Hydrocodone is an opioid substance used in many prescription medications to treat cough and pain. Hydrocodone is available in formulations of pure hydrocodone (Hysingla, Zohydro) or in combination with other pain relievers like ibuprofen (Vicoprofen) or acetaminophen (Vicodin, Lortab, Norco) 1,2.
Hydrocodone produces effects similar to other opioids, including oxycodone and morphine 3.
It is the most frequently prescribed opioid pain reliever in the US. Of the 207 million prescriptions for pain medications in 2013, hydrocodone accounted for approximately 124 million of them; in other words, roughly 60% of all painkiller prescriptions are for hydrocodone 4. High prescription rates like these contribute to the ever-prevalent problem of opioid abuse in the U.S.
According to the Drug Enforcement Administration, in 2013 2:
- More than 24 million people in the U.S. had abused hydrocodone at some point in their lives.
- Over 5% of high school seniors admitted to abusing Vicodin in the previous year.
All those who abuse hydrocodone aren’t necessarily obtaining the drug illicitly (for example, by purchasing diverted prescriptions). Any hydrocodone user—whether or not they hold a prescription—can misuse the drug. Hydrocodone abuse occurs any time a user 3:
- Takes more of their medication than recommended.
- Consumes the substance more often than recommended.
- Takes a prescription from someone else.
- Uses the substance to achieve a euphoric high or sense of relaxation.
- Changes the method of ingestion, for example crushes and snorts it, to heighten the drug’s effects.
Does Snorting Hydrocodone Cause a Faster High?
Yes. Snorting hydrocodone can cause a faster (and more dangerous) high in many situations.
Any time a person changes a drug’s route of administration, the effects of the substance are modified. With many substances, there is a direct relationship between the speed of onset and the strength of the drug effects. Effects that are slower to develop will last longer but provide a less euphoric influence. Effects with a faster onset (such as those achieved by snorting and injecting) come on strong, but in many cases, they will last for a shorter amount of time.
The act of amplifying the absorption of or release of a drug into the system to maximize the concentration of active substance in the brain is known as “dose dumping” 5. Dose dumping is a dangerous phenomenon in terms of increasing the risk of adverse drug effects, drug toxicity and/or overdose, as well as the potential for addiction.
Extended-release formulations are frequently abused because they contain larger amounts of hydrocodone. When a long-acting medication is tampered with, the substance that is meant to be absorbed over a long period is available immediately. While there is a strong appeal for those seeking an intense high, the dangers of bypassing the extended-release mechanism are significant 4,5. As one of the primary risks, overdose may easily result from an immediate release of a large amount of hydrocodone.
While no user is immune to the side effects of it, those who abuse the drug may experience increasingly severe effects compared with those who take it according to the prescription. These side effects may include 1,11:
- Rapid mood changes.
- Increased worry and anxiety.
- Trouble thinking clearly.
- Drowsiness and/or problems sleeping.
- Feeling dizzy or lightheaded.
- Diminished appetite.
- Stomach pain.
- Back pain.
- Ringing in ears.
- Dry mouth and throat.
- Skin problems (itchiness, rash).
- Problems urinating.
Depending on the individual and the magnitude of drug use, more troublesome and potentially dangerous side effects of hydrocodone use can emerge, such as 1,11:
- Nausea and uncontrollable vomiting.
- Slowed or inconsistent breathing patterns.
- Lack of coordination; loss of motor control.
- Frequent periodic loss of consciousness.
New or worsening mental health symptoms, such as agitation, confusion, and hallucinations (auditory or visual).
People snorting hydrocodone products containing acetaminophen, such as Vicodin, risk liver toxicity if large enough amounts are consumed 2, as acetaminophen taken in excess may damage the liver.
People snorting Vicodin and other hydrocodone products put themselves at risk of other effects relating specifically to nasal insufflation. These risks include 7:
- Tissuenecrosis, or severe tissue injury within the nasal cavity.
- Nasal crusting.
- Perforated nasal septum or palate—holes or tearing in the nose and roof of the mouth.
- Facial pain and swelling.
- Ear pain.
- Trouble swallowing.
- Sinus congestion or running nose.
Can Snorting Painkillers Cause an Overdose?
Yes. Snorting painkillers like hydrocodone can easily result in an overdose, especially in the case of extended release formulations (e.g., Zohydro).
