Hydrocodone Misuse and Addiction: Signs, Effects, and Treatment

Hydrocodone is a prescription opioid medication doctors prescribe to people suffering from moderate to severe pain.^{1, 2} Although it can be beneficial when taken as directed under doctor supervision, it can be misused, which can lead to hydrocodone addiction.¹ If you or a loved one are concerned about being addicted to hydrocodone, learning more about misuse, addiction, and how to find treatment can help you make an informed decision about your health.

What Is Hydrocodone?

Hydrocodone, available by brand names such as Vicodin, Lortab, and others, is an opioid analgesic, or pain reliever, and antitussive, or cough suppressant.^{1, 2, 3} It is often found in combination products that include hydrocodone and another pain reliever, such as acetaminophen. Doctors may prescribe hydrocodone to treat moderate to severe pain that cannot be adequately relieved with other medications or to treat severe cough.²

Hydrocodone is listed as a Schedule II narcotic under the Controlled Substances Act as it has a high potential for misuse, which may lead to severe psychological or physical dependence.^{3, 4}

In addition to its analgesic properties, hydrocodone can, particularly at higher doses, cause feelings of euphoria and relaxation and is often misused for its opioid effects, or to get high.³ It is generally misused by swallowing the pill, but people can misuse opioids like hydrocodone in several ways, including:^{1, 3}

• Taking hydrocodone in a dose or way other than prescribed by their doctor (e.g., injecting, snorting).
• Taking someone else’s hydrocodone prescription, even if for a legitimate medical complaint.
• Taking hydrocodone for the effects it causes (e.g., to get high).

Is Hydrocodone Addictive?

Yes, misuse of hydrocodone or other prescription opioids can lead to the development of a substance use disorder (SUD), specifically an opioid use disorder (OUD).¹ An SUD is a chronic, relapsing, and treatable medical condition that involves compulsive substance seeking and use despite the negative consequences it causes in a person’s day-to-day life.⁵ The most severe form of an SUD is addiction.^{1, 5}

Signs of Hydrocodone Addiction

Doctors and other qualified professionals formally diagnose an opioid use disorder (OUD) using criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).⁵ Only a professional can diagnose an OUD, but it can be helpful to know the diagnostic criteria, which includes:⁶

• Using opioids such as hydrocodone in larger amounts or over a longer period than was intended.
• Being unable to control or cut down opioid use.
• Spending a lot of time in activities necessary to obtain, use, or recover from opioids such as hydrocodone.
• Cravings, or a strong desire to use opioids.
• Failing to fulfill major obligations at work, school, or home due to opioid use.
• Continuing to use opioids despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of opioids.
• Giving up or reducing important social, occupational, or recreational activities because of opioid use.
• Using opioids such as hydrocodone in situations where it is physically hazardous to do so (e.g., driving, or operating machinery).
• Continuing opioid use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by opioids.
• Tolerance, meaning a person needs markedly increased amounts of opioids to achieve intoxication.
• Withdrawal when opioid use is cut back or stopped.

Health Effects of Hydrocodone Misuse and Addiction

Even when taken as directed, hydrocodone use can result in several health effects, some of which can be uncomfortable.² While the most common adverse effects of hydrocodone are constipation and nausea, hydrocodone use can also have effects on the entire body.²

Opioids like hydrocodone can have harmful respiratory effects, such as slowed breathing, which can cause hypoxia, or a lack of oxygen to the brain.¹ A high enough dose of hydrocodone can completely stop breathing. Hypoxia can result in brain injury, coma, or death.¹ People can also suffer from a wide range of adverse effects on the entire body due to hydrocodone misuse or chronic use, including cardiovascular, dermatological, endocrine, gastrointestinal, and neurological effects.²

Different methods of administration also pose additional risks. Snorting hydrocodone, for example, has been reported to result in a higher risk of toxic effects, including hypersensitivity pneumonitis, which can cause respiratory failure.⁷

Additionally, hydrocodone misuse can increase the risk of tolerance, dependence, overdose, and addiction.¹

Hydrocodone Overdose

It is possible to overdose on hydrocodone.¹ An overdose means that a person has taken enough hydrocodone to cause severe or life-threatening symptoms.¹ Opioid overdose can occur for many reasons, such as hydrocodone or other opioid misuse, using illicit hydrocodone or other opioids that have been contaminated with other substances like fentanyl, resuming hydrocodone or opioid use after a period of abstinence, or using opioids like hydrocodone with alcohol, benzodiazepines, or other central nervous system (CNS) depressants.⁸

Symptoms of an opioid overdose include:⁸

• Unconsciousness or inability to be awakened.
• shallow, or stopped breathing or difficulty breathing.
• Choking, gurgling, or snoring.
• Blue or purple fingernails or lips.
• Pinpoint pupils.

