Oxycodone vs. Hydrocodone: Similarities, Differences, Strength

The opioid epidemic has been at the forefront of our nation for the past three decades, and the number of drug overdose deaths has quadrupled since 1999. In 2019, an estimated 70 percent of overdose deaths involved an opioid. For the first time in our history, overdose deaths exceeded 100,000 people in 2021.

The opioid overdose crisis stems from overprescribing opioids like oxycodone and hydrocodone in the late 1990s and early 2000s. Although both are considered potent opioids, there are many differences. This article will examine oxycodone vs. hydrocodone to better understand their similarities, differences, and strengths.

The Opioid Crisis

As mentioned above, the opioid crisis came in three waves. The first wave was in the late 1990s when the pharmaceutical industry convinced doctors that drugs like OxyContin were not addictive. While it was well-intentioned and meant to improve pain, pharmaceutical companies preyed on those in pain. It all started in 1995 when the American Pain Society launched a campaign to monitor pain the same way as heart rate and blood pressure. Before the epidemic, opioids were mainly used for pain relief after surgery or for those with cancer. However, the United States believed opioids would be safer than previously thought.

OxyContin swept the nation, which is an extended-release version of the decades-old medication called oxycodone. Oxycodone has always been a powerful opioid, but OxyContin genuinely helped those in pain. Unfortunately, it was soon found that people were becoming addicted and requiring more to achieve their desired effect. Doctors were also prescribing hydrocodone at a rapid clip.

Eventually, the government realized the dangers of opioids, which led to a new round of restrictions on the medication. Doctors weren’t willing to lose their licenses to prescribe the drugs anymore, and addicts moved from doctors to the street. It led to the rise of heroin addiction, which was a cheaper and more potent alternative in the 2010s. Eventually, fentanyl swept the scene and caused massive destruction nationwide. Today, the fentanyl crisis rages on, and people might forget it all stemmed from drugs like oxycodone and hydrocodone.

What Is Oxycodone?

Oxycodone is an extremely potent prescription opioid used to treat moderate-to-severe pain. It’s only prescribed by physicians when other pain medications do not work or cannot be tolerated. It belongs to a group of drugs known as narcotic analgesics. Oxycodone produces effects on the central nervous system (CNS) to relieve pain. It’s considered one of the stronger opioids available to treat pain. It should not be used to treat the pain you have once in a while or as needed and should not be prescribed by physicians when you’re recovering from surgery for a short period.

When oxycodone is used for prolonged periods, it will likely cause tolerance. The drug is also habit-forming, leading to mental or physical dependence. However, those with excessive or prolonged pain should not let the fear of dependence stop them from using medication to relieve their pain. Only a doctor can determine if the benefits outweigh the risks. Mental dependence is unlikely to occur when used for this purpose. Physical dependence can lead to withdrawal symptoms if treatment is stopped abruptly. Severe withdrawal symptoms can be mitigated by gradually reducing the dose before treatment is halted altogether.

What Is Hydrocodone?

Hydrocodone is another potent prescription opioid used to treat pain in opioid-tolerant patients that require around-the-clock pain relief. Like oxycodone, it shouldn’t be used if you need pain medication for a short period. It should not be used to treat mild pain or pain that occurs once in a while. Hydrocodone belongs to the same class of drugs that act on the central nervous system (CNS) to relieve pain. As an opioid, it can become habit-forming, especially when abused. While it’s not considered as potent as oxycodone, it can be highly addictive when the individual doesn’t follow their doctor’s orders.

Below, we’ll examine the similarities, differences, and strengths of the two medications.

Oxycodone vs. Hydrocodone: Similarities

As mentioned above, oxycodone and hydrocodone are prescription pain medications prescribed for long-term pain in opioid-tolerant patients. They might also be prescribed in the event of chronic cough, arthritis, and pain from cancer. Both medications can be taken alone. However, you might also find combination versions of each drug.

For example, acetaminophen is commonly used with hydrocodone and oxycodone to provide additional pain relief. These drugs, known as Percocet and Vicodin or Norco, make a specific narcotic analgesic. It can calm a person’s mood and allow the painkiller some extra time to work. Hydrocodone is sometimes used in conjunction with antihistamines to create cough syrup that suppresses the cough reflex. It also provides pain relief from excessive coughing.

Which Is Stronger?

On paper, these drugs are very similar. However, there are some key differences. One distinct difference is the potency. Despite them both being Schedule II drugs, oxycodone is 50 percent stronger than hydrocodone. However, long-acting versions of hydrocodone can last longer than extended-release oxycodone. The reason for this is the half-life, which refers to how long it takes your body to clear half of a single dose.

The half-life of hydrocodone is seven to nine hours, while oxycodone is only 4.5 to 5.6 hours. Although oxycodone is more potent than hydrocodone, it doesn’t translate to better pain control. Hydrocodone and acetaminophen are as effective in treating pain as oxycodone.

Differences in Side Effects

Although oxycodone is considered the stronger of the two, they both produce similar side effects to each other and other opioids. These include the following:

  • Nausea and vomiting
  • Constipation
  • Dizziness
  • Sedation
  • Lightheadedness
  • Insomnia
  • Itching
  • Headache
  • Weakness
  • Dry mouth
  • Motor skill impairment
  • Lethargy
  • Shallow or light breathing

Oxycodone is more likely to lead to dizziness, drowsiness, and fatigue. It can also cause headaches and extreme euphoria. Hydrocodone is more likely to cause stomach pain and constipation. Severe but less common side effects of these two drugs include:

  • Seizures
  • Painful urination
  • Confusion
  • Feeling like you might pass out
  • Rapid heartbeat that causes heart failure

Which Medication Is Right for You?

Both drugs are extremely effective at treating acute and chronic pain. Unfortunately, each drug’s reputation has been dragged through the mud. The opioid crisis has been a stain on our society and how these medications are viewed. In most cases, chronic pain patients bear the brunt of the crisis as they’re less likely to receive access to medicines. However, the differences between the two are minimal, and choosing the right one for you is a decision you and your doctor must have. They might determine neither drug will be effective for your pain.

A doctor will base their decision on your personal medical history. They likely will weigh the pros and cons of these medications and discuss their addictive tendencies. Since researchers and medical professionals find hydrocodone less powerful compared to oxycodone, they might start you on hydrocodone first to see how your body tolerates the drug. If it doesn’t work, they might consider something stronger. If it does work, they’ll find a dose that’s right for you.

Dependence and Addiction

While these drugs effectively treat pain, the risk of addiction and dependence is real. This is why doctors will discuss the pros and cons before prescribing to make sure you understand the reality. Opioid medication creates a pleasurable response in the brain that triggers the reward system. When this occurs, it’ll rewire the brain to want opioids over anything else. You’ll start taking more and more to keep this feeling going.

Dependence differs from addiction in that it can occur independently from it. Dependence is the result of your body taking a drug; it no longer feels normal without its presence in your system. When you’re dependent on oxycodone or hydrocodone, your body will develop withdrawal symptoms. When you’re addicted to one of these drugs, you’ll start taking more than you need and go through prescriptions faster than you get them. You might also engage in risky activity to get more of the drugs, which can put your job, family, or life in jeopardy.

If you exhibit any of these symptoms, you must speak to your doctor right away. They’ll consider changing your dose or cutting you off altogether.

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