Any misuse of prescription opioids increases the risk of overdose, and opioid overdose is a major concern in the United States 3. Painkillers like hydrocodone accounted for 19,000 deaths in 2014—more than 3 times the number seen in 2001 3. Hydrocodone/acetaminophen products, in particular, account for more than 1 out of every 7 overdoses 5.
An overdose is rarely a risk for people that use the medication as prescribed, but the risk increases when people manipulate the substance to enhance the high 4. Just one large dose of hydrocodone can trigger an overdose 3. Additionally, mixing it with other substances that may slow breathing— including alcohol and sedatives like benzodiazepines—lead to more frequent harm 3.
Overdose is also more likely among those who take higher doses to combat an increasing tolerance. As tolerance to a drug builds, the substance may no longer produce the strong effects it once did. People with a high tolerance to hydrocodone will often consume high doses to overcome the decrease in perceived high but, in doing so, increase their chances of overdose. Compounding overdose risks is the fact that tolerance is fluid. If someone has not used it for some time and returns to use at the same dose, their body could be unprepared for the strong effects and experience an overdose 4.
Signs of hydrocodone overdose include 1,3,11:
- Marked changes in pupil size; pupils unreactive to light stimuli.
- Breathing problems marked by slowed, shallow, irregular, or stopped breathing.
- Irregular,slowed, or stoppedheartbeat.
- Cold or blue skin, lips, or fingernails.
- Extreme weakness, loss of coordination.
- Profound drowsiness; obtundation.
- Loss of consciousness/coma.
- Uncontrollable vomiting.
Signs That Someone is Addicted to Hydrocodone
Snorting hydrocodone is linked to increased risk of addiction 4. This is due to the short time between snorting the substance and experiencing the high. Someone who continually snorts hydrocodone will become conditioned to associate hydrocodone use with the pleasant effects of dopamine being released in the brain 3. In some cases, the artificial surges of dopamine associated with drug use can be so rewarding that the addicted individual will seek to repeat use without regard to the unwanted or dangerous consequences that may transpire.
Someone that is addicted to hydrocodone may 8:
- Use hydrocodone in larger amounts for longer periods of time.
- Spend excessive amounts of time attempting to acquire and ingest the drug.
- Spend a lot of time recovering from the influence of the drug.
- Have strong cravings to use the drug.
- Display increasing problems in established relationships.
- Be unable to reduce or end their use in the long term.
- Struggle to maintain responsibilities at home, work, or school.
Someone that is specifically snorting hydrocodone may display other signs that might indicate the presence of a problem include:
- Possessing tools to crush and snort the powder including straws, mirrors, and credit cards.
- White powdery substance on their clothes, hands, or nose.
- Sniffing or wiping their nose often.
Remember, even someone prescribed the medication can be addicted to hydrocodone 3.
Major barriers to beginning a drug-free life are the unwanted and uncomfortable withdrawal symptoms that present when someone who is dependent on hydrocodone ends use or abruptly decreases their intake 9,10.
Symptoms created by hydrocodone withdrawal include 9,11:
- Restlessness and agitation.
- Pain in muscles and bones.
- Inability to sleep.
- Cold flashes.
- Teary eyes.
- Runny nose.
- Goose bumps.
- Loss of appetite.
- Changes in breathing and heartbeat.
- Involuntary muscle twitches.
For someone who is addicted, experiencing withdrawal, and needing help to quit, there are a variety of treatment options10:
- Detoxification. This treatment manages the symptoms of withdrawal in a controlled way with the supervision of medical professionals to reduce symptoms and improve comfort. Medically assisted detox programs may use medications (see below) to alleviate withdrawal and control cravings, whereas social detox programs will simply provide a safe and comfortable environment in which to rid your body of hydrocodone.
- Pharmacotherapies. Available throughout the recovery process, medications can be used to reduce withdrawal symptoms and prevent relapse. Other types of medications can benefit those in recovery by blocking the effects of opioids (to deter future use) or by treating any co-occurring mental health issues.
- Behavioral therapies.Beginning at the conclusion of detox, behavioral therapies refer to a collection of treatments aimed at modifying the thoughts, feelings, and/or behaviors of the person in recovery. Therapy can focus on past issues contributing to substance abuse, as well as ways to avoid relapse in the future. Addiction treatment therapy is available on an inpatient or outpatient basis.
The abuse of prescription opioid medications in the US is an epidemic that continues to claim many lives and cause an array of harmful effects. To reduce the risk of experiencing these effects firsthand, consider seeking treatment. Professional treatment can give you your life back. To begin the process, call today.