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Hydrocodone & Addiction

Hydrocodone is an opioid painkiller prescribed to treat short-term pain, such as after a surgery or procedure. However, due to its euphoric and relaxing effects, this medication has the potential for abuse, dependence, and addiction.

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What Is Hydrocodone?

Quick Answer

Per the National Library of Medicine, hydrocodone is one of the most common pain medications doctors prescribe, and it’s one of the most frequently abused drugs by patients.[1]

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. 

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Hydrocodone is normally sold as a short-acting opioid, meaning that it has a rapid onset of effects, relieving pain, but these effects also wear off relatively quickly. Drugs like this are dangerous, as the whipsaw between intoxication and sobriety causes intense brain cell harm. 

Newer medications (like Zohydro) contain hydrocodone in an extended-release capsule, offering relief for longer periods. It contains no features to deter abuse, so experts consider it very dangerous. 

Chemists package hydrocodone in pill form, often combined with anti-inflammatory medications (like acetaminophen). People who misuse the drug do so by:

  • Taking higher or more frequent doses than prescribed
  • Crushing and snorting the pills
  • Injecting them
  • Mixing them with other substances

Key Facts About Hydrocodone

Key Facts

  • The economic toll of the opioid addiction crisis, fueled by medications like hydrocodone, cost Americans nearly $1.5 trillion in 2020 alone.[2]
  • 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.[3]
  • 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.
  • 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.[4]
  • In the United States alone, 3 million people are struggling with opioid use disorder.[5]

Types of Hydrocodone

Hydrocodone refers to the generic name of the opioid painkiller. Several brand-name versions exist, including the following:

  • Vicodin: Tablets contain hydrocodone and acetaminophen. Hydrocodone doses in tablets range from 2.5 mg to 10 mg.
  • Norco: Norco contains hydrocodone and acetaminophen. Hydrocodone doses in tablets are typically 5 mg.
  • Lortab: Lortab tablets contain a combination of acetaminophen and hydrocodone. Tablets contain hydrocodone doses from 5 mg to 10 mg.
  • Zohydro: Tablets contain an extended-release form of hydrocodone in doses from 10 mg to 50 mg.

History & Statistics

Hydrocodone first entered the medical field in the 1920s. But it wasn’t until the early 2000s, when pharmaceutical companies began aggressively marketing opioid painkillers to doctors, that the opioid crisis began. 

In 2013 alone, doctors dispensed more than 136.7 million prescriptions for pills that contained hydrocodone. But when doctors realized that their patients were abusing their medications instead of getting relief from them, things changed. In 2018, prescriptions dropped to 70.9 million. That number continues to fall.[6]

While people who abuse hydrocodone may feel trapped, treatment works. With the proper treatment plan, many people with addiction recover.

Potential for Abuse: How Addictive Is Hydrocodone?

Hydrocodone is an opioid, which is what makes it so incredibly 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. 

Causes & Risk Factors for Hydrocodone Addiction

Why do some people develop an addiction to drugs like hydrocodone and others do not? Researchers say several risk factors are involved, and they all play a part in the dangers of taking these drugs. 

Biology 

Genes can influence how many opioid receptors are in your brain and how powerful each dose feels. Those factors could raise your risk of developing an addiction after you take just a few opioid painkillers. 

Environment 

Growing up in households where opioid abuse is common can normalize the behavior and make you more likely to experiment with drugs. Living with someone who abuses opioids as an adult can also normalize substance abuse. 

Social 

Friends and family members can push opioids as a solution to common problems. Your first exposure to drugs could be the one that leads to addiction. Going to parties fueled by drugs can have the same effect. 

Psychological 

Some people use opioid drugs to ease difficult feelings like anxiety, depression, or stress. These underlying mental health factors could increase your risk of addiction after using opioid drugs.

Side Effects: How Hydrocodone Affects the Body 

Opioid use is associated with a variety of health concerns, including some that can be life-threatening. Some complications appear with short-term use, and others are more likely in people who use the drug for the long term. 

