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Snorting Vicodin

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Vicodin is the brand name for a prescription medication that is frequently used for the treatment of moderate to moderately severe pain. Vicodin is comprised of two active pain relievers 1:

  • Hydrocodone – an opioid pain reliever. Hydrocodone it is a semisynthetic narcotic, meaning that it is manufactured from naturally occurring opioid alkaloid precursors (in this case, from codeine) 2. Hydrocodone interacts with opiate receptors throughout the central nervous system (CNS) to change perceptions of pain. Hydrocodone is prescribed more than any other opioid painkiller 3.
  • Acetaminophen – a common over-the-counter pain reliever.

Vicodin has the potential to be addictive. The drug triggers a temporary elevation in the dopamine activity in certain regions of the brain (especially when misused). The fleeting surge of dopamine helps to produce the rewarding sense of euphoria and relaxation that is associated with opioid use. Compulsive drug use often begins as repeated attempts to achieve these sensations are made, despite the negative consequences that result from such use 2.

With a startling 136 million prescriptions written for hydrocodone-containing products in 2013 alone, misuse and abuse of Vicodin is a nationwide concern. Addiction to prescription opioids has grown to epidemic proportions and touches millions, without regard to age, gender, ethnicity, or socioeconomic class. More than 24 million people abused hydrocodone at some point in their lives, according to 2013 data from the Drug Enforcement Administration (DEA) 3. And young people are affected as well—the DEA reported that 5.3% of 12th graders used Vicodin recreationally in the year prior to their survey 3.

About 40% of people that misuse prescription opioids snort the substance 4.

Crushing and snorting these substances is the most common method of manipulating these drugs 4.

Vicodin abuse can take many forms. Oftentimes, people attempt to experience a more intense high by 2,4:

  • Tampering with the substance (such as extracting the opioid component from the pill for more concentrated effects).
  • Ingesting the substance through a different route of administration.

Is Snorting Vicodin Dangerous?

Yes. Snorting Vicodin is dangerous.

The danger arises from changing the route of administration. Any time this is done, it distorts the intended effects. The results become more unpredictable with increased risk of harm.

So why is snorting Vicodin any different from taking it orally? When the medication is taken as prescribed, the side effects are relatively limited, because oral administration takes more time. When a substance like Vicodin is consumed orally, it begins being absorbed into the bloodstream in the stomach and then the intestine. This effect is slow and less intense as the body proceeds to process the drug before it can act on the brain 5.

In most cases, snorting a drug will not provide a high quite as rapidly or intensely as smoking the drug or injecting it directly into the bloodstream, but it will be quicker and more powerful than oral consumption 5.  When Vicodin is snorted, it is absorbed into the bloodstream through the mucus membranes in the nose. This is a more direct route to the brain, wherein effects may be elicited more rapidly 5.

Does Snorting Vicodin Lead to Heroin Use?

Evidence suggests that any kind of opioid abuse raises the risk of eventual heroin use 6. Several factors contribute to this. First, as a user continues to misuse an opioid drug like hydrocodone, they become tolerant to the drug. As tolerance gets stronger and the subjective effects of Vicodin, in turn, get weaker, users may transition to heroin for a more potent high 6.

Second, opioid medications tend to be very expensive when compared to the price of heroin on the street. Users who are no longer financially able to support their addiction may switch over to heroin to get similar effects at a lower price 6.

Third, heroin is often easier to get than prescription opioids, so in the absence of Vicodin, addicts may look to heroin to get their high and/or relieve withdrawal 6.

Side Effects

Like many other medications, Vicodin is relatively safe and effective when used as directed. Unwanted side effects can emerge, though, and risks for serious complications rise with nasal insufflation 6.  Side effects include 1:

  • Sedation.
  • Cloudy thinking.
  • Anxiety.
  • Fearfulness.
  • Mood changes.
  • Depressed mood.
  • Lightheadedness.
  • Dizziness.
  • Nausea and vomiting.
  • Itchiness.
  • Severe constipation.
  • Problems urinating.
  • Slowed breathing.

Since Vicodin contains acetaminophen, someone abusing the drug may easily permanently damage their liver 3. This danger increases when people have a pre-existing liver condition or when they abuse Vicodin with alcohol 1.

Snorting drugs often results in an additional set of side effects. As a result, people that snort drugs such as Vicodin continue to put themselves at risk for the aforementioned side effects while adding potential new complications, such as 7:

  • Facial pain.
  • Ear pain.
  • Hoarseness.
  • Sinus congestion.
  • Sinus drainage.
  • Difficulty swallowing.
  • Nosebleeds.
  • Death of sinus tissue.
  • Tearing of the septum.
  • Deterioration of the soft or hard palate.

To learn more, visit our page on the Dangers of Snorting and Sniffing Drugs.

Can Snorting Vicodin Cause an Overdose?

Snorting Vicodin

When someone snorts Vicodin, it creates a stronger impact 4,5,6. The risk of overdose is amplified, as the body is overwhelmed by the faster-than-usual onset of potent opioid effects. Because hydrocodone is an opioid that depresses the central nervous system, overdose typically involves severe respiratory distress that may be fatal. Dangers increase even more when the user combines Vicodin with other substances that impact breathing like benzodiazepines and barbiturates 2,4.

