Dealing with Addiction to Hydrocodone

What is Hydrocodone?

Hydrocodone is an opioid medication that is mainly used to treat pain. It is a federal, Schedule II controlled substance. This class of narcotic drugs has a strong potential for misuse that can lead to severe psychological or physical addiction or dependency.¹

The drug hydrocodone is a derivative of codeine as it contains some natural substances that come from poppy seeds. Hydrocodone, however, has about six times as much opiate activity than codeine does.²

The specific class of drugs that hydrocodone fall into is called antitussives. Hydrocodone works by changing the way a person’s brain and nervous system feels pain. It helps stop coughs that disrupt your sleep by lessening activity in the brain that causes you to cough.

Hydrocodone Use and Abuse

In 2013, physicians gave out 136.7 million prescriptions for drugs containing the opiate hydrocodone. Close to 94 million hydrocodone-containing products were prescribed in 2016, and 83.6 million were dispensed in 2017. The medication that is given to patients most frequently is a hydrocodone-acetaminophen combination drug, usually Vicodin or Lortab.³

In the year 2016, it was reported that 2.9% of senior high school students had used a hydrocodone product for recreational purposes. The same was true for 1.7% of 10th graders and 0.8% of 8th grade students.⁴ In the United States, 11.5 million people 12 years old and up abused hydrocodone that same year.⁵

History of Hydrocodone

Scientists Carl Mannich and Helene Lowenheim prepared the first formulation of hydrocodone in 1920 for the German drug company Knoll. The pair created the chemical by combining a hydrogen atom to opium-based codeine particles. The Food and Drug Administration (FDA) approved the substance for sale in the US in 1943.

The first company to sell hydrocodone was Knoll in Germany, with a drug called Dicodid in 1924. This drug was made of pure hydrocodone and was sold in 5 and 10 mg tablets. Although the drug eventually caught on and was widely marketed in the US, it was not very common in Europe. In fact, countries other than the US make up less than 1% of sales of products containing hydrocodone.

The US government began making it harder for physicians to prescribe hydrocodone beginning in 2011 when the drug was moved from being a Schedule III to a Schedule II narcotic. During that year, hydrocodone-containing medicines were linked to about 100,000 emergency room visits in the US. ⁶

Which Medications are Combined with Hydrocodone?

Doctors often prescribe hydrocodone in combination with other drugs to treat different types of pain. Some combinations are used to treat moderate or severe pain, while others are given to suppress persistent coughs.

Popular Medicines Containing Hydrocodone

There are hundreds of brand name and generic products that contain hydrocodone on today’s market. The medications that are most often combined with hydrocodone to treat pain and other conditions include:

Acetaminophen

Phenylephrine

Aspirin

Guaifenesin

Chlorpheniramine

Carbinoxamine

The most common of these combination medicines prescribed to treat pain is the hydrocodone-acetaminophen combination. Aspirin is also sometimes used in these pain-relieving drugs.

Chlorpheniramine is used with this opiate in antihistamine medications that treat sneezing, itching, and runny noses. They work together to relieve cold and allergy symptoms as well as to suppress coughing. A combination of hydrocodone and phenylephrine, another antihistamine, work to do much of the same as the above. The same is true when combined with guaifenesin. These can be in the form of a tablet or cough syrup.

All three add-on substances (chlorpheniramine, phenylephrine, and guaifenesin) combined with hydrocodone work as an antihistamine for sneezing, an expectorant to reduce phlegm, and a decongestant to thin nasal passage inflammation as well as stopping excessive coughing and relieving pain.

Pain and Cough Medicine with Hydrocodone

The following medications that your doctor may prescribe for pain or cough will contain hydrocodone:

Vicodin

Zydone

Norco

Lortab or Lorcet

Vicoprofen

Cough syrups or pills that include hydrocodone

Any medicines that include the words “Aspirin -ASA” or “Acetaminophen – APAP”

Common and Rare Side Effects

Medications containing Hydrocodone can cause some side effects. Some are more common than others, and some can be signs of needing immediate medical treatment.

