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Signs and Symptoms of Hydrocodone Misuse and Addiction

Hydrocodone is an opioid medication frequently prescribed to treat moderate to severe pain or as a cough suppressant.1 According to the Drug Enforcement Administration (DEA), hydrocodone is the most frequently prescribed opioid medication in the US, with 70.9 million prescriptions dispensed in 2018.1

Like other opioids, misuse of the drug is associated with tolerance, dependence, and addiction.1 The National Survey on Drug Use and Health (NSDUH) reports that 4.7 million people aged 12 and older misused hydrocodone products in 2020 and explains that hydrocodone was the most misused prescription painkiller that year.2 The NSDUH also reports that 2.3 million people aged 12 and older had a prescription pain reliever use disorder (the diagnostic term the NSDUH uses for addiction to these medications) in 2020.2

If you misuse hydrocodone, or you know someone who you suspect might be misusing the substance, you may wish to learn more about hydrocodone use. This article will help you understand what you need to know about hydrocodone, how to recognize signs and symptoms of hydrocodone use and misuse, and what to do if someone is showing signs of hydrocodone misuse.


Find Out If Your Insurance Plan Covers Hydrocodone Addiction Rehab

American Addiction Centers can help people recover from hydrocodone misuse and opioid use disorder (OUD). To find out if your insurance covers opioid addiction treatment at an American Addiction Centers facility, click here or fill out the form below. Your information is kept 100% confidential.


What is Hydrocodone?

Hydrocodone is a type of opioid medication that doctors may prescribe to people who are suffering from moderate to severe pain.1 It is classified as a Schedule II substance by the DEA, which means that it has an accepted medical use but a high potential for misuse, which can lead to physiological dependence.3

There are many generic and brand name formulations of hydrocodone; it is frequently found in combination products that include acetaminophen.1 Common brand names of hydrocodone include Vicodin, Norco, Zohydro, Lortab, and many others.1,4


Signs of Hydrocodone Use

The signs of hydrocodone drug use are typically observable, unlike symptoms, which generally tend to be experienced by the person. Signs of opioid use, including hydrocodone usage, can be physiological or behavioral.

Some signs of hydrocodone use may include:3,5,6

  • Changes in physical appearance.
  • Constricted pupils.
  • Slowed breathing.
  • Changes in appetite.
  • Abrupt weight changes.
  • Slurred speech.
  • Changes in personality or attitude.
  • Mood changes.
  • Appearing euphoric.
  • Seeming sedated.
  • Social isolation or avoiding friends and family.
  • Sudden change in social group.
  • Changes to hobbies or activities.
  • Poor performance at work.
  • Sudden drop in grades at school.
  • Secretive behavior.
  • Stealing or lying.
  • Overdose.

Symptoms of Hydrocodone Use

Symptoms of opioid use, including hydrocodone use, are usually subjective and may be perceived only by the affected person. Symptoms can often vary from person to person and can also depend on different factors, such as the amount of hydrocodone a person uses, how long they’ve used it, and how they take the substance.7

Some of the symptoms of hydrocodone use can include:4,5

  • Nausea.
  • Constipation.
  • Depression.
  • Low motivation.
  • Anxiety.

Signs of Hydrocodone Withdrawal

People who are dependent on opioids such as hydrocodone can experience withdrawal symptoms when they stop using the substance.8 Dependence means that a person’s body has adapted to the presence of the drug, and they need to take it to feel normal and to function in everyday life.9 People who are dependent might continue to compulsively use the substance just to avoid withdrawal symptoms.10

Specific opioid withdrawal symptoms can include:10

  • Dysphoric (low and unhappy) mood.
  • Nausea or vomiting.
  • Muscle aches.
  • Teary eyes.
  • Runny nose.
  • Dilated pupils.
  • Goose pimples.
  • Sweating.
  • Diarrhea.
  • Yawning
  • Fever.
  • Insomnia.