Short-Term Effects

Hydrocodone can affect the body in a number of different ways, including the following:[1],[6]

  • Dry mouth 
  • Foot, leg, or ankle swelling
  • Headaches
  • Ringing in the ears 

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 Effects 

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

Other known effects of hydrocodone abuse include the following:[1]

  • Collapsed veins due to injecting drugs
  • Nasal and mouth problems due to inhaling drugs 
  • Liver damage due to acetaminophen exposure and poisoning 

Some people who abuse hydrocodone move on to stronger drugs, such as heroin or fentanyl. These substances come with high risks of overdose and death. 

Combining Hydrocodone With Other Substances 

Hydrocodone is a powerful substance, and it can be even more dangerous when mixed with other addictive drugs. These are among the most dangerous combinations:

  • Hydrocodone and alcohol: Mixing two sedating drugs like alcohol and hydrocodone can lead to intense sedation, slowed breathing, and overdose deaths. 
  • Hydrocodone and Xanax: Benzodiazepine drugs like Xanax can slow breathing and raise the risk of overdose from hydrocodone. 
  • Hydrocodone and marijuana: Combining marijuana and hydrocodone can lead to a worsening of your opioid abuse issue. Marijuana lowers your inhibitions and ability to make good decisions. 
  • Hydrocodone and cocaine/stimulants: Hydrocodone and stimulants put pressure on your heart and cardiovascular system, potentially leading to a heart attack. 

Signs & Symptoms of Abuse: What to Look Out For 

Hydrocodone abuse can trigger symptoms that can be split into three classifications. Understanding what they are can help you learn when someone you love needs help.

Physical Symptoms

People who abuse hydrocodone often seem sleepy, slow, or sedated when they’re high. They may drop into and out of sleep with a distinctive head-bobbing motion people refer to as being on the nod.

People who inject hydrocodone may have needle marks on their arms and legs. Those who snort the drug may have frequent nosebleeds or sniffles. 

Mental Symptoms

Hydrocodone and other opioids are sedating drugs, so people often seem foggy and slow. They may not remember conversations held recently. They may seem unusually happy or pleased while high. When the drug wears off, they may be worried about finding another dose. 

Behavioral Symptoms

Secrecy and an intense need for privacy are common in people who abuse hydrocodone. The person may withdraw from friends and family to use drugs. Frequent absences from work or school are common too.

Physical SymptomsMental SymptomsBehavioral Symptoms
Unexplained sedation, including episodes of being on the nodSedation or mental dullnessIncreased isolation and a need for privacy
Needle marks on the arms and legs, or frequent nosebleeds and sniffles Anxiety or nervousness between doses Withdrawing from friends and family 
Withdrawal symptoms, such as diarrhea or anxietyUnexplained happiness while intoxicated Poor performance or frequent absences from work and school 

Overdose Risk

With repeated use, brain cells become accustomed to hydrocodone. Larger doses are required to deliver intoxication. Overdose risks rise as the abuse continues. 

Signs of hydrocodone overdose include the following:[8]

  • 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. 

Even if you are uncertain if the person is experiencing an opioid overdose, administer naloxone. There is no negative effect of doing so, and you could save the person’s life. 

Further medical treatment is needed even if the overdose is reversed. Wait for emergency personnel to arrive or take the person to a hospital.

Hydrocodone Withdrawal Symptoms & Detox 

People who abuse hydrocodone will feel sick without it. Some people develop mild withdrawal symptoms between doses. Others develop intense symptoms when they try to reduce their doses or quit cold turkey. 

Acute hydrocodone withdrawal is characterized by the following symptoms:[9]

  • 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. If cravings aren’t addressed, relapse is likely.

Treatment Options

People with hydrocodone addictions have several available treatment options. With the right program, people can get better and build a healthy life. 

Inpatient Rehab

It’s difficult to recover from hydrocodone addiction when surrounded by temptation. An inpatient rehab program for Hydrocodone allows you to move away from your home and into a facility that provides around-the-clock care.

