Coverage of the opioid epidemic has shed a lot of light on the dangers of hydrocodone, the generic opioid sold under various brand names. Many people want to break their dependence on hydrocodone, but doing so is a very risky process, raising the question of whether hydrocodone withdrawal can be lethal.
Hydrocodone is an extraordinarily addictive opioid medication. Once addicted, individuals find themselves trapped in the throes of withdrawals. Learn more about Hydrocodone abuse, withdrawal symptoms, and how to get off of the opioid medication in a safe manner.
What used to be one of the most prescribed drugs in America, hydrocodone found its original use as an opioid formulated from codeine. It is administered orally as a painkiller for the treatment of mild-to-moderate levels of pain. Being derived from codeine, it is also capable of suppressing the cough reflex.
As an opioid, the chemical compounds in hydrocodone seek out and attach to the opioid receptors in the brain and central nervous system. This has the immediate effect of reducing the incoming pain signals and stimulating the brain to produce dopamine, the neurotransmitter that carries messages indicating pleasure, reward, and the anticipation of more pleasure.
It is this mechanism of action that had made hydrocodone such a popular and effective painkiller; patients are numbed to their pain, and they feel good after taking their medication.
One of the problems with this is that hydrocodone started to be marketed, prescribed, and used for off-label purposes, such as for patients with anxiety, depression, and other kinds of mood disorders. The euphoria would be helpful for keeping those negative feelings at bay, but the patients who used the hydrocodone in this way would end up becoming almost entirely dependent on it to regulate their moods.
Dependence led to many patients struggling to stop using hydrocodone, as the medication became their sole lifeline for managing pain and discomfort, and feeling any kind of pleasure. As with most forms of opiate (and drug) addiction, this manifested as a deep desire to continue using the medication even when there was no actual reason for doing so, to the point where the drug-induced changes to the brain became longer-lasting with deeper impacts.
Patients become physically and psychologically dependent on hydrocodone to the extent that trying to stop taking it causes the body to react in unpleasant and disturbing ways. The brain and central nervous system (CNS), and the dozens of systems they regulate, get so used to hydrocodone controlling their operations that the sudden deprival of the opioid does not merely reset them back to their default state. The loss throws those systems into disarray, and it takes careful control and treatment to bring the body back to normal.
This process is known as withdrawal. While it is a necessary first step to break hydrocodone addiction, it is a very stressful experience for patients, and it should not be endured without medical attention. Symptoms of hydrocodone withdrawal include:
SYMPTOMS OF HYDROCODONE WITHDRAWAL
In cases of long-term hydrocodone abuse or if other drugs are present, the symptoms can include fluctuations in heartbeat, the respiratory system, and psychological problems such as suicidal thoughts.
It is in such cases that hydrocodone withdrawal presents its greatest risks. People who have factors in their life that could exacerbate the effects of dehydration and malnourishment might be at a severe risk for losing vital nutrients and fluids. Withdrawal takes a severe toll on the body, which is why medical supervision is necessary. Without that oversight, patients are at risk for expected side effects of the process becoming a life-or-death emergency.
In and of itself, withdrawal is not usually life-threatening, although to those undergoing the process, it can feel as though it is. Drastic changes brought about by the withdrawal process could potentially cause other problems that can be life-threatening. This can include pushing the body to the brink of dehydration and malnutrition as well as convulsions and cardiac arrhythmias, where the heart pumps blood irregularly and inefficiently.
When people withdraw from hydrocodone in the right settings (at a hospital or a drug treatment center), the chances of this happening are low. There are doctors and nurses on hand who can ensure that patients get the nutrients they need to avoid the worst of the process, and who can administer anticonvulsants, such as phenobarbital or clonazepam, to control seizures if needed. Additionally, they can administer the drugs in the right doses and formulas to ensure that introducing more medications to a wildly fluctuating system does not cause any further imbalances.
The real danger is in trying to do hydrocodone withdrawal without any of these. Some people might be concerned about the cost of treatment or they might be too scared and ashamed to ask for professional help. These are understandable reasons, but they expose these individuals to a serious danger that the withdrawal process will cause problems that are actually life-threatening, with no medical professionals in attendance to rectify them.
