Hydrocodone Addiction: Effects, Withdrawal and Treatment

Hydrocodone is a powerful prescription opioid commonly used to treat pain, usually following surgery or injury.1 The substance works by affecting certain receptors in the brain and nervous system so that the sensations of pain are dulled.1 Doctors often prescribe hydrocodone for patients experiencing severe pain following surgery, injury, or painful chronic conditions like arthritis. In some cases, hydrocodone is used as a cough suppressant when other treatments prove ineffective.

Hydrocodone is classified as a narcotic analgesic, which makes it part of the opioid family, along with other well-known painkillers like oxycodone and morphine. When combined with additional ingredients, such as acetaminophen, hydrocodone is marketed under brand names like Vicodin®, Lortab®, Lorcet-HD®, Hycodan®, and Vicoprofen®.

Hydrocodone is available in tablet, capsule, and liquid solution form.1 While it is supposed to be taken by mouth, some people abuse the drug by crushing the pills and snorting the powder to experience a faster, more intense “high,” with its feelings of euphoria. Due to its high potential for addiction and misuse, hydrocodone is classified as a Schedule II controlled substance under the Controlled Substances Act.1

Misusing one’s hydrocodone prescription in any way, like taking more than what is prescribed, using it for non-medical reasons, or altering the proper method of use, increases the risk of hydrocodone dependence and addiction. When misused, hydrocodone overstimulates the brain’s reward system, quickly leading to increased tolerance, wherein the user requires more of the drug to achieve the desired effect. Over time, the user’s body will grow physically dependent on hydrocodone, relying on the drug simply to function normally.

It should be noted that dependence and addiction are distinct concepts. Dependence refers to the body’s adapting to the drug, leading to the development of physical withdrawal symptoms upon stopping use.5 Addiction, or, in this case, opioid use disorder (OUD), goes beyond mere physical dependence to involve compulsive drug-seeking behaviors despite the psychological harm or negative life consequences involved in OUD.5 According to the DSM-5 criteria, the signs of OUD include:4

• Taking larger amounts of the drug or over a longer period than intended
• Unsuccessful efforts to cut down or control opioid use
• Spending inordinate time and effort on obtaining opioids, using opioids, or recovering from their effects
• Cravings, or the strong desire to use opioids
• Recurrent opioid use, resulting in failure to fulfill obligations at work, school, or home
• Continued opioid use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the use of opioids
• Important social, occupational, or recreational activities are given up in favor of continued opioid use

If you or a loved one are displaying signs of an opioid use disorder, it’s important to get professional help at an addiction treatment facility like Empowered Recovery Center in Atlanta.

Effects of Hydrocodone

Hydrocodone’s side effects tend to be more frequent and more intense when the drug is misused or taken in larger doses than prescribed.1 This makes it crucial to use hydrocodone only as directed by a medical professional. Hydrocodone effects may include:1,2

• Nausea and vomiting
• Drowsiness and fatigue
• Respiratory depression (shallow or slowed breathing)
• Headache
• Hypotension
• Anxiety
• Insomnia
• Dizziness
• Constipation and abdominal pain
• Mood changes
• Irregular menstruation 
• Changes in libido
• Dependence

Hydrocodone may cause other side effects as well. If you are experiencing unusual side-effects, even if you’re taking your medication as prescribed, it’s important to contact your doctor.

Yes, you can overdose on hydrocodone. Hydrocodone overdose occurs most often when the drug is misused or abused, like when it is taken in large amounts or used without a prescription. Combining hydrocodone with other substances, such as alcohol, other opioids, or benzodiazepines like Xanax further increase the chances of overdose. Such substances depress the central nervous system, which can result in slowed or arrested breathing. This is why it is essential to avoid mixing hydrocodone with other substances.

The most common signs of a hydrocodone overdose are similar to those of most other opioid overdoses. The signs of an opioid overdose include:2

• Extreme drowsiness or inability to stay awake
• Slowed or shallow breathing
• Cold, clammy skin
• Slow or irregular heartbeat
• Unresponsiveness or unconsciousness

If you suspect someone is overdosing on hydrocodone, call 911 immediately and administer naloxone (Narcan) if available. Naloxone is a medication that temporarily reverses the effects of an opioid overdose until emergency medical help arrives.

Quitting hydrocodone may result in withdrawal symptoms, depending on how long one has been using the drug and in what quantity. Those who have developed a dependence or addiction to hydrocodone are much likelier to experience withdrawal symptoms after they stop using.1 These symptoms can be uncomfortable and even dangerous, which makes it difficult to quit without proper support.

Common hydrocodone withdrawal symptoms include:2,3,6

• Muscle aches
• Nausea and vomiting
• Diarrhea
• Insomnia
• Sweating or chills
• Anxiety or depression
• Cravings for hydrocodone
• Irritability
• Rapid heart rate

Medical detox offers a manageable path for those looking to quit hydrocodone once and for all. During the detox phase of treatment, medical professionals might prescribe FDA-approved medications to reduce the intensity of withdrawal symptoms. This is known as Medication-Assisted Treatment, or MAT. Medications commonly used to treat opioid withdrawal symptoms include buprenorphine, methadone, or naltrexone.3 These drugs help reduce drug cravings and withdrawal symptoms, thus giving people a better chance at a lasting recovery.

References  

1. U.S. National Library of Medicine. (n.d.). Opioid use disorder: Epidemiology and treatment. National Institutes of Health. Retrieved September 24, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK538530/
2. MedlinePlus. (n.d.). Buprenorphine: MedlinePlus drug information. National Institutes of Health. Retrieved September 24, 2024, from https://medlineplus.gov/druginfo/meds/a614045.html
3. U.S. National Library of Medicine. (n.d.). Benzodiazepine use disorder: Epidemiology and treatment. National Institutes of Health. Retrieved September 24, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK310652/
4. American Society of Addiction Medicine. (2017). DSM-5 diagnostic criteria for opioid use disorder. ASAM. Retrieved September 24, 2024, from https://www.asam.org/docs/default-source/education-docs/dsm-5-dx-oud-8-28-2017.pdf
5. Manhapra, A., Quinones, M., & Rosenheck, R. (2021). Three models of office-based buprenorphine treatment in the VA: Is one better than another? Journal of Substance Abuse Treatment, 129, 1-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8583742/
6. Substance Abuse and Mental Health Services Administration. (n.d.). Clinical guidelines for the use of buprenorphine in the treatment of opioid addiction (SMA10-4554). SAMHSA. Retrieved September 24, 2024, from https://store.samhsa.gov/sites/default/files/sma10-4554.pdf