In the U.S. in 2016, it was reported that about 11.5 million people, at least 12 years old, misused hydrocodone at least one time in the prior year, according to the U.S. Drug Enforcement Administration. Hydrocodone is an opioid just like heroin and oxycodone, so there is a high potential for abuse. Being informed about this drug and its potential effects can help people know when they need help to overcome hydrocodone abuse or addiction.
Hydrocodone is an opioid that may come alone or be combined with other pain medications, such as acetaminophen. This drug is prescribed for pain and to help stop a cough.
Like other opioids, hydrocodone is widely misused and abused. The risk of overdose is present when someone misuses this drug.
Like all medicines, side effects can occur when taking this medicine. The most common side effects include lightheadedness and dizziness. Other side effects that are not uncommon, according to MedlinePlus, are:
Side Effects Of Hydrocodone
- Stomach pain
- Back pain
- Frequent, painful, or difficult urination
- Trouble sleeping
- Part of the body shaking uncontrollably
- Dry mouth
- Muscle tightening
- Ringing in the ears
- Swelling of the leg, ankle, or foot
Specific side effects are considered more serious. If these occur, the person needs to seek medical attention immediately:
- Chest pain
- Trouble swallowing or breathing
- Nausea, dizziness, vomiting, weakness, or appetite loss
- Itching or hives
- Erection difficulties
- Changes in heartbeat
- Menstruation irregularities
- Reduction in sexual desire
- Swelling of the head or neck
- Severe twitching or stiffness of the muscles
- Coordination loss
If you experience any of the above effects, notify the prescribing doctor immediately or call 911.
Abuse and Addiction Potential
Like other opiates, this medication produces its effects when it binds to opiate receptors in the brain and body. When someone uses this drug in increasing amounts, they can develop a tolerance to it. This means they have to keep increasing the dosage if they want to achieve the same effects.
Hydrocodone is a Schedule II drug that can lead to psychological and physical dependency, especially when it is misused, according to the National Institutes of Health. The Schedule II designation of this drug highlights the potential for abuse despite its positive medical uses.
It can result in dependence even with legitimate medical use. As a result, most doctors will only prescribe hydrocodone for short-term use. Alternative pain management methods are preferred over long-term opioid use.
When someone has been taking hydrocodone for an extended period, doctors will work to slowly wean them off the substance rather than stopping it suddenly. If the drug is stopped suddenly after dependence has formed, withdrawal symptoms will likely start. These can be highly uncomfortable and often motivate the person to return to taking the drug, which is known as relapse.
Recreational hydrocodone use can result in heightened feelings of well-being and euphoria. These feelings are associated with the reward center of the brain, and they compel continued use. As the person continues to use the drug, dependence begins to take hold.
Once dependence has formed, the person often feels constrained to keep taking hydrocodone despite the adverse effects. If used recreationally, dependence can form incredibly quickly.
Since withdrawal can be so intense, it’s also recommended that those who abuse the drug recreationally do not stop their use suddenly. Instead, they should contact a physician or addiction treatment program for help safely weaning off the drug.
The Rise of Laced Hydrocodone
A 2016 U.S. CDC report highlights an outbreak in counterfeit Norco (hydrocodone and acetaminophen) pills between late March and early April of that year. Two people were admitted to the emergency room after taking counterfeit pills tainted with fentanyl and promethazine.
Fentanyl is known to be 100 times more powerful than morphine. It is not approved for use in pill form. It also works quickly in the nervous system. Promethazine is commonly used to make opioid highs more intense.
The U.S. Drug Enforcement Administration (DEA) issued a warning about fake pills that might be cut with fentanyl, as mentioned in The Guardian in July 2016. Not only did this warning cover hydrocodone, but it also addressed other popular prescription medications that are often abused, such as Xanax, oxycodone, and Valium.
The U.S. DEA mentioned that prescription drug counterfeiters often use pharmacy-grade machines that can make street versions of these medications look similar to the real thing.
A Rolling Stone article from August 2018 mentions two possible explanations for why fentanyl is found in so many street drugs.
- Illegal Profit: Dealers use fentanyl to cut costs and sell counterfeit pills at a high price.
- Cross-contamination: Dealers are not careful when they separate their merchandise, and fentanyl could be entering these substances by accident because of poor cleanup.
Taking too much hydrocodone puts people at risk for an overdose. The potential for overdose is influenced by many factors, such as a person’s health, other personal factors, the dose taken, and whether any other substances are taken at the same time.
