Updated on February 6, 2024
5 min read

What You Should Know Before Taking the M365 Pill


  • M365 is a prescription opioid analgesic medication containing acetaminophen and hydrocodone
  • M365 is used to relieve moderately severe pain temporarily
  • It's considered a highly addictive Schedule II controlled substance
  • Although it's an effective painkiller, it can trigger various side effects ranging from mild to severe
  • The risk of side effects is greater for long-term users and/or those who mix M365 with other drugs
  • Treatment is available fore people addicted to M365

What is the M365 Pill?

The M365 pill combines two common pain medications: acetaminophen (325 mg) and hydrocodone (5 mg). It’s a generic version of Norco, a brand-name prescription opioid painkiller prescribed for pain relief. 

Healthcare providers may prescribe M365 for: 

  • Moderate to severe pain
  • Pain after injury
  • Pain after surgery 

The FDA classifies M365 as a Schedule II controlled substance. Schedule II drugs have a high risk of abuse of this drug and only limited medical applications.

Used as directed, the M365 opioid medication is considered safe and effective. 

However, M365 is highly addictive. It eases pain and produces a feeling of euphoria when taken in large doses. Long-term users or those who abuse the drug are at risk of developing tolerance. This means over time, they’ll need larger doses to achieve the same effects. 

The drug also produces uncomfortable symptoms once someone has developed an addiction.


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M365 Pill Side Effects

M365 users are at risk of experiencing several side effects including:

  • Anxiety
  • Allergic reactions
  • Blurred vision
  • Constipation
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Headache
  • Lightheadedness
  • Mood changes
  • Nausea
  • Problems with urination
  • Tinnitus (ringing in the ears)
  • Stomach upset
  • Vomiting

Some of these side effects, especially dizziness and lightheadedness, are possible even when M365 is used as directed. The risk of these side effects is much greater when someone abuses the drug. 

There is also a risk of drug interactions when using M365 with other substances. 

More Severe Side Effects

The risk of side effects for M365 users increases when they misuse the drug.

Misuse of a drug includes:

  • Taking a dose of a drug too soon or too late after the last dose
  • Increasing the dose without a recommendation from a doctor or other healthcare provider
  • Using the drug recreationally/without a medical reason
  • Using the drug without a prescription

For example, taking a higher than recommended dosage of M365 produces a drug “high” that includes:

  • Euphoric feelings
  • Relaxation
  • Contentment
  • Ease of socializing

The high from M365 is one of the primary reasons for the abuse of the drug.

Additionally, long-term use of M365 puts users at risk of:

  • Agitation
  • Social withdrawal
  • Irritability
  • Lack of motivation
  • Fatigue
  • Exhaustion
  • Mood swings
  • Nausea and vomiting

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Risks of Using M365

There are several risks associated with using M365. 

One of the greatest concerns is the risk of developing an addiction. M365 is intended for temporary pain relief. Both tolerance and dependence are concerns for those using M365, especially long-term.

Other risks include:

  • Liver damage
  • Loss of self-control
  • Psychosis
  • Mood swings
  • Opioid overdose 
  • Death

People with a predisposition to depression or anxiety have a higher risk of triggering mood disorder symptoms when using M365.

Additionally, the risk of overdose and/or death increases when M365 is mixed with other medications. This risk is the greatest when combined with cough medicines containing benzodiazepines.1

Risks of Acetaminophen

In addition to the risks associated with the combination of drugs in M365, acetaminophen poses a risk to liver health. 

Large doses of acetaminophen put users at risk of acute liver failure. The majority of instances of liver failure occurred in adults taking more than 4,000 mg of acetaminophen per day.2

M365 Withdrawal Symptoms

Stopping the use of M365 can result in uncomfortable withdrawal symptoms. The likelihood of symptoms is greater when someone suddenly stops using the drug. Symptoms range from mild to severe and include:

  • Anxiety
  • Insomnia
  • Irritability
  • Muscle aches
  • Excessive sweating

Call 911 and/or seek immediate medical attention if you suspect you or someone you know needs medical care.

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Treatment for M365 Addiction

There are several treatment options for people abusing M365. 

In most cases, the most effective option is the combination of various treatment approaches, including medication-assisted treatment (MAT) and psychotherapy.

Treatment options include:

Inpatient Treatment

Inpatient treatment offers full-time supervision in a sober living environment. Most of these programs last for 30 days, but some people need a longer stay.

The programs combine a variety of treatment approaches, including:

  • Medically supervised detox
  • MAT
  • Group counseling
  • Individual counseling and psychotherapy
  • Peer support groups

Outpatient Treatment

Outpatient treatment combines access to intensive treatment without removing someone from their regular life. You don’t stay overnight in an outpatient program. These programs usually feature several hours per week of treatment and include:

  • Individual counseling
  • Group therapy
  • Access to medication
  • 12-Step programs

12-step programs, including Narcotics Anonymous, offer access to treatment with the support of peers. They use the traditional 12-step approach introduced by Alcoholics Anonymous. They can be used independently or in conjunction with other treatment approaches.


Dual-diagnosis programs treat addiction and any co-occurring mental health issues.

Medication-Assisted Treatment (MAT)

Medications used to treat M365 addiction include:

  • Methadone
  • Naltrexone
  • Buprenorphine

Medications reduce the severity of both cravings and withdrawal symptoms. They’re also effective in supporting long-term abstinence from opioid addiction. MAT is most effective when used as part of a comprehensive treatment program.

Detox and withdrawal from M365 are extremely difficult. Medically supervised detox is recommended when possible. This is true even for people who intend to pursue outpatient treatment after the initial detox from the drug.

M365 addiction often begins as the result of a legal prescription for the drug to treat pain. Many users develop a physical dependence on the drug. It’s important to receive care for any lingering effects of the initial injury to reduce the temptation to medicate with M365 when treating addiction.

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Updated on February 6, 2024

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