Hydrocodone Addiction: Signs, Risks, and Getting Help
According to the U.S. Drug Enforcement Administration, hydrocodone is the most frequently prescribed opioid painkiller in the U.S.1 Even when used as directed, people who use hydrocodone are at risk of addiction and unintentional overdose.2
The 2020 National Survey on Drug Use and Health (NSDUH) reports that 4.7 million people (1.7%) aged 12 or older misused hydrocodone products in the past year.3 That same year, 2.3 million people (0.8%) aged 12 or older had a past year prescription pain reliever use disorder, the term used by the NSDUH for addiction to these substances.3
People who use hydrocodone should know the potential dangers of using the substance to use it safely and avoid addiction or overdose. This article will help you understand what hydrocodone is, hydrocodone risks, the signs of hydrocodone dependence, and how to seek help if you think that you or someone you care about might have a hydrocodone addiction.
What Is Hydrocodone?
Like other prescription opioids, hydrocodone is typically prescribed to treat moderate-to-severe pain, usually due to cancer or surgery.2 It can also be prescribed as an antitussive (cough suppressant). It is available as both a standalone product or in combination products (e.g., a single pill that contains hydrocodone combined with other medications such as acetaminophen, aspirin, or an antihistamine).
Hydrocodone (also known by brand names Hysingla, Norco, and Vicodin, among others) is one of the most prescribed prescription opioids.1 It is a substance that is closely related to codeine and morphine because it produces similar effects.1
Prescription opioids are commonly misused for nonmedical reasons, such as to get high (e.g., experience euphoria) or to relax.4 Hydrocodone is misused most frequently via oral administration and is often taken in combination with alcohol.1
According to the National Institute on Drug Abuse (NIDA), around 21 to 29% of people who are prescribed opioids for chronic pain misuse them, 8 to 12% develop an opioid use disorder (addiction), and 4 to 6% of people who misuse prescription opioids transition to heroin.5
What Is the Difference Between Hydrocodone and Oxycodone?
Hydrocodone and oxycodone are both prescription opioid painkillers, but they are not the same drug. Most studies have shown that they are similar in effectiveness for pain relief.6 Both block pain signals sent by the body by binding to mu-opioid receptors.7, 8 They are also both the most popular opioid painkillers among people who misuse these types of drugs.9
What is the difference between oxycodone and hydrocodone? Some reports indicate that people who mishandle opioids may prefer to use oxycodone because they say it produces a better high and results in more euphoric effects than hydrocodone.9
What Is Hydrocodone Addiction?
Misusing prescription opioids like hydrocodone means that a person takes the medication in a way that it’s not intended to be used.10 For example, they may misuse the medication by grinding up the pill and injecting or snorting the powder to get high. They may also take and use someone else’s prescription.10
Substance misuse can lead to addiction, a chronic medical disease characterized by compulsive or uncontrollable drug-seeking and substance-using behavior despite the harmful consequences.1, 10
The American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines the criteria for a variety of substance use disorders (SUDs), the clinical term for a drug or alcohol addiction. A hydrocodone addiction falls under the category of an opioid use disorder (OUD), and the APA provides 11 diagnostic criteria for OUD.
To qualify for a diagnosis, an individual must meet at least 2 criteria within a 12-month period. The disorder can range in severity from mild to severe based on the number of criteria met.11 While only a qualified professional can diagnose OUD, it can be helpful to know the criteria, which include:11
- Using opioids in greater amounts or more often than originally intended/prescribed.
- Being unable to cut back or stop opioid use despite a desire to do so.
- Spending a great deal of time obtaining, using, and recovering from the effects of opioids.
- Experiencing cravings, or an intense desire, to use opioids.
- Being unable to fulfill obligations at work, home, or school due to opioid use.
- Continuing to use opioids despite having social or interpersonal problems that are caused or worsened by your substance use.
- Using opioids in situations where it is hazardous to do so (such as while driving or operating machinery).
- Using opioids despite knowing that you have a persistent physical or mental health problem that is likely due to your substance use.
- Giving up activities you once enjoyed to use opioids.
- Developing tolerance, which means you need to use more of the substance to achieve previous effects.
- Experiencing withdrawal symptoms when you stop using opioids.
Note that the final two criteria, tolerance and dependence, are not considered to be met for individuals taking opioids solely under appropriate medical supervision.
Is Hydrocodone Addictive?
Yes, repeated misuse of hydrocodone or other prescription opioids can lead to a substance use disorder (SUD), specifically opioid use disorder (OUD), as mentioned above.1, 10 SUD is the general term used to diagnose substance addiction and can occur due to chronic substance use.10
An SUD can develop when repeated use of a substance causes changes in the brain and behavior that’s characterized by uncontrollable drug or alcohol use, resulting in significant negative consequences, such as health problems or an inability to meet responsibilities at work, school, or home.10
Adverse Effects and Risks of Hydrocodone Use
Although hydrocodone is a prescription medication, there are potential risks even if used as directed.2 Some of the adverse effects of hydrocodone can include:2, 12
- Dry mouth.