According to the Mayo Clinic, overdose symptoms can include:
- Cloudy or bloody urine
- Chest discomfort or pain
- Reduced responsiveness or awareness
- Feeling generally ill or uncomfortable
- Irregular heartbeat
- Loss of consciousness
- No muscle movement or tone
- Severe sleepiness
- Unpleasant breath odor
- Change in consciousness
- Clammy and cold skin
- Extreme drowsiness
- Increased sweating
- Dizziness, lightheadedness, or fainting
- Breathing cessation
- Sudden reduction in urinary output
Death is possible when someone overdoses on this drug. If someone is experiencing an overdose, call 911 immediately. Prompt medical attention could save their life.
With continued opioid abuse, various adverse effects will take hold. These include difficulties in relationships, at work or school, financially, and in regard to health. While addiction’s effects can be devastating, there is hope in comprehensive addiction treatment. With effective care, people can leave opioid abuse in their past and embrace a vibrant life in recovery.
Once someone goes into treatment for hydrocodone addiction, they typically start with the detox phase. This is a medically assisted process for opioid dependence, so professionals are available to help clients through it. There are certain medications, such as buprenorphine, that might be administered during the process to reduce withdrawal effects, according to the National Institute of Drug Abuse.
There is a lot of research on the efficacy of buprenorphine. In fact, in Baltimore, a study looked at how this detox medicine could help to reduce heroin-related overdose deaths, which is an opiate similar to hydrocodone. Buprenorphine did this by reducing instances of relapse. The study concluded that there was a 37 percent reduction in the overdose deaths associated with heroin, according to the research published in the American Journal of Public Health.
“While detox is essential, it’s not enough on its own. It must be followed with therapy. A person may decide to get treatment while still maintaining their regular schedule at an outpatient facility. This requires that they have a strong support system at home. There are also inpatient facilities where clients live on site while they are receiving treatment. This allows total focus on recovery during this time.”
Clients usually participate in different forms of therapy once they enroll in a treatment program. These work to help people find support, get to the root of their issues, and make positive and productive choices in their lives.
While hydrocodone can be a useful medication for those who experience pain after surgery or an injury, it is frequently abused. Here are some answers to commonly asked questions about the drug.
How Do People Use Hydrocodone?
Hydrocodone comes in the form of a tablet. The color, shape, and size depend on the brand that someone receives from the pharmacy. There are many brand names for hydrocodone, such as Norco, Vicodin, Hycet, Lorcet, and Zamicet.
When used legitimately, people simply take the tablets as prescribed by their doctor. When abused, people who don’t have a prescription may take the pills, or people may take doses that are higher than prescribed. Some people crush the pills down into a powder so that they can snort the resulting substance.
While less common, it is also possible for someone to inject hydrocodone. They crush the pills and then mix them with water, resulting in a solution that can be injected. There is a pill that is pure hydrocodone, which is referred to as Zohydro, that people might use for injection purposes.
How Long Does It Take the Body to Process Hydrocodone?
The exact length of time this drug stays in someone’s system ultimately depends on several factors. Among them are:
- How much body fat a person has and their overall weight
- Their age
- How much of the drug they consumed
- Whether the person consumed other drugs or alcohol
- What else was in the stomach at the time of consumption
- Their metabolic rate
- How they took the drug, such as oral ingestion or snorting it
- The person’s overall liver or kidney function
Generally, the pain relief effects of hydrocodone can be felt for four to six hours. The drug and its metabolites remain in the body even after the effects have worn off, however.
How Long Can It Be Detected on a Drug Test?
Different types of drug tests can detect hydrocodone for varying amounts of time.
Hydrocodone tends to stay in a person’s hair the longest. On average, hair testing can detect the presence of hydrocodone for about 90 days, according to information presented by Drug and Alcohol Dependence.
The other ways to test for hydrocodone usually cannot detect this drug for as long because it has a short half-life. For example, if someone submits to saliva testing, this test can only detect the presence of hydrocodone for about 12 hours to 36 hours.
Hydrocodone may stay in the urine for two to four days, according to the Substance Abuse and Mental Health Services Administration. In most cases, when a test is done for hydrocodone, it is urine that is used to look for the presence of this drug.
Blood tests are generally not used to look for hydrocodone in the body. This is because they are largely unreliable since the drug’s half-life is so short.
People who plan to go to a treatment facility for hydrocodone abuse or addiction will usually take a drug test when they start the intake process. It is common for additional testing to be administered throughout the program to ensure the person is staying sober.
“There aren’t many people can do to speed up the processing of hydrocodone. While various detox kits are sold online, their effectiveness is doubtful.”
What Are the Effects of Hydrocodone Withdrawal?