Symptoms of opioid withdrawal can be very uncomfortable and often feel like a severe case of the flu combined with gastroenteritis, anxiety, and dysphoria.6 Medically supervised withdrawal can help people successfully manage these symptoms and help them stay as safe and comfortable as possible.6


Opioid Use Disorder

People who display the previously mentioned signs may not necessarily have an addiction but may be struggling with misuse of opioids like hydrocodone. If an individual is struggling with hydrocodone misuse, there is a possibility that they may have a substance use disorder. Medical professionals diagnose addiction as a substance use disorder (SUD).8 There are many types of SUDs; an addiction to opioids like hydrocodone is categorized as an opioid use disorder (OUD). The criterion for an OUD is outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).10

OUD can only be diagnosed by a physician or another qualified mental health professional. An OUD diagnosis requires that a person meets at least 2 of the diagnostic criteria within a 12-month period. These criteria include:10

  • Using opioids in larger quantities or more frequently than originally intended.
  • Being unable to cut back or stop using opioids despite expressing a desire to do so.
  • Spending a lot of time obtaining, using, and recovering from the effects of opioids.
  • Experiencing cravings, or intense desires for opioids.
  • Being unable to fulfill obligations at work, home, or school due to opioid use.
  • Continuing to use opioids despite developing social or interpersonal problems that are caused or worsened by opioids.
  • Continuing to use opioids despite the knowledge that the person has a persistent or ongoing physical or mental health problem that is likely due to opioids use.
  • Giving up activities the person once enjoyed to use opioids.
  • Using opioids in situations where it is physically dangerous to do so (such as while driving or operating machinery).
  • Experiencing tolerance, which means a person needs more opioids to achieve previous effects.
  • Developing withdrawal symptoms when the person stops using opioids.

What to Do If Someone Is Showing Signs of Hydrocodone Misuse

If you exhibit some or all the signs of hydrocodone addiction, or if you notice signs someone is misusing hydrocodone or other opioids, it might be time to seek help. If you’re wondering what to do next to help someone you know, you can try to encourage the person to seek help or at least get them to talk to their physician to have an evaluation. You can also call the free, confidential helpline offered by Rehabs.com at to speak to an admissions navigator about potential hydrocodone addiction treatment options.

Some common hydrocodone rehab settings include:

  • Detox programs. This can be the first step in the recovery process for many people. It helps people stop using substances and supports them as they undergo withdrawal.6 People often receive medication, such as methadone or buprenorphine, during detox to help them stay as safe and comfortable as possible and to eliminate cravings and minimize withdrawal symptoms.6,11
  • Inpatient or residential This means that you live at a treatment center and receive 24/7 care, monitoring, and support. This can be a good option for many people, such as those who require a high level of care, including those with co-occurring medical or psychiatric conditions, people without stable work or home environments, and those without sufficient social support.12
  • Outpatient programs. This means that you live at home but travel to rehab on a regular schedule for treatment. This can be a helpful option for many people who do not require the level of support offered by inpatient programs, such as those with less severe addictions, those with supportive family and friends, and those with stable home environments.12

During rehab, you may receive different types of therapies and treatments, including:

  • Medication-assisted treatment, or MAT. This is a comprehensive form of treatment that involves a combination of medication, psychotherapy, and behavioral therapies.13
  • Treatment for co-occurring disorders. A co-occurring disorder, also known as dual diagnosis, means that a person has a mental health condition and a substance use disorder at the same time. Half of the people who experience one of these conditions will also experience the other.12 Treating both disorders concurrently in an integrated treatment program is the standard of care for treating co-occurring disorders.12
  • Behavioral therapies. This can include therapies like motivational interviewing, which help increase your motivation to change; contingency management, which aims to produce positive behavioral outcomes by providing positive reinforcement; or cognitive-behavioral therapy (CBT), which helps people make positive changes and teaches improved coping, stress management, and relapse prevention skills.6

Sources

  1. Drug Enforcement Administration. (2019). Hydrocodone.
  2. Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  3. National Center for Biotechnology Information (2022). PubChem compound summary for CID 5284569, hydrocodone.
  4. National Institute on Drug Abuse. (2020). Commonly used drugs charts: Prescription opioids (oxy/percs).
  5. Cofano, S. & Yellon. R. (2021). HydrocodoneIn: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing.
  6. Substance Abuse and Mental Health Services Administration. (2021). Medications for opioid use disorder. Treatment Improvement Protocol (TIP) Series 63 Publication No. PEP21-02-01-002. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  7. National Institute on Drug Abuse. (2020). Drugs, brains, and behavior: The science of addiction: Drug misuse and addiction.
  8. National Institute on Drug Abuse. (2020). Misuse of prescription drugs research report: What classes of prescription drugs are commonly misused?
  9. National Institute on Drug Abuse. (2018, January). Principles of drug addiction treatment: A research-based guide (Third edition): Is there a difference between physical dependence and addiction?
  10. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  11. Substance Abuse and Mental Health Services Administration. (2019). Treatment options: What happens next?
  12. Substance Abuse and Mental Health Services Administration. (2019). Treatment options: Types of treatment.
  13. Substance Abuse and Mental Health Services Administration. (2022). Medication-assisted treatment.

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