Hydrocodone Addiction

Hydrocodone is an opioid and has a serious abuse and addiction risk if not used carefully. It can cause physical dependence, resulting in withdrawal if you stop taking it suddenly. Misuse of hydrocodone can result in a deadly overdose. 

What Is Hydrocodone?

Hydrocodone is an opioid painkiller that is used to treat severe pain for individuals who need around-the-clock pain relief. Because opioids have significant abuse and addiction potential, hydrocodone is generally only prescribed when alternative medications won’t provide needed relief. 

If you’re prescribed hydrocodone, it’s important to use it only as prescribed. Opioids have legitimate medical uses, but they can also do serious harm if misused. 

Always talk to your doctor before taking this medication with any other drug, including recreational drugs like alcohol. Mixing opioids with certain other drugs can increase a person’s overdose risk and have serious health consequences, even including death.

Key Facts About Hydrocodone

Here are some key facts about hydrocodone and other opioids:

• Hydrocodone is about two-thirds as potent as morphine, another opioid that is commonly used as a comparison point for the potency (strength) of different opioids.
• The United States and many other parts of the world are in the middle of a long-lasting opioid abuse epidemic, with prescription opioids like hydrocodone contributing to over 15,000 deaths most years.
• According to DEA documentation, hydrocodone is the second most frequently encountered opioid pharmaceutical submitted as drug evidence at both a federal and state level.
• Even when used as prescribed, opioids can often cause physical dependence, meaning you will go through withdrawal if you suddenly stop taking them. If you have been taking hydrocodone for a while, you should work with your doctor to taper your dose, so you can reduce or completely avoid withdrawal symptoms.

What Makes Hydrocodone Addictive?

Hydrocodone is an opioid, a fact that is important when understanding how it can be addictive. 

The primary way opioids affect us is by attaching to opioid receptors on the surfaces of certain neurons throughout the brain and body. As opioids reduce feelings of pain, they also trigger a biochemical process that makes us feel rewarded. This process is normally activated for activities that promote life functions like eating. 

With repeated use, opioids essentially hijack the brain’s reward system, which “rewires” itself to adjust for the reward process opioids repeatedly send it through. This rewiring can cause physical dependence, as the brain expects the presence of opioids. 

If opioid use stops suddenly, uncomfortable withdrawal symptoms will occur until the brain can reacclimate to the body’s “normal” state. When opioids are used in the absence of pain or not as prescribed, they can reinforce this reward system, quickly leading to addiction. 

Signs & Symptoms of Hydrocodone Abuse

When a doctor is considering diagnosing a patient with opioid use disorder (OUD), which a hydrocodone addiction would fall under, they check to see if at least two of the following criteria can apply to the patient within a 12-month period:

• The individual has taken larger amounts of opioids or taken them over a longer period than intended.
• They have a persistent desire, or have made efforts, to cut down on their opioid use but have been unable to do so.
• They spend a significant amount of time trying to get opioids, use opioids, or recovering from the use of opioids.
• They have strong cravings to use opioids.
• Their opioid use has resulted in an inability to meet major obligations, like going to work or school.
• Their opioid use has caused social or interpersonal problems, or made existing problems worse.
• Opioid use has caused the individual to give up or reduce other social, occupational, or recreational activities that were important to them.
• The individual’s opioid use has resulted in physically hazardous situations.
• The individual knows opioids are causing significant physical or psychological problems, or making those problems worse, but continues to misuse opioids.
• The person has developed a tolerance for opioids, needing more to achieve the same effect as they previously had been experiencing with a lower dose.
• The individual enters withdrawal in the absence of opioid use.

How Hydrocodone Affects the Body & Mind

Hydrocodone can affect the body and mind in a number of different ways. Some of these have already been discussed, such as how it can help reduce severe pain and cause a sense of euphoria. It can also cause some side effects, including these:

• Back pain
• Difficult, frequent, or painful urination
• Difficulty falling asleep or staying asleep
• Dry mouth
• Foot, leg, or ankle swelling
• Headaches
• Muscle tightening
• Ringing in the ears
• Stomach pain
• Tiredness
• Uncontrollable shaking of a part of the body, such as the leg

Opioids are respiratory depressants, meaning they weaken your breathing and cause you to take in less oxygen. When the medication is used as intended and not mixed with any medications that strengthen this effect, it is generally not a major health concern. However, it becomes life-threatening if the drug is misused or a person has certain health conditions.