In terms of how long hydrocodone withdrawal lasts, the Journal of Pain Research notes that Vicodin, a brand-name version of hydrocodone, is formulated to be an “immediate release” medication, with the effects lasting between four and six hours. Some extended-release hydrocodone products provide effects that can last up to 12 hours. The difference is important because the onset of withdrawal is determined by how long it takes for the body to finalize breaking down the opioid compounds in the medication.In most cases, withdrawal from hydrocodone begins between six and 12 hours after last consumption. The symptoms reach their peak after three days, and they mostly dissipate by the seventh day of the process. However, if a person has health complications or was a chronic user of hydrocodone, lingering symptoms might persist for weeks. If a person does not receive proper care and counseling, the temptation to go back to hydrocodone might persist for months.
Other factors influencing the duration of withdrawal include how long the person had been using hydrocodone, if other drugs were present (either during the withdrawal process or during ongoing abuse), if the person has a family history of substance abuse or mental health illnesses, and any lifestyle or environmental factors that contribute to the degree of dependence on the hydrocodone.
Generally speaking, the greater the dependence and rate of abuse, the better the chances that withdrawal will be on the longer end of the spectrum, and the person will need more care and supervision to detox safely.
Again, attempting detox without medical supervision is not advised. If a person insists on withdrawing from hydrocodone without medical help, there are some steps they can take to do this more safely. Even with taking these precautions, an at-home detox increases the risk of complications that could result in death.
The most important thing to remember is that abruptly cutting off the hydrocodone intake will result in the worst effects of withdrawal, and doing so raises the chance of triggering complications that might result in a serious medical emergency. The best way to avoid this is to gradually cut back on hydrocodone intake, slowly allowing your body to get used to smaller and smaller amounts of the opioid.
However, this is not easy for people who are physically or psychologically dependent on hydrocodone, and the temptation to resume standard use will be very strong.
One way to counter this risk is to detox from hydrocodone with the assistance of a trusted and knowledgeable friend or family member who can provide moral support during the process and ensure you stay away from hydrocodone or other drugs during withdrawal.
Since you won’t have the benefit of intravenous drips for hydration and nutrition, you will have to be supplied with sufficient hydrating fluids. It is imperative that you maintain the ideal balances in your body during the ordeal of withdrawal. Some sugars and sweet foods are acceptable, but your main focus is nourishment.
Don’t eat anything that might induce nausea or vomiting, such as heavy or greasy foods. It might be necessary to use supplements to ensure your body is getting the right nutrients and resources until your digestive system is settled enough to move onto more comfortable and familiar food.
Over-the-counter medications will counter some of the more difficult parts of withdrawal (Imodium for diarrhea or Dramamine for nausea), but even these drugs will have to be taken carefully. The body is in recovery during withdrawal, and too much of these medications can cause unwanted side effects. Additionally, these medications can have negative interactions with any other drugs that are still in your system, so you should not take them until you are absolutely sure they are safe to consume.
It is still imperative that you address the loss of fluids and nutrients that arises from the diarrhea and vomiting of withdrawal. Not doing so will weaken your body to the point where another complication could cause serious problems.
It is also is essential that you be as comfortable as possible as you withdraw from hydrocodone dependence. As your body goes through significant changes, you will need a way to occupy yourself. This could mean anything from brief, light exercise to getting some fresh air and sunshine, small amounts of chocolate (dark chocolate is best), or watching a funny video for the laughs
All these actions (and many more) will boost your body’s endorphins, natural chemicals that interact with the opioid receptors in the brain to help with mood and pain regulation.
Endorphins are, in effect, the body’s own opioids. As you adjust to not having the opioid molecules in hydrocodone anymore, doing things to stimulate endorphin production will help your body reset itself and counter the stress of withdrawal.
Although hydrocodone withdrawal is not usually lethal, you should nonetheless be ready to call 911 (or have someone do it for you) if there are any medical complications that make the process take a turn for the worse.
You should be ready to do this if you experience dehydration, malnutrition, rapid heartbeat, or breathing problems, or if there is a danger of relapsing when the craving symptoms reach their apex (usually around the third day of the weeklong ordeal).
If you follow these guidelines, you should have a good chance of safely withdrawing from hydrocodone, but you will also need therapy and aftercare support to ensure your long-term recovery from hydrocodone dependence. Treatment centers are good places to get connected with the services that will help you in your recovery.
If you are worried about how long you can stay in any program, speak with an addiction specialist at Delphi Behavioral Health Group at (844)-208-4761. We can help you manage resources so you get the best combination of treatment approaches available.
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