Hydrocodone overdose can result in markedly impaired respiratory rate. Often, breathing will become dangerously slowed, which can result in the skin turning blue due to lack of oxygen 1.

Other signs and symptoms of a hydrocodone overdose include 1:

  • Extreme sleepiness that can progress to loss of consciousness and coma.
  • Cold, clammy skin.
  • Dangerously low heart rate and significant hypotension (low blood pressure).

The acetaminophen in Vicodin will produce unique overdose effects like 1:

  • Nausea.
  • Vomiting.
  • Sweating.
  • Significant damage to the liver.
  • Right upper quadrant abdominal pain.
  • Hypoglycemic coma.
  • Problems with blood clotting.

About 19,000 people died in 2014 from an opioid medication overdose 2. Hydrocodone/ acetaminophen products have been linked to more deaths than any other opioid medication 4. A Vicodin overdose can result in death from 1:

  • Stopped breathing,
  • Cardiac arrest.
  • Collapse of the circulatory system.
  • Liver failure.

Someone experiencing overdose symptoms must receive immediate medical attention to minimize or reverse the effects 1. They may be given an overdose treatment drug called naloxone—essentially an opioid antidote to manage adverse reactions and prevent death 2.

Signs That Someone is Addicted

Someone snorting Vicodin may be at even greater risk of addiction than those abusing it by oral routes because of the intensely rewarding speed of onset and strength of effects. Generally, addiction is seen as the repeated use and abuse of a substance even when use is likely to cause harm to one’s self or loved ones. Addiction signs include 8:

Struggle with living up to expectations at work
  • Using Vicodin more and more often and in increasingly greater amounts.
  • Making multiple, unsuccessful attempts to end or reduce use.
  • Spending more time and money getting, using, and recovering from use.
  • Experiencing new struggles living up to expectations at home, work, or school.
  • Changing interests to focus more on Vicodin use.
  • Experiencing continuous conflict with loved ones.
  • Suffering from new or compounded physical and mental health problems.

Other signs to watch out for if you worry that someone you love is using Vicodin recreationally include the following:

  • Using the drug without a prescription.
  • Visiting multiple doctors in an attempt to get more Vicodin.
  • Possessing items used to snort the drug, such as straws, mirrors, and rolled up bills.
  • White powder on the hands, nose, and clothes.
  • Frequent sniffing or wiping of the nose.

Getting Help for Addiction

Vicodin addiction can lead to many harmful and dangerous consequences; quitting the cycle of compulsive use will be imperative for full restoration of a person’s health. However, suddenly stopping use can bring about a severe withdrawal syndrome that may trigger relapse. Symptoms of Vicodin withdrawal may include 2,6:

  • Pain throughout the body.
  • Difficulty sleeping.
  • Cold flashes.
  • Leg twitches.
  • Diarrhea.
  • Nausea.
  • Vomiting.
  • Increased blood pressure.
  • Increased heart rate.

To help manage an otherwise unpleasant withdrawal experience and minimize the risk of immediate relapse, professionally overseen painkiller detox is a preferred option for many recovering users. A period of medically supervised detox can provide a safe, comfortable, and supportive environment to manage symptoms 6,9.

Treatment for Vicodin addiction may include medications to reduce cravings and reduce withdrawal symptom severity. Medications include 6,9:

  • Full opioid agonists like methadone that produce a long-acting, less euphoric range of effects that facilitate scheduled dosing and eventual tapering.
  • Partial opioid agonists like buprenorphine (either as monotherapy, or in combination with naloxone as Suboxone) that activate opioid receptors but to a lesser degree. Buprenorphine has a ceiling to its effects, which discourages further abuse.
  • Antagonists like naltrexone (Vivitrol) that prevent opioid receptors from being activated by other substances.

When it comes to managing opioid dependence, medications have become an increasingly significant part of many treatment protocols, but behavioral therapies will be vital as well. Options like contingency management (CM) and community reinforcement approach (CRA) plus vouchers are known to be effective in treating opioid addiction:

  • CM treatment provides people in recovery with tangible, desirable rewards to encourage drug-free actions and activities 9.
  • CRA plus vouchers is a 24-week program that reinforces social skill building, family relationships, and vocational counseling to maintain recovery 9.

These treatments have the shared focus of rewarding drug-free behaviors in the individual to counteract the reinforcement that Vicodin provides 9.

Vicodin abuse and addiction are very serious issues that deserve special attention and consideration. If you or someone you love is abusing this medication, treatment is essential. To begin the process of taking back control from Vicodin, call today.

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Eric Patterson, MSCP, NCC, LPC, is a professional counselor who has been working for over a decade to help children, adolescents, and adults in western Pennsylvania reach their goals and improve their well-being.

Along the way, Eric worked as a collaborating investigator for the field trials of the DSM-5 and completed an agreement to provide mental health treatment to underserved communities with the National Health Service Corp.

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