Less Severe Side Effects

Constipation
Sleepiness
Lightheadedness
Anxiety
Feeling unusually happy or sad
Dry throat
Trouble urinating
Rash or itchiness

Serious Side Effects

Difficult or slowed breathing
Irregular breathing
Feeling very agitated
Hallucinations
Fever
Sweating
Racing heartbeat
Shivering
Extreme muscle stiffness or twitching
Nausea, vomiting, loss of appetite
Irregular menstrual period
Decreased sexual desire
Unable to get an erection
Chest tightness

Symptoms of an Overdose

Narrowed or widened pupils
Shallow breathing or no breath
Slowed heartbeat
Clammy or blue skin
Extreme sleepiness
Losing consciousness
Seizures
Death

Hydrocodone-Acetaminophen Side Effects

Lowered blood pressure
Constipation
Dizziness
Sleepiness
Nausea
Feeling weak or faint
Feeling very relaxed
Feeling a little ill

Naloxone Can Save Lives

There is a rescue medication available in case of an opioid overdose. This drug is called naloxone. It can reverse the possibly fatal effects of a hydrocodone overdose. If you or someone you care about take a hydrocodone product, it’s a good idea to have naloxone on hand in case of an emergency. People will probably not be able to treat themselves during an overdose situation, a family member or loved one can be told what to do until EMTs arrive.

Dealing with Hydrocodone Constipation

If you are taking hydrocodone medication and experience constipation, you can do the following:

Eat more fiber in your diet
Drink plenty of water
Exercise more
Take a laxative if constipation is severe

Dealing with Lightheadedness or Dizziness

If the medicine is causing you to be lightheaded or dizzy, be sure to rise slowly from a seated or lying position.

Withdrawal Symptoms

For people who are taking medications containing hydrocodone for two weeks or less, it usually isn’t a problem to stop when the prescription runs out or sooner. But when continuing to take this opioid consistently for more than 14 days, some serious side effects may begin to occur.

With regular use of hydrocodone, a person may begin to need higher doses of the drug in order to achieve the same level of pain reduction. For those taking this drug for recreational purposes, higher doses become necessary in order to achieve the same ‘high’ as before. This is because the body develops a tolerance for the drug. The same dosage no longer produces the same effects.

If you need to stop taking hydrocodone medicine because you or your doctor thinks a physical or psychological dependence may develop, it’s best to be weaned off this opioid slowly. By slowly tapering off hydrocodone, you will not experience the more serious side effects that can go along with withdrawal.

Withdrawal from this opioid can cause the following side effects, some of which are much more serious than others:

Nausea
Vomiting
Stomach pain
Muscular aches
Bone pain
Dilated pupils
Constipation
Diarrhea
Sweats
Goosebumps, chills

Psychological addiction to hydrocodone can cause anxiety and insomnia, as well as mood changes. Cravings for the drug might also develop, causing someone to try to get more illegally.

Hydrocodone Addiction

If you are given a prescription for a medication that contains hydrocodone, be sure to take it as directed. Do not take more of a dosage than recommended and don’t take it for longer than two weeks unless speaking with your doctor.

Another good idea for preventing addiction is to keep a personal log of your pain symptoms each day. If you note that your pain is getting better, tell your doctor. He or she may decide to decrease your dosage gradually so you can wean off the drug and stop taking it eventually.

If you have feelings of cravings for the drug even when you’re not in pain, speak with your health professional right away.

Signs of Addiction

If you think someone you care about may have become addicted to hydrocodone, it’s important to be aware of some of the signs of addiction. Some of the symptoms are physical, such as those mentioned above, and some are psychological or visibly apparent.

These signs of hydrocodone addiction include:

Someone trying to get the drug, even though they know its dangers and possible consequences
This person is no longer interested in hobbies and activities that once held their attention
Social isolation – the person no longer wants to be with other people
Financial problems are cropping up, usually because money is being spent on drugs
A person is behaving recklessly (driving while experiencing a high)
Stealing money or raiding family members’ or friends’ medicine cabinets for drugs

Despite best efforts or due to other reasons, many people do end up developing an addiction to hydrocodone. If you continue taking this drug longer than it was prescribed or in larger doses than given, you may have an addiction. The same is true if you find yourself taking this medication just to feel its relaxing, euphoric side effects.orper mattis, pulvinar dapibus leo.

The Danger of Stopping Hydrocodone Suddenly

If you stop using hydrocodone all of a sudden, it can lead to those withdrawal symptoms mentioned previously, some of which can be quite painful and dangerous. You may be able to wean yourself off this drug slowly, but there are good programs available to help you with addiction treatment.

If someone has been using high doses of hydrocodone for a long period of time, it will take much longer to recover from that addiction than someone using it for a shorter term.

