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Updated on September 30, 2021

Hydrocodone: Side Effects, Risks & Addiction

What is Hydrocodone?

Hydrocodone is a prescription medication that relieves severe pain. It is an opiate (narcotic) analgesic medication that works by interfering with the way the brain and nervous system sense pain.

Hydrocodone Addiction & Abuse

Hydrocodone is only used on an ongoing basis, for an extended time, after lower-level pain management options are unsuccessful. If used long-term, the drug can be habit-forming and cause mental or physical dependence.

Types of Hydrocodone

As well as Vicodin, other brand name versions of hydrocodone are Norco® and Lortab®. Each product contains hydrocodone and a non-opioid pain reliever, acetaminophen. Hydrocodone without acetaminophen sells under the brand name Zohydro®.

Some people with a hydrocodone addiction prefer a specific brand of the drug. However, all opioids have similar effects when consumed in large quantities, including morphine, codeine, and heroin.

Causes of Hydrocodone Addiction

Hydrocodone is an opioid in a type of drugs known as narcotic analgesics. These drugs link to proteins in the brain and spinal cord called opioid receptors. Opioids interfere with pain signals reaching the brain to adjust your perception of pain and your emotional reaction to it.

When used properly and for a short period, hydrocodone is typically safe and effective. Some people who begin taking hydrocodone for pain take it to achieve a euphoric and ecstatic feeling instead. As a result, they use it for longer than suggested or use larger quantities than their doctor prescribed.

Taking hydrocodone for long periods can build a tolerance to the drug. This means your body requires more of the drug to reach the same effects.

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Hydrocodone Side Effects

Hydrocodone comes with a black box warning, which is the most severe warning issued by the Food and Drug Administration (FDA). It alerts the medical community and consumers about a drug’s dangerous side effects and risks.

The most concerning side effect of hydrocodone is that it has a high risk of misuse and abuse. Hydrocodone is also addictive and can lead to overdose and possibly death.

Other side effects include:

  • Respiratory depression
  • Nausea
  • Vomiting
  • Lightheadedness
  • Dizziness
  • Constipation
  • Sedation

Less common side effects include:

  • Swelling
  • Upper respiratory tract infections
  • Muscle spasms
  • Urinary tract infections
  • Back pain
  • Tremor
  • Tachycardia
  • Chills
  • Hot flashes

Hydrocodone vs Oxycodone

Oxycodone is similar to hydrocodone. Both are opioid narcotic pain medications. It is safe to combine hydrocodone with acetaminophen, guaifenesin, and pseudoephedrine, which is not the case with Oxycodone.

Some of the side effects of Oxycodone are more serious than those of Hydrocodone and include:

  • Loss of energy or strength
  • Gastritis
  • Twitching
  • Anxiety
  • Confusion
  • Hiccups
  • Insomnia
  • Flatulence
  • Depression
  • Impotence
  • Dry skin
  • Dermatitis
  • Agitation
  • Seizures
  • Tinnitus
  • Urinary retention

Both medications impair judgment, alter thought processes, and decrease the ability to drive or operate machinery. Both have a risk for respiratory depression, especially for elder users or users with serious lung disease.

Oxycodone and hydrocodone, like all opioid medications, have a high risk of physical and psychological addiction. They are also highly regulated and illegal to misuse.

Drug Interactions

Hydrocodone has potentially life-threatening drug interactions. Mixing this medication with alcohol or benzodiazepines might cause excessive sedation, coma, and death. Hydrocodone is usually prescribed as a combination of hydrocodone and acetaminophen. Using hydrocodone with drugs metabolized in the liver might cause breathing problems. Liver failure can also occur.

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Addiction Symptoms

Hydrocodone addiction symptoms tend to vary from person to person. Some are also normal side effects of the medication. The most common symptoms of hydrocodone addiction include:

  • Blurred vision
  • Cold or clammy skin
  • Confusion
  • Depression
  • Dizziness
  • Fatigue
  • Fear
  • Headaches
  • Muscle weakness
  • Nausea
  • Ringing in the ears
  • Seizures
  • Slowed heartbeat
  • Vomiting

Hydrocodone Withdrawal

Stopping the use of hydrocodone can trigger several unpleasant symptoms. Medically supervised detoxification eases intense withdrawal symptoms early in the recovery process. This reduces the risk of relapse.