- Increased pain sensitivity.
- Nausea and vomiting.
- Tinnitus (ringing in your ears).
- Low testosterone, which can cause reduced sex drive, energy, and strength.
- Severe respiratory depression, meaning slowed, shallow, or stopped breathing.
- Shortness of breath.
- Low blood pressure.
Hydrocodone can cause overdose, especially if you take more than originally prescribed or misuse it in high doses. Hydrocodone can also be especially dangerous when combined with alcohol or other sedatives (e.g., benzodiazepines such as Xanax and Valium) and sleep aids (e.g., Ambien). Each of these substances can slow down your breathing rate and taking too much can result in an overdose.13
The signs of overdose include:14
- Pinpoint pupils.
- Slowed, shallow, or stopped breathing (e.g., respiratory depression).
An overdose can result in coma, brain damage, or even death.14 Do not leave a person who has overdosed alone; call 911 immediately.14 Administer naloxone if you can do so. Naloxone is a lifesaving medication that can rapidly reverse overdose from hydrocodone or other opioids.15
Naloxone can restore a person’s breathing, but it only has temporary effects, which is why the person must also receive prompt medical care.15 People who have overdosed should be monitored for at least 2 hours to ensure that they keep breathing.15
Signs of Hydrocodone Dependence
Hydrocodone, like other types of opioids, can cause dependence, even when taken as prescribed and directed by a doctor.2 Dependence means that a person develops withdrawal symptoms when they stop using a substance.2 NIDA says that people who are addicted to prescription opioids like hydrocodone can experience withdrawal symptoms that can range in severity and can include:10
- Muscle and bone pain.
- Sleep problems.
- Cold flashes with goosebumps.
- Uncontrollable leg movements.
- Severe cravings.
Treatment for Hydrocodone Addiction
If you or someone you care about are struggling with hydrocodone addiction or another OUD, you should know that there are effective, evidence-based treatments that can help.10
It’s not advisable to quit using hydrocodone “cold turkey” as opioid withdrawal can be extremely uncomfortable and distressing.16 The Substance Abuse and Mental Health Services Administration (SAMHSA) says that trying to withdraw from opioids without medication can cause needless suffering, especially in people who already have a limited pain tolerance.16
Professional detox is typically the first step in the recovery process and can help you safely and comfortably undergo withdrawal and prepare you for further treatment, such as inpatient or outpatient drug rehab.16, 17
Withdrawal typically starts 8 to 24 hours after your last dose and lasts about 7 to 14 days, or longer in some cases.18
During medical detox, you may receive medication to help eliminate or minimize withdrawal symptoms and ensure your comfort. Medications can include:10, 16, 19
- Methadone. This is an opioid agonist medication that binds to the same brain receptors as opioids. It helps to prevent or minimize withdrawal symptoms. People can remain on methadone after detox and formal treatment is complete to help them avoid relapse.
- Buprenorphine. This is a partial opioid agonist medication that also acts in a similar way to methadone to prevent or minimize withdrawal symptoms. People can also remain on buprenorphine following detox and formal treatment to help reduce the risk of relapse.
- Lofexidine. This is a non-opioid medication that helps minimize withdrawal symptoms.
People who have completed detox programs are usually advised to transition to a treatment program to help them identify and address the underlying issues that led to the addiction.16, 17 Treatment can take place in different settings and at different levels of intensity but usually involves an outpatient program or residential inpatient rehab.
While treatment varies, patients can expect to receive different types of group and individual therapies to help them learn new skills and address substance-using behaviors. Therapies can include:10, 20, 21
- Cognitive-behavioral therapy (CBT), which helps you identify and replace negative, unhelpful, or unhealthy thoughts and behaviors that contribute to your substance use. You learn new coping skills and healthier ways of managing stress.
- Contingency management (CM), which provides positive reinforcement for healthy behavioral changes. People often receive rewards or vouchers to exchange for tangible goods when they achieve target behaviors (such as providing negative drug tests).
- Family or couples therapy, which can help address issues in relationships that impact substance use or are affected by the person’s addiction.
Getting Help for Hydrocodone Addiction
Getting help for hydrocodone addiction can feel overwhelming, but you don’t have to do it alone. American Addiction Centers (AAC) is a leading provider of evidence-based addiction treatment across the U.S. Our admissions navigators are available 24 hours a day, 7 days a week when you contact . You can share your story, learn about treatment options, and can verify your insurance over the phone.