Inpatient programs can be particularly helpful during detox. Quitting cold turkey can lead to intense withdrawal symptoms and relapse for relief. An inpatient program can provide medications to ease the transition. 

Medication-Assisted Treatment (MAT) 

Brain cells altered by hydrocodone respond to medications that mimic opioids. Several FDA-approved opioid abuse treatment therapies exist:

  • Buprenorphine: This weak opioid antagonist latches to receptors used by hydrocodone, easing withdrawal without causing intoxication. 
  • Methadone: This stronger opioid medication can control withdrawal in people accustomed to very large doses of hydrocodone. 
  • Suboxone: This medication contains buprenorphine for withdrawal relief and naloxone for abuse protection. Suboxone can be used as a take-home medication. This ease of use makes it a popular choice for MAT.
  • Naltrexone: Naltrexone is an injectable medication that can’t lessen withdrawal, but it can block euphoria during relapse. 

Behavioral Therapy 

Counseling helps people build relapse prevention skills and healthy habits to sustain a long-term sober life. 

Many addiction treatment programs use cognitive behavioral therapy (CBT) to help people examine the thoughts that drive their behaviors. Some also use family therapy to help people repair relationships damaged by addiction. 

Researchers say people treated with medication are more likely to remain in therapy than those who are not.[7] Combining medications and therapy is deemed a whole-person approach to addiction. For opioid use disorder, MAT is widely considered the gold standard in treatment.

Frequently Asked Questions About Hydrocodone

We’ve compiled some of the most frequently asked questions about hydrocodone.

Does hydrocodone make you sleepy?

Yes. Hydrocodone is a central nervous system depressant, so it does cause sedation.

How long does hydrocodone stay in your system?

It depends. Some hydrocodone formulations are short-acting and move out of your body within a few hours. Others are made to stay in your body for longer periods.

How addictive is hydrocodone?

Hydrocodone, like all opioids, is very addictive. The drug latches to brain cells and produces powerful euphoria that some people spend the rest of their lives trying to recreate.

What does hydrocodone look like?

It depends. The drug is typically packaged in white tablets, but every formulation looks a little different.

Does hydrocodone make you itch?

Some people experience itchy skin when taking drugs like hydrocodone.

Is hydrocodone an opioid?

Yes. Hydrocodone is a painkiller medication in the opioid class.

Is hydrocodone dangerous?

Hydrocodone is dangerous if misused. While the medication is very effective at managing pain, it should not be used outside of a valid prescription. Hydrocodone abuse can lead to overdose, which can be fatal.

Is it bad to take hydrocodone every day?

Opioid painkillers like hydrocodone are generally only prescribed for short-term use. If you feel you need to take hydrocodone for longer than prescribed, talk to your doctor about other pain management options.

Profile image for Dr. Alison Tarlow
Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated January 19, 2024
Resources
  1. Habibi, M. and Kim, P. Hydrocodone and acetaminophen. StatPearls. Published December 2022. Accessed June 20, 2023.
  2. Aboulenein, A. Opioid crisis cost U.S. nearly $1.5 trillion in 2020—Congressional report. Reuters. Published September 28, 2022. Accessed June 20, 2023.
  3. WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. World Health Organization. Published 2018. Accessed June 20, 2023.
  4. Drug Overdose Death Rates. National Institute on Drug Abuse. Published February 2023. Accessed June 20, 2023.
  5. Azadfard, M. and Huecker M. and Leaming J. Opioid addiction. StatPearls. Published April 29, 2023. Accessed June 20, 2023.
  6. Hydrocodone. Drug Enforcement Administration. Published October 2019. Accessed June 20, 2023.
  7. Effective treatments for opioid addiction. National Institute on Drug Abuse. Published November 2016. Accessed June 20, 2023.
  8. Opioid Overdose. Substance Abuse and Mental Health Services Administration. (2023).
  9. Shah M, Huecker MR. Opioid Withdrawal. [Updated 2023 Apr 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.
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