Hydrocodone Addiction: Abuse Signs, Effects & Treatment

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A Guide to Hydrocodone Addiction and Treatment

Hydrocodone is one of the most commonly prescribed pain medications. It’s great for treating mild to moderate pain from surgery, tooth extraction, and minor injuries. When taken as prescribed, it’s very effective. However, misuse often leads to dependency and addiction. Although opioid addiction has devastating effects on the user and everyone around them, treatment for hydrocodone abuse is widely available.

Hydrocodone Addiction Treatment

Why Hydrocodone Is So Addictive

Opioids work by binding to opioid receptors in the brain. These receptors, known as mu receptors, block the transmission of pain signals between the nervous system and brain. These are the signals that tell the body you’ve been injured in some way and trigger a reaction between the brain and body.

Because they’re so addictive, most doctors only prescribe hydrocodone-based medications for short-term pain treatment rather than chronic pain management. In fact, the high potential for misuse classifies brands containing hydrocodone as Schedule II controlled substances that are highly regulated.

Hydrocodone is a synthetic form of naturally occurring opiates that are cultivated from the seeds of the opium poppy. You might be more familiar with this medication under the brand names Vicodin®, Norco®, and Loritab®.

Each of these formulations contain between 5 and 10 milligrams of hydrocodone blended with 300 to 325 milligrams of acetaminophen, which is about as potent as regular-strength Tylenol. The amount of acetaminophen was reduced from the typical 500 to 750 milligrams per tablet in order to reduce the risk of liver damage from daily use.

The addition of an opioid to the over-the-counter pain reliever boosts its effectiveness while keeping acetaminophen levels relatively low. For more severe short-term pain management, doctors might prescribe Zohydro® instead. Approved by the FDA in 2013, this brand is the first prescription medication to be formulated purely from hydrocodone without any additional pain reliever.

One factor that leads to hydrocodone misuse relates to the way the drug works on the body. The same mechanism that blocks pain receptors also affects dopamine release in the pleasure center in the brain, resulting in a mild euphoria when taking the drug.

Trying to maintain this pleasurable feeling often leads to hydrocodone abuse, which can begin to occur within as little as five days after starting the medication. The rise of opioid misuse and addiction has resulted in many doctors limiting prescriptions to no more than seven pills. More severe or prolonged pain is typically managed in other ways in an effort to prevent people from becoming dependent on prescription narcotics or street drugs to deal with chronic pain.

Hydrocodone Addiction vs. Dependence

Using more than the prescribed amount or taking the medication for longer than prescribed can lead to dependence on the drug. When dependence is prolonged, it can develop into addiction.

Although the two terms seem to refer to the same condition and are often used interchangeably or gathered under the umbrella term of substance use disorder (SUD), they are two distinct conditions.

Drug dependence refers to the physical symptoms that appear when the body becomes tolerant of a substance. Ceasing the medication after becoming dependent leads to withdrawal symptoms like nausea, confusion, excessive sweating, and constipation.

Withdrawal symptoms can become so severe and uncomfortable that the user returns to taking the substance or finding more dangerous alternatives in an effort to relieve their pain and distress. You can become dependent on a drug without becoming addicted, but this cycle of behavior often leads to addiction.

Drug addiction occurs when the person can’t stop using a substance despite negative consequences, such as lost jobs, damaged relationships, and even financial ruin or homelessness. Addiction can be the result of physical dependence or an attempt to recapture the high and euphoric feelings that accompany use.

It’s a vicious cycle that will cause your life to spiral out of control if it’s not addressed. When you or a loved one reaches the point of physical and psychological dependence on opioids, supervised addiction treatment is the best route to a successful recovery.

Effects of Hydrocodone Misuse

Using hydrocodone, even as indicated by your doctor, affects you by disrupting sleep patterns, diminishing your appetite, and elevating your mood. Misuse leads to short- and long-term effects that range from mildly unpleasant to severe and possibly life-threatening.

Short-Term Effects

Over the short term, the effects of hydrocodone use can be mild, even pleasant. You’ll feel drowsy but content, which will ensure that you rest and heal after surgery or an injury. However, even after a few days, you’ll notice that your mood can change suddenly, especially if you’re late taking a dosage.

Shortly after you begin taking hydrocodone, you’ll notice constipation setting in and a decrease in your appetite. Mild nausea and trouble sleeping are common effects of taking the medication as well. You might also experience numbness because the pain receptors in your brain aren’t functioning properly. Most of these symptoms will disappear shortly after you’ve finished the recommended course of treatment.

Long-Term Effects

The most dangerous long-term effects of opioids are addiction and dependence. However, they aren’t the only problems with long-term use or misuse.

You’ll also experience:

• Acetaminophen toxicity
• Severe mood and sleep disruption
• Chronic fatigue and constipation
• Sensorineural hearing loss or tinnitus
• Headache
• Nausea and vomiting
• Anxiety

Preoccupation with finding and taking the drug, in addition to the physical and psychological symptoms, will affect personal relationships, job performance, and mental health.

There are also some severe side-effects of prolonged opioid misuse, including:

• Slow or irregular heartbeat
• Respiratory distress
• Nightmares
• Compulsive behavior
• Lethargy
• Allergic reaction
• Trouble urinating

Signs of Hydrocodone Misuse

The signs of hydrocodone addiction can be subtle at first. However, they will escalate with time and become more obvious to those around you. Physical dependence can begin within a week of taking medications containing hydrocodone or other opioids.

