Hydrocodone is an opioid and is the active ingredient in many branded prescription painkillers such as Norco®, Lortab® and Vicodin®. Hydrocodone is commonly combined with acetaminophen, which is the active ingredient in Tylenol®. Together, these two ingredients work on different pain receptors in the body to minimize moderate to severe pain. Hydrocodone is one of the most commonly abused opioids, and like many prescription opioids, is overprescribed.
Hydrocodone Use Disorder
According to the Drug Enforcement Administration, hydrocodone is the most overly prescribed opioid in the United States. Doctors may prescribe a hydrocodone-based medication after a tooth extraction or minor procedure to help relieve some of the pain without realizing the high addiction potential it can cause. Hydrocodone can harvest substance use disorder side effects in as little as five days, and as a result, the risk for developing a chronic hydrocodone use disorder increases significantly.
Hydrocodone not only suppresses pain but also causes euphoria, and this sense of extreme happiness commonly leads to the desire to use more of the drug. The same receptors in the brain that result in pain suppression are also responsible for the euphoric high. When individuals try to reduce the amount of hydrocodone they are taking, they may experience withdrawal side effects and crave this drug even more.
Prescription opioids are often viewed as safe because they are coming from a physician. This false misconception has caused many teenagers and adults to become unintentionally addicted. When individuals who are addicted to hydrocodone can no longer receive hydrocodone prescriptions, they often turn to the streets to buy this drug illegally or turn to heroin. Hydrocodone use disorder often results in unintentional overdose and can wreak havoc on your personal and professional life. Individuals may go to extreme measures to obtain hydrocodone, in an attempt to avoid withdrawal symptoms and to chase the euphoric high.
Signs and Symptoms of Hydrocodone Intoxication
- Excessive drowsiness
- Pinpoint pupils (meiosis)
- Slurred speech
- Respiratory depression (shallow and short breathing)
- Track marks on skin or fresh puncture wounds
- Weight loss
- Mood swings
Withdrawing from hydrocodone and all other opioids can be extremely uncomfortable and even painful. Withdrawal symptoms are one of the main reasons why it is so difficult to quit using hydrocodone. Quitting cold turkey is not recommended, as many individuals will relapse because of the withdrawal side effects. Physical withdrawal symptoms from hydrocodone usually peak between 24-48 hours after the last dose of hydrocodone and can continue for approximately one week.
Signs and Symptoms of Hydrocodone Withdrawal
- Muscle aches
- Bone pain
- Severe sweating
- Excessive tearing and runny nose (lacrimation and rhinorrhea)
- Abdominal pain
Seeking Help for Hydrocodone Use Disorder
Medication-assisted treatment (MAT) uses medications to ease the withdrawal effects of certain addictive substances such as hydrocodone. MAT has been proven to lessen withdrawal effects, prevent future cravings and reduce relapse rates. Three FDA-approved medications can be given for hydrocodone use disorder to help prevent withdrawal symptoms. These medications include methadone, buprenorphine (the main ingredient in Suboxone) and naltrexone.
The first step in hydrocodone treatment is to undergo detoxification in a safe and calm environment under supervision. Medications are administered to help prevent withdrawal symptoms, and once you are no longer in danger of acute withdrawal, these medications are continued but at a lower dose. Patients may continue these medications for many months, and some patients may even stay on methadone or buprenorphine for years.
Methadone, Buprenorphine, and Naltrexone
Methadone and buprenorphine can help relieve pain without inducing the opioid-like euphoric state. These medications are opioid based that can result in physical dependence but are fundamentally different and much less dangerous than hydrocodone.
Naltrexone is not opioid-based and, therefore, does not have the potential for physical dependence. Naltrexone will cause opioid withdrawals in the presence of hydrocodone, and as a result, you must be opioid-free for at least 7-10 days before you can begin taking naltrexone. Naltrexone helps with opioid treatment by decreasing the reinforcing reward of prescription painkillers and also helps by reducing hydrocodone cravings.
Psychotherapy should always be combined with MAT because psychotherapy is known to uncover any underlying triggers associated with hydrocodone abuse. Psychotherapy also helps you adopt positive coping skills to guide you throughout your recovery. Cognitive behavioral therapy (CBT), dialectal behavior therapy (DBT), interpersonal therapy and family therapy are all psychotherapy techniques. It is also highly recommended to attend a community support group such as Narcotics Anonymous and to continue outpatient therapy regularly.