Hydrocodone Addiction: Signs, Symptoms & Treatments

What to Know About Hydrocodone

Hydrocodone is the most frequently prescribed opioid medication in the U.S. In 2018, pharmacies filled nearly 71 million prescriptions for products containing hydrocodone.¹ The substance is so popular because, like other opioids, it works quickly and effectively to promote pain relief and cough suppression. Hydrocodone is notable because it possesses morphine’s pain relief properties and codeine’s cough reduction effectiveness.¹

Hydrocodone is frequently prescribed alone or as a combination product, often with the addition of another pain reliever like acetaminophen. There are hundreds of hydrocodone products available.

Some of the most common hydrocodone products available are:^2,3

• Hydrocet
• Hycodan
• Lorcet
• Norco
• Vicodin

These substances are legal but strictly controlled. In an effort to lower the risks of the drug, prescribing rates are down. It is illegal to possess hydrocodone without a prescription.¹

As an opioid, hydrocodone’s impact on the body is similar to other drugs, like heroin, oxycodone, and fentanyl. These substances all bind to receptors in the brain and throughout the body.^4,5 Whether used as prescribed or abused, hydrocodone can produce a range of effects, such as sleepiness, euphoria, and a reduction in pain.

Uses for hydrocodone include:^4,5

• Pain relief
• Cough suppression
• Treating diarrhea
• Feelings of happiness
• Creating sleepiness and relaxation
• Changing or enhancing the effects of another drug

Beyond the desired outcome, people may encounter side effects of hydrocodone use.

Side effects of hydrocodone include: ⁴

• Confusion
• Nausea
• Constipation
• Slowed breathing
• Sedation

Hydrocodone is a powerful drug, which makes it appealing for those interested in the prescribed results as well as illicit effects.

How Is Hydrocodone Addictive?

Like many abused drugs, hydrocodone’s addictive nature is due to its ability to manipulate chemical messengers in the brain. When a person uses hydrocodone, the substance disrupts the brain’s normal balance of chemicals while also triggering the release of dopamine, a neurotransmitter linked to a strong feeling of reward.⁴

The rewarding feelings sparked by dopamine draw a person to repeat and reproduce that response, causing a hydrocodone addiction to begin. With continued hydrocodone use, a person may encounter tolerance, dependence, and a substance use disorder.⁴

Tolerance is marked by a person needing to use hydrocodone more often, at higher doses, or in different ways to produce the wanted effects.⁴ Repeated use leads the brain to decrease the intensity of its response, so an increase in the drug is needed. Tolerance is a typical response, even when using the drug as prescribed.

Dependence occurs when the brain and body need the substance in the system to feel well and function normally. A person dependent on hydrocodone will feel unwell when it’s unavailable.⁴ Like tolerance, dependence is a common result of long-term opioid use.

An opioid use disorder (OUD) is not expected. With this condition, a person has a problematic relationship with hydrocodone. Having an OUD indicates a person has signs and symptoms of opioid addiction, tolerance, and dependence.

Addiction differs from dependence, even though there is overlap. Dependence is a normal reaction to using a prescription substance, while addiction is a marked change in one’s thinking and behavior patterns. With addiction, the person’s life revolves around obtaining and using the substance.

Hydrocodone Addiction Statistics

Hydrocodone addiction remains a significant issue, but with reforms, prescription, abuse, and addiction rates are lower now than in the previous decade. In 2018, 5.5 million people in the U.S. misused hydrocodone, compared to 6.9 million in the previous year.¹

Additional hydrocodone addiction facts and statistics include:

• About 2.3 million people had a prescription opioid use disorder in 2020
• About 16,500 people died from a prescription opioid overdose in 2020
• 1.7% of high school seniors used Vicodin in 2018
• IN 2017, more than 1,800 calls to poison control involved hydrocodone

Risk Factors & Causes of Hydrocodone Addiction

The risk factors for developing an addiction involve a combination of biological and environmental issues. The combination of these factors may lead someone to be more likely to develop a substance use disorder.