When someone is dependent on this drug, or addicted to it, they can experience withdrawal symptoms when they stop using hydrocodone. Withdrawal symptoms may include:
- Changes in blood pressure
- Fevers or sweating
- Difficulty sleeping
- Anxiety or feeling restless
- Rapid heart rate
- Vomiting or nausea
- Increased pain
The severity of withdrawal differs from person to person. It can be incredibly severe for some people but milder for others. Generally, those who have abused higher doses of hydrocodone or abused it for a longer time will experience more intense withdrawal symptoms.
What Is the Usual Withdrawal Timeline?
When someone stops taking this drug, they can start to experience withdrawal symptoms within about eight hours to 24 hours, according to information in the book Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. This is because this medicine is considered a short-acting opioid.
Once the withdrawal symptoms begin, they can last for four to 10 days, on average. However, it is possible to experience withdrawal symptoms to a lesser degree for several months. For example, a few months after someone’s last dose, they may experience a depressed mood or cravings for hydrocodone.
Since medication-assisted treatment is frequently used for opioid withdrawal, the overall withdrawal timeline will be extended. The symptoms of withdrawal are significantly reduced, however, and often, they are eliminated.
What Are the Long-Term Effects Associated with Hydrocodone Addiction?
Long-term use of any opioid, such as hydrocodone, can result in serious health effects. These include cardiovascular damage, respiration difficulties, chronic constipation, other gastrointestinal issues, and hormonal fluctuations.
In addition, addiction to any substance brings a range of serious effects. Eventually, hydrocodone use will become the primary focus of a person’s life to the detriment of one’s career, family, other relationships, and health. Without proper addiction treatment, it’s highly unlikely that a person will recover.
What Happens During a Hydrocodone Overdose?
When someone overdoses on hydrocodone, their body can’t handle the amount of the drug that is present. This can cause a variety of symptoms, such as respiratory depression. When respiratory depression occurs, a person can stop breathing.
When someone is not properly breathing, this can lead to either anoxia or hypoxia, both of which can lead to damage to the brain, according to the Cleveland Clinic. Anoxia refers to no oxygen getting to the brain. Hypoxia refers to insufficient oxygen getting to the brain.
The longer a person’s brain is without oxygen, the more damage can occur. This also affects how likely a person is to make a full recovery from this event. During the recovery process, the following are possible:
- Muscle twitches and spasms
- Personality regression
- Memory loss
Can You Overdose on Acetaminophen?
Many forms of hydrocodone also have about 325 mg (milligrams) of acetaminophen in each tablet. This means that someone can overdose on the acetaminophen component, either with the hydrocodone or separately.
The recommendation is that no one should take more than 4,000 mg of this medicine in 24 hours, according to MedlinePlus. Symptoms of an acetaminophen overdose may include:
- Upset stomach
- Vomiting and nausea
- Abdominal pain
- Appetite loss
How Do Healthcare Professionals Treat a Hydrocodone Overdose?
Naloxone is typically given to reverse the effects of an overdose because hydrocodone is an opiate. Sometimes multiple doses are needed to effectively reverse the overdose. Further medical treatment is needed in addition to naloxone.
The person will generally be placed on their side to reduce the risk of aspiration. When aspiration occurs, stomach contents come up through the esophagus, but if the person is lying on their back, they may breathe these contents into their lungs. This could lead to choking and pneumonia in some cases, according to American Nurse Today.
If the person was having difficulty breathing, oxygen or ventilation might be provided. Keeping the person hydrated and addressing any specific overdose symptoms they might be experiencing are also standard treatment.
What Are the Common Treatments for Addiction?
Once a person is ready for treatment, they will typically start with the detox process. Detox should be medically supervised, and it often involves the use of replacement medications, such as buprenorphine, to ease withdrawal. It is then followed with comprehensive therapy.
People can choose an inpatient or an outpatient facility, depending on their preferences and needs. Both facilities offer similar treatment regimens. The programs often include various types of therapy to help people identify why they became addicted so that they can work on developing positive coping mechanisms.
What Steps Should You Take to Choose a Treatment Facility?
Choosing the right facility is crucial. It is important that the facility can provide the client with everything they need to recover from their addiction and maintain their general health. Looking at the programs the facility offers is the best place to start. Assess whether the facility appeals to you and its overall success in treating people who struggle with opioid addiction.
From there, people should explore the financial details and location of the facility. Most private rehab centers take insurance, so check with the facility and your provider to see how insurance can offset your out-of-pocket costs. Also, consider the location of the center, particularly if you want family and friends to be able to visit you easily.