Addiction to any substance, but especially opioids, can cause a variety of nasty issues. Relationships, jobs, mental and physical health, and other important parts of life can be directly affected by addiction. It’s best to seek help and treatment as soon as possible.

Treatment Options

Addiction is primarily a brain disease that has a physical and psychological component. No one makes a conscious choice to become addicted to substances.

Harm Reduction Treatment

A harm reduction approach treats the addiction and also looks at the circumstances that led someone to their present state. Treatment plans focus on ways to manage safer use of medications. Many other therapies are used to lessen drug use, with the final goal being complete recovery from drug use.

Another tool used during harm reduction treatment includes motivational interviewing, which is a counseling technique that helps a person decide why they should change their habits and behaviors.

Addiction Treatment

When withdrawal from hydrocodone is necessary and not safe to be done at home, detox can be achieved in a setting that is appropriate for each person’s needs.

Detox is the process of removing all toxins and harmful substances from the body. It can cause painful symptoms and medication may be needed for some people to ease these symptoms.

Medication-Assisted Treatment

The need for detox medication-assisted treatment (MAT) will depend on the length of time the addiction has been going on and how severe the addiction is. A medical professional should be on hand during this process.

Some medications that can be used during the withdrawal process can also be used as a substitution therapy drug after detox is completed. These medications are based on narcotics and act on the brain but do not produce feelings of euphoria.

Methadone, buprenorphine, suboxone, naltrexone, and naloxone are used to reduce withdrawal symptoms, block the effects of a narcotic if an overdose is taken, or helps someone transition from addiction to sobriety.

Residential Treatment

Before moving on to actual treatment for addiction, a person must go through detox and withdrawal. This is the first step to achieving sobriety. You may go through the withdrawal process in a residential treatment center and then continue with your treatment there.

A harm reduction approach may be used in treatment to encourage staying away from substance use. Treatment will include empowering persons to make the changes they need to make to live a better, more productive life.

A stay in a residential treatment center can vary, with the average length of stay being 30-90 days. This can be different depending upon the severity of the addiction.

This treatment involves living on-site full-time in a residence where all treatment will take place. Meals and therapeutic sessions are included. Treatment may consist of:

Individual counseling sessions

Group therapy sessions

Alternative therapies such as yoga, massage, meditation, equine therapy

Exercise to heighten mood and lessen cravings

Group discussions

Socialization

Learning coping skills for resisting cravings

Intensive Outpatient Program (IOP) for Addiction

For those who can’t or don’t wish to stay in a residential center for treatment, there are outpatient programs that allow patients to attend meetings and sessions during the day and evenings. The time spent going through an IOP may take between 12 and 16 weeks on average. Some of the services provided may include:

Group therapy sessions

Individual therapy

Family counseling

Medication management

Workshops

Seminars

Outpatient Programs

These are similar to an IOP with more flexible scheduling of meetings. An outpatient program is a good alternative for those who need to continue working or going to school full-time. It’s also convenient for people who have family responsibilities to attend to.

Most people in outpatient programs are somewhat less dependent on hydrocodone and have been using the drug for a shorter period of time. It’s important to have a supportive family, as well.

Caring for Yourself After Recovery

When a person has completed treatment for hydrocodone addiction, there is usually still work to be done. Some may need to be placed in a sober living home for a period of time. The main reason for aftercare treatment is to prevent relapse.

Other people will continue with individual therapy sessions, group therapy meetings or regularly go to group recovery meetings such as Narcotics Anonymous in order to maintain sobriety.

For those who are still undergoing MAT, visits to a methadone clinic or to a doctor for certain prescriptions may be needed. Regular physical checkups with drug tests are also part of the recovery plan.

Because there is a significant chance for relapse after one year of hydrocodone recovery, a relapse prevention program is an important part of your sobriety. Continued care and using effective strategies to avoid relapse can ensure that this chronic condition of addiction does not return to become a part of your life.

Mindfulness-based Relapse Prevention (MBRP) helps those who have suffered from hydrocodone addiction deal with never-ending cravings even after recovery. This relapse prevention technique keeps you mindful that your tolerance for opioids, particularly hydrocodone, is now very low. So, just a normal dosage of the drug can cause severe effects or an overdose. The key is to be mindful that addiction is a chronic disease, requiring maintenance and awareness.

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