Risk factors for hydrocodone addiction include:⁶

• Being younger. A person who develops an addiction in their teens or 20s will face an increased risk.
• Living in stressful situations
• Being unemployed
• Having little money
• Legal problems
• Mental health issues like depression and anxiety
• High risk-taking behaviors and high impulsivity
• Relationship problems with friends or family

With opioid use disorder, there appears to be a strong genetic component. This connection means that having a close family member with an opioid addiction could greatly increase a person’s risk.⁷

Hydrocodone Addiction Signs & Symptoms

Hydrocodone addiction signs and symptoms can be behavioral, physical, cognitive, and psychological. Unlike the immediate effects of hydrocodone, addiction symptoms take some time to develop. They may be challenging to identify initially as the person may be inclined to hide, minimize, or deny the substance’s impact on their life. With time, addiction will affect all parts of a person’s life.

Behavioral signs of hydrocodone abuse include:^6,7,8

• A notable change in attitude, personality, or general demeanor
• Avoiding contact with loved ones and isolating
• Change in relationships and friend groups
• Decreasing performance in home, work, and school responsibilities
• Stealing, asking people for money, or selling possessions

Physical signs of hydrocodone abuse include:^6,7,8

• Physical appearance changes, like losing or gaining weight, poor hygiene, wearing old or dirty clothes
• Seeming really tired, falling asleep in the middle of a conversation, or sleeping for long periods
• Small pupils
• Weak or slowed breathing
• Being sick with flu-like symptoms frequently
• Wearing long-sleeve shirts, even in the summertime

Cognitive and psychological signs of hydrocodone abuse include:^6,7,8

• Mood swings
• Irritability
• Appearing very stressed and anxious
• Making a series of odd or poor decisions
• Seeming forgetful and losing things
• Being distracted and disinterested

Effects of Hydrocodone Abuse

Hydrocodone abuse will increase the harm caused by the drug, and may cause behavioral dependence that can negatively impact one’s work, home, and social lives. Abusing the drug may also change how hydrocodone impacts the mind and the body, leading to a greater chance of developing tolerance, dependence, and addiction.

The effects of hydrocodone abuse and addiction may include:⁷

• Using hydrocodone more frequently or in higher amounts than intended
• An inability to reduce or stop use
• Spending a lot of time trying to get, use, and recover from use
• Developing strong urges and cravings to use the drug
• Struggling to complete one’s responsibilities because the focus is on drug use
• An increase in interpersonal conflicts
• Giving up interests and hobbies
• Using the drug in hazardous situations, like when driving
• Continue to use the drug when it is creating physical or mental health complications
• Tolerance
• Dependence

With hydrocodone addiction, a person can lose their housing, transportation, relationships, and health.  Eventually, the condition will damage all parts of their life and well-being.

Co-Occurring Disorders With Hydrocodone Addiction

Hydrocodone addiction frequently occurs with other mental or physical health conditions. Having two or more conditions makes symptoms more difficult to understand and makes achieving  recovery more challenging.

Disorders that commonly co-occur with hydrocodone addiction include:⁷

• Alcohol use disorder
• Cannabis use disorder
• Stimulant use disorder
• Sedative use disorder
• Various depressive disorders like major depressive disorder
• Insomnia
• Bipolar disorder
• Post-traumatic stress disorder (PTSD)
• Personality disorders, like borderline personality disorder and antisocial personality disorder

Depending on the way people use hydrocodone, they could become exposed to various viral and bacterial infections like HIV and hepatitis.⁷

Symptoms of Hydrocodone Withdrawal

When a person dependent on hydrocodone suddenly stops or cuts back on use, they will experience opioid withdrawal symptoms that are both physical and psychological in nature. The intensity and duration of hydrocodone withdrawal symptoms depend on a range of individual differences and how much of the drug is being used. In all cases, opioid withdrawal is an uncomfortable process.