If you suspect that you or someone else is overdosing, it’s important to call 911 right away and administer naloxone if available.¹ Then, follow these steps:⁹

• Try to keep the person awake and breathing.
• Lay them on their side to prevent choking.
• Stay with them until emergency medical personnel arrive.

Naloxone is an opioid overdose reversal medication that can save a person’s life by blocking the effects of opioids and restoring breathing.¹⁰ These effects can be temporary, and additional doses of naloxone may be necessary, so it is important that a person who’s overdosed still receive medical attention, even if naloxone appears to have reversed the overdose. Naloxone is available as a prefilled nasal spray (Narcan), which can be administered by anyone without medical training.¹⁰ People can obtain over-the-counter naloxone without a prescription in all 50 states, but if you or a loved one are prescribed hydrocodone, you should also ask your doctor about co-prescribing naloxone.¹⁰

Hydrocodone Withdrawal

Hydrocodone can lead to physiological dependence, which means that the body has adapted to the presence of hydrocodone, and a person needs to take the medication to function as they would normally.¹ Physiological dependence manifests itself as withdrawal symptoms.¹

Hydrocodone Withdrawal Symptoms

Opioid withdrawal symptoms can occur when a person who is dependent on the drug abruptly cuts back or stops taking it.¹ Opioid withdrawal is not typically medically dangerous, but symptoms can be distressing and uncomfortable.¹¹

Opioid withdrawal symptoms can include:¹¹

• Abdominal cramps.
• Nausea.
• Vomiting.
• Diarrhea.
• Bone and muscle pain.
• Anxiety.

Hydrocodone Addiction Treatment

Hydrocodone addiction is treatable, and treatment can help people safely stop using hydrocodone and learn how to live healthier lives free of opioids and other substances.¹² Treatment for opioid use disorder (OUD) may begin with detox, often followed by inpatient or outpatient rehab.¹¹ During treatment, people may receive a combination of medication, behavioral therapy, and evaluation and treatment for co-occurring disorders (e.g., anxiety or depression), and participate in support groups, such as Narcotics Anonymous (NA).¹²

Medically Assisted Hydrocodone Detox

Treatment can vary from person to person but may include medical detox to manage opioid withdrawal.¹¹ While not generally life-threatening, people can also have a risk of medical complications during withdrawal.¹¹ Detox may involve the use of specific medications to alleviate or reduce withdrawal symptoms and medical supervision and support to help people stay as comfortable and safe as possible throughout the withdrawal process.¹¹

Medications sometimes used during opioid withdrawal include:

• Methadone, the most studied medication for opioid withdrawal; it can help reduce cravings and withdrawal symptoms and can block or reduce the effects of opioids.¹³
• Buprenorphine, used to minimize opioid withdrawal symptoms and cravings and blunt the effects of illicit opioids.¹³
• Lofexidine, an FDA-approved nonopioid medication that can help reduce opioid withdrawal symptoms.¹

Inpatient and Outpatient Rehab for Hydrocodone Addiction

Following detox, people are encouraged to enter treatment to address the underlying causes of their hydrocodone addiction.¹¹ Different levels of addiction treatment can take place in inpatient or outpatient settings. The appropriate setting for you will depend on your needs, which will be evaluated before the start of treatment during a clinical assessment.¹⁴

In both inpatient and outpatient treatment, you may receive medications (e.g., methadone, buprenorphine, naltrexone) and participate in different forms of behavioral therapy, (e.g., cognitive-behavioral therapy (CBT) or contingency management).^{12, 14} Behavioral therapy is designed to help people make changes to maladaptive behaviors associated with substance misuse.¹²

Inpatient addiction treatment involves living onsite at a rehab facility for the duration of treatment.¹⁴ You receive round-the-clock care and different therapies and treatments. These programs can be a good option for people with co-occurring disorders and people with stable living environments or support systems.¹⁴

Outpatient drug rehab involves living at home but traveling to a rehab facility on a predetermined schedule.¹⁴ This level of care can vary in duration and intensity, ranging from highly structured intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs), which may require daily attendance, to standard programs, which may only require attending treatment 1-3 times per week.¹⁴ Outpatient treatment can be a good option for people who can attend regular sessions and have stable living environments and support systems.¹⁴

Find a Rehab Facility for Hydrocodone Addiction

If you’re ready to find treatment for hydrocodone misuse or addiction, American Addiction Centers (AAC) can help. Use our treatment directory to find rehab facilities near you or out of state. Easily filter your search results by insurance accepted, location, and treatment offered. You can also verify your insurance now by filling out the short form below.

If you need assistance, our admissions navigators are available 24/7 when you call . They can answer your questions, discuss treatment options, and help you begin the admissions process once you’re ready.