerance develops, regular oxycodone use can limit the brain’s ability to manage anxiety, making symptoms worse.

As the brain adapts to the regular use of opioid drugs, it produces less of its natural pain-killing and anxiety-reducing chemicals. This means that as tolerance develops and oxycodone loses its power to make people feel better, the brain also produces fewer endorphins and loses its capacity to manage discomfort. Over time, this alteration can make people more sensitive to pain and stress and less able to tolerate it with or without medication. The scientific term for this phenomenon is hyperalgesia.

Does oxycodone cause anxiety, then? Research supports that it does, showing that regular oxycodone use makes people more sensitive to stress and more prone to anxiety. Among psychological oxycodone side effects, anxiety is one of the most frequently listed. In extreme cases, these side effects can trigger panic attacks even in people who haven’t had them before.

Oxycodone and Anxiety Attacks

Anxiety attacks can occur in many contexts but are a definitive feature of panic disorder, which affects over 8 million Americans every year. A panic or anxiety attack is an intense wave of anxiety that arises suddenly. Unlike the vague sense of dread that accompanies generalized anxiety disorder, panic attacks can make people feel like they are dying or having a heart attack.

The intensity of these fears and the physical components of a panic attack often make people feel like they need to go to the hospital. Many eventually do go to an emergency department (ED) for evaluation, especially before they receive a panic disorder diagnosis and understand that their symptoms do not signal a medical emergency. Research on ED visits from 2009 to 2011 showed that nearly one percent of ED visits, or over a million visits every year, are for anxiety or panic attacks.

Substance-induced anxiety drives many of these visits. In addition to increasing rates of generalized anxiety, opioids like oxycodone can also trigger panic attacks. Oxycodone anxiety attacks may be especially common. Research shows that disrupting the function of natural opioids contributes to the development of panic disorder.

Oxycodone for Anxiety Treatment

It is true that in the short-term, oxycodone helps anxiety. Early on, it functions in a very similar way as natural opioids produced in the brain, soothing mental discomfort and inducing calm. This effect has made some people consider whether oxycodone for anxiety would be an effective treatment option.

In a 2016 opinion piece in The New York Times, psychiatrist Anna Fels considers the case of a patient who only experienced relief from depression when she used opioids. She wonders if opioids might ever come back into vogue as medication for depressionanxiety and other mental health disorders, though she acknowledges the dangers they pose.

It is possible that further research might lead to the development of a new opioid drug or a new class of opioid-derived medications that can treat anxiety and other mental health conditions safely. For now, the risks associated with opiate addiction outweigh the potential psychological benefits of opiates, even as breakthrough drugs for short-term use. Research shows that opioid drugs like oxycodone ultimately worsen rather than improve mental health.

Key Points: Oxycodone and Anxiety

Key points to remember about oxycodone and anxiety include:

  • Oxycodone mimics natural opiates in the brain that help alleviate pain, reduce stress and signal that a threat has passed
  • Opiates like oxycodone can only provide short-term relief from anxiety and ultimately, they make it worse as the cycle of tolerance develops
  • As greater amounts of oxycodone are required to alleviate anxiety, levels of the brain’s natural painkillers also drop, leaving people more sensitive to pain and stress, making them more uncomfortable or anxious than they originally were before they started using opiates
  • Integrated treatment programs can help people recover from anxiety while also helping them address substance use disorders and control cravings

The Recovery Village operates treatment centers across the United States that provide integrated treatment for co-occurring disorders including anxiety and opioid addiction. If you are concerned that your use of oxycodone has progressed to addiction, you can read more about signs of oxycodone abuse here. If you want to learn more about how anxiety disorders are diagnosed or treated, you can read an overview here and more about panic disorder here. If you need urgent help, reach out to local emergency service providers. If you aren’t having an emergency but know you have a problem and need treatment, contact The Recovery Village today. A representative will help you explore treatment options and choose the one that best meets your needs.

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Editor – Megan Hull
Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more
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Medically Reviewed By – Stephanie Hairston, MSW
Stephanie Hairston received her Bachelor of Arts degree in Psychology and English from Pomona College and her Master of Social Work degree from New York University. Read more

Dark, Tyra. “Epidemiology of Emergency Department Visits for Anxiety in the United States: 2009–2011.” Psychiatric Services, March 2017. Accessed March 19, 2019.

Johns Hopkins University Bloomberg School of Public Health. “Opioid abuse linked to mood and anxiety disorders.” December 13, 2011. Accessed March 19, 2019.

National Center for Biotechnology Information. “Translational approach to the pathophysi[…]d endogenous opioids.” May 2017. Accessed March 19, 2019.

National Institute of Mental Health. “Panic Disorder.” Accessed March 19, 2019.

SAGE Journals. “Opioids and anxiety.” June 8, 2010. Accessed March 19, 2019.

Zagorski, Nick. “Many Prescription Opioids Go to Adults With Depression, Anxiety.” Psychiatric News, August 17, 2017. Accessed March 19, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.