Symptoms of hydrocodone withdrawal may include:^2,4

• Restlessness
• Teary eyes
• Runny nose
• Yawning
• Sweating
• Chills
• Muscle pain
• Anxiety
• Insomnia
• Poor appetite
• Nausea, vomiting, and diarrhea
• Leg twitches
• Strong cravings for more of the drug

Signs of a Hydrocodone Overdose

As a person misuses the drug, hydrocodone overdose can happen at any time, with dangerous or even deadly consequences. Severe withdrawal symptoms require medical attention, while others can be managed at home. Taking more of the drug, mixing it with other substances, or taking it in a way other than prescribed can increase the risk of overdose.⁴

To reduce the risk of hydrocodone overdose, always take the drug exactly as prescribed. Avoid increasing the dose and never use another person’s pills. If you have not used hydrocodone in a long time, check with your doctor about proper dosing.

Signs of a hydrocodone overdose include:²

• Slowed or stopped breathing
• Extreme sleepiness
• Blue-ish color to lips or nails
• Seizures
• Limp body
• Cold, clammy skin
• Very small or very big pupils
• Slowed heartbeat
• Trouble answering questions and confusion
• Struggle waking up
• Coma and death

If you suspect that you or a loved one is experiencing the signs of an opioid overdose, seek out medical assistance immediately. Medical personnel may utilize naloxone to slow or reverse symptoms of an overdose.

Treatment for Hydrocodone Addiction

Setting out for opioid treatment is challenging because each person’s needs are unique. Some people may need intensive inpatient treatment, while others can be well-maintained at home.

First, a person should get a thorough evaluation from an addiction expert to assess their symptoms and risks. Based on the recommendations,  a hydrocodone addiction treatment facility can tailor treatments to the needs and experiences of the individual. Providers may offer a combination of medications and therapies to manage the addiction.

Treatment options for hydrocodone addiction include:^9,10

Rehab

Inpatient or residential rehabilitation (rehab) requires the person to leave their home and live at the treatment center for the duration of their treatment. These programs are typically short, lasting only days or weeks, and intense with around-the-clock care.

Depending on the goals and treatment plan, a person may need a period of detoxification for the body to process and remove the drug from the system. This process is performed under a doctor’s care to ensure safety and stability.

Some rehabs resemble homes where the person receives a range of therapies to improve their mind and body. They usually share the space with others in treatment.

Intensive Outpatient Treatment

The person’s current symptoms and previous treatment experiences will dictate their need for inpatient vs. outpatient treatment. Outpatient treatment allows the client to live at home and maintain their outside responsibilities while attending treatment.

Outpatient treatment options range from one weekly session to daily sessions lasting several hours. People may only use individual sessions, while others utilize a combination of individual, group, and family therapy sessions. More treatment isn’t necessarily better, so finding the best treatment and leisure time balance is essential.

Residential rehabs usually last for one, two, or three months, but outpatient treatments may continue for years. Research shows that longer treatment periods are linked to more extended recovery periods.

Therapeutic Interventions

Working to find the right therapist and the best treatment facility can improve a person’s duration of recovery. Therapists will guide the recovery process and work to make a relapse prevention plan. Therapists may utilize a combination of therapeutic styles.

Therapy options for addressing hydrocodone addiction include:⁹

• Cognitive behavioral therapy (CBT): CBT helps address various mental health conditions, including substance use disorders, by focusing on the connection between a person’s thoughts, feelings, and behaviors.
• Contingency management (CM): CM uses reinforcement to build wanted behaviors in an individual. If the person engages in recovery-focused behaviors, they will earn a prize or reward to motivate additional behaviors.
• Motivational interviewing (MI): Where CM increases motivation from the outside, motivational interviewing helps to develop the person’s internal motivation. MI focuses on looking at a person’s goals and if their actions support the result.
• Family therapy or family systems therapy: These treatments utilize communication skills and communication to identify and resolve problems in healthier ways.
• Online Opioid Treatment Options: There are now online opioid treatment options, such as Bicycle Health, Workit Health, and Ophelia Health, which offer support and treatment for opioid use disorder and associated conditions.

Final Thoughts

Many people struggle with opioids as substances like hydrocodone create dependence, withdrawal, and addiction. Anyone interested in breaking out of this cycle should seek treatment immediately. With professional care and a dedicated treatment team, recovery is possible