Common hydrocodone addiction withdrawal symptoms include:

  • Agitation
  • Anxiety
  • Chills
  • Diarrhea
  • Feeling of “skin crawling”
  • Flu feeling
  • Headache
  • Insomnia
  • Irritability
  • Muscle, bone, and joint aches
  • Nausea
  • Pounding heart
  • Restlessness
  • Runny nose
  • Stomach cramping
  • Sweating
  • Tremors
  • Vomiting
  • Watery eyes

Even low dose, long-term use of hydrocodone can trigger withdrawal symptoms. It also doesn’t matter if hydrocodone use was abusive or under the direction of a doctor, though abusing the drug does increase the risk of more serious withdrawal symptoms.

Withdrawal from hydrocodone and opioids, in general, is intense and fast. Hydrocodone withdrawal symptoms can start after 8 hours, but take longer for extended-release doses. Symptoms tend to subside in about a week. 

Hydrocodone Overdose Symptoms

There are many symptoms and signs that emerge when someone overdoses on hydrocodone.

Some of the more common hydrocodone overdose symptoms include:

  • Pupils so small they appear as pinpoints
  • Nausea
  • Vomiting
  • Stomach or intestinal tract spasms
  • Constipation
  • Drowsiness
  • Coma
  • Seizures
  • Weak pulse
  • Low blood pressure
  • Issues breathing
  • Stopping breathing
  • Slow, difficult, and/or shallow breathing
  • Fingernails and lips turning blue

Someone who experiences symptoms of hydrocodone overdose should seek emergency medical assistance. The overdose-reversal drug Narcan, or Naloxone, may be given.

Preventing Hydrocodone Addiction

The easiest way to prevent hydrocodone addiction is to take the medicine as your doctor prescribes. It would also help if you also recorded your pain in a diary while you take hydrocodone. Review your pain diary now and then to understand how you are progressing.

If you notice your pain is decreasing, let your doctor know. Do this even if your prescription has not run out. Your doctor may decide to reduce your dosage gradually and stop you from taking it sooner than planned.

If you start to crave the drug even when you feel little or no pain, speak with your doctor immediately. They can work with you to prevent you from developing a hydrocodone addiction.

Treatment Options for Opioid Abuse & Addiction

There are several options for people suffering from opioid addiction. These include:

  • Medication-Assisted Therapy (MAT) There are three medications approved to treat opioid use disorder: buprenorphine, methadone, and naltrexone. Buprenorphine and methadone can help you manage withdrawal symptoms throughout the detoxification process. Naltrexone is less commonly used, but it blocks your opioid receptors, making it impossible to get high. Medication-assisted therapy is most effective when combined with other forms of treatment.
  • Inpatient Programs — Inpatient programs are the most intensive and effective treatment options for opioid addiction. These programs guide you through medically supervised detoxification, then behavioral therapy and other services (possibly including MAT), will be added to your treatment. They typically last 30, 60, or 90 days, however they may be longer if necessary.
  • Partial Hospitalization Programs (PHPs) PHPs are also known as intensive outpatient programs (IOPs). They are the next most intensive type of treatment for opioid addiction. They provide similar services to inpatient programs such as detoxification, behavioral therapy medical services, and custom treatments such as MAT. The difference is that in a PHP, the patient returns home to sleep. Some programs will include transportation and meals, but this varies by program. Partial hospitalization programs are helpful for both new patients and patients who have completed inpatient treatment and still need intensive recovery therapy.
  • Outpatient Programs Outpatient programs work best for people who have a high level of motivation to recover. They create treatment programs that work around your schedule. These programs can either be an effective treatment option for new patients or a part of an aftercare program for people who complete inpatient or partial hospitalization program.

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Resources

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Cardia, Luigi et al. “Preclinical and Clinical Pharmacology of Hydrocodone for Chronic Pain: A Mini Review.” Frontiers in pharmacology vol. 9 1122. 1 Oct. 2018, doi:10.3389/fphar.2018.01122, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174210/

Cassidy, Theresa A et al. “Patterns of abuse and routes of administration for immediate-release hydrocodone combination products.” Pharmacoepidemiology and drug safety vol. 26,9 (2017): 1071-1082. doi:10.1002/pds.4249, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637894/

Miller, Norman S, and Andrea Greenfeld. “Patient characteristics and risks factors for development of dependence on hydrocodone and oxycodone.” American journal of therapeutics vol. 11,1 (2004): 26-32. doi:10.1097/00045391-200401000-00008, https://pubmed.ncbi.nlm.nih.gov/14704593/

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