For example, you may become preoccupied with taking your medication, watching the clock for your next dose, or counting pills. You might become defensive when questioned about your habits, steal or turn to street drugs when your prescription runs out, and otherwise behave out of character.

When using leads you to negative behavior such as arriving late for dinner or standing people up, missing work or school, and engaging in dangerous or criminal activity just to obtain the drug, addiction has set in. In fact, addiction leads people to disregard everything but finding more drugs. People have even been known to fake an injury in an attempt to get another prescription.

Hydrocodone Withdrawal

One of the main reasons that opioid abuse is so tenacious is the withdrawal symptoms that occur when you stop taking it. These symptoms are even present when you take opioids for a short time, and they can become very severe when use is prolonged, or you become addicted to hydrocodone.

The effects of opioid withdrawal begin about six to 12 hours after the last dose is taken. They can last for up to a month and become so uncomfortable that beginning opioid use again just to relieve them is tempting. It’s this cycle of use/withdrawal/relapse that leads to the kind of long-term addiction that destroys lives.

Withdrawal symptoms from opioid misuse include:

• Muscle cramping or weakness
• Nausea and vomiting
• Runny nose and eyes
• Excessive yawning
• Irritability and mood swings
• Restlessness
• Chills, shakes, and sweating
• Diarrhea
• Fever

More serious side-effects from severe addiction or prolonged use can include depression, self-harm, heart or liver failure, respiratory distress, coma, and death. Because some withdrawal symptoms and side effects can be severe and life-threatening — and the danger of relapse is so high — treatment should always occur with medical supervision, preferably as an inpatient client at a licensed rehabilitation facility and/or under a doctor’s care.

Types of Hydrocodone Addiction Treatment

There are several options for addiction treatment, including outpatient, inpatient, and long-term management. Each has its benefits and drawbacks.

Outpatient Treatment

Outpatient care is usually given to those with less severe or short-term addictions and those who can’t participate in inpatient care due to financial, work, or family obligations. Treatment is usually conducted through a mental health facility, which the client will attend daily for six to eight hours.

Therapies can include:

• Drug education
• Mental health counseling
• Group and private therapy
• Career and lifestyle counseling
• Medical maintenance

Inpatient Treatment

Inpatient care requires becoming a guest at a rehabilitation facility for 30 to 90 days. The first few days will usually include detox to wean you off of the substances.

You’ll then begin a regular routine of individual counseling, group therapy, art therapy, and other techniques to help you uncover the source of your addiction. Therapies include learning new tools and coping mechanisms to help you handle stress, deal with temptation, and prevent relapse in the future.

An emphasis on health and nutrition is also essential during your recovery because eating right and staying fit rarely factor into an addict’s daily routine. However, outside contact will usually be limited so that you can focus on sobriety away from triggers, co-dependent relationships, and stressful environments.

Many facilities do provide a family visitation day to help maintain or repair important bonds. Since it takes an average of 60 days to undo bad habits and incorporate healthier ones, a stay of 90 days followed by aftercare has been deemed the most effective length of treatment.

Long-Term Treatment

Long-term treatment is reserved for clients who have relapsed after an initial stay in rehab or are struggling with long-term opioid misuse. It usually begins with a stay at an inpatient facility, but the client is released to a sober living facility for up to a year after they leave rehab. Management with a maintenance drug like methadone or suboxone is normally part of long-term care.

Whatever rehabilitation environment you choose, treatment for hydrocodone addiction usually follows several phases:

1. Detox – This is the most precarious time during addiction treatment. You’ll begin experiencing symptoms of withdrawal within six to 12 hours after your last dose, so a doctor will prescribe certain medications to manage the pain, nausea, and discomfort. You’ll also be monitored for concurrent medical conditions during this phase, which lasts for between 24 and 48 hours.

2. Counseling – This can be done at a treatment facility or as an outpatient. Therapy is usually divided between individual therapy to diagnose and treat any concurrent mental health conditions and address the root of addictive behavior. If indicated, it can also include family therapy.

Group therapy allows clients to form relationships with others who are in treatment. Sometimes it helps to learn that you’re not alone in your feelings or behavior. This dynamic is also helpful for checking behaviors, such as rationalizing drug misuse.

3. Aftercare – This important aspect of recovery should not be underestimated. Aftercare is necessary for monitoring behavior after you leave rehab, allows you to continue health and mental health services, and provides you with ongoing support when you’re feeling triggered by circumstances or tempted to use.

In addition to ongoing support, aftercare can also consist of long-term medical maintenance and job counseling. You may also get help locating housing and other resources and means of support that are available to help you stay on the path to a long, healthy, and sober life.

When You’re Ready to Find Help

Few people choose to misuse hydrocodone. The cycle of dependency and addiction often creeps up slowly, affecting every aspect of your life. If you or someone you care about is struggling with hydrocodone addiction, help is as close as a phone call. Addiction treatment centers are located in cities and towns across the U.S. Take the first step toward a life of sobriety by contacting a drug rehabilitation center near you today.

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Reviewed By:

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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