Long-term opioid use is associated with a variety of health concerns, including chronic constipation and problems related to sleep. 

Can You Overdose on Hydrocodone?

It’s possible to overdose on any opioid if enough is taken, with the risk of an overdose increasing if a person uses other drugs to try and enhance the effects of the opioid. The risk of overdose associated with opioids is one of the main reasons the opioid abuse epidemic is so concerning.

Again, opioids can suppress breathing. With enough use, it can become literally impossible to manually intake enough air to support the brain, which can cause a person to asphyxiate. This is the term for when the brain isn’t getting enough oxygen. It is extremely dangerous, potentially causing a person to go comatose, experience permanent brain damage, and even die. 

Overdose Symptoms

The following are the symptoms of an opioid overdose:

• Pale, clammy skin
• Limp or very weak body
• Inability to awaken or falling in and out of consciousness
• Severe confusion or an inability to speak
• Slowed or stopped heartbeat
• Slowed or stopped breathing
• Vomiting or gurgling noises

In the event a person is experiencing the above, consider it a medical emergency and call 911 immediately. If available, administer naloxone (Narcan), a drug that can counteract opioids and reverse an overdose.

Hydrocodone Withdrawal Symptoms

Acute opioid withdrawal is characterized by the following symptoms:

• Anxiety
• Back or joint pain
• Chills
• Diarrhea
• Fast breathing
• Goosebumps
• Irritability
• Loss of appetite
• Muscle pain
• Nausea
• Rapid heartbeat
• Restlessness
• Runny nose
• Stomach cramps
• Sweating
• Teary eyes
• Vomiting
• Weakness
• Widened pupils

After initial withdrawal has passed, a person will experience a longer, less intense withdrawal period where they will feel generally unwell and experience strong drug cravings. While this feeling will fade over time, it’s important to work with a medical professional during this period to keep drug cravings controlled so a person doesn’t relapse.

Treatment for Hydrocodone Addiction

Opioid addiction treatment, including hydrocodone addiction treatment, is generally some combination of inpatient and outpatient treatment. The exact treatment plan is best guided by a patient’s unique circumstances and needs. 

By working with an addiction treatment professional, a patient can participate in a variety of treatments, such as these:

• Individual therapy
• Group therapy
• Peer support and other support-building measures
• Treatment for co-occurring disorders, such as depression 
• Alternative therapies

Generally, medication-assisted treatment (MAT) that involves the use of methadone or buprenorphine is recommended to treat severe or long-term cases of opioid use disorder. Suboxone (a combination of buprenorphine and naloxone) is commonly used to promote long-term recovery. 

These medications keep withdrawal symptoms and cravings under control, so people can focus on the recovery process. People often remain on these medications for months or years as they build a strong foundation in recovery.

References

Hydrocodone. (January 2021). National Library of Medicine.

WHO Guidelines for the Pharmacological and Radiotherapeutic Management of Cancer Pain in Adults and Adolescents. (2018). World Health Organization.

Overdose Death Rates. (January 2022). National Institute on Drug Abuse.

Hydrocodone. (October 2019). Drug Enforcement Agency.

The Neurobiology of Opioid Dependence: Implications for Treatment. (July 2002). Science & Practice Perspectives.

Opioid Use Disorder: Diagnostic Criteria. The American Osteopathic Academy of Addiction Medicine. 

Opioid Overdose. (September 2022). Substance Abuse and Mental Health Services Administration.

Opioid Withdrawal. (September 2022). StatPearls.

Treatment Approaches for Drug Addiction. (January 2019). National Institute on Drug Abuse.

The Neurobiology of Opioid Dependence: Implications for Treatment. (July 2002). Addiction Science & Clinical Practice.