Hydrocodone is a primary ingredient in several prescription pain medications. It is formulated in combination with other pain relievers such as acetaminophen or ibuprofen. Hydrocodone is an opiate-type medication which can be used to treat pain or relieve coughs. Brand name hydrocodone drugs such as Norco, Vicodin, and Lortab have been widely used for decades but have resulted in many emergency room visits and deaths due to overdose. Even though hydrocodone is commonly abused, addiction can be effectively treated by health professionals.
Hydrocodone is an opioid pain medication that was originally formulated in the 1920s. It is a synthetic opiate, chemically modified from naturally-occurring codeine and is used for moderate to severe pain and severe cough disorders. It was introduced as Vicodin, a combination with acetaminophen in 1978 and quickly became one of the most commonly used pain medications available.
There are about 20 name-brand medications which contain hydrocodone as a combination product but most people receive a generic version of the prescription. Until recently, hydrocodone was largely available as a controlled substance Schedule III (C-III) medication but it has been upgraded to the more controlled C-II class and usually requires a special type of prescription.
Hydrocodone Brand Names
- Hydrocodone extended release – Hysingla ER, Zohydro ER
- Hydrocodone with acetaminophen – Vicodin, Lortab, Norco, Lorcet
- Hydrocodone with ibuprofen – Vicoprofen
Hydrocodone Controlled Substance Classification
When hydrocodone first became popular as a pain reliever and cough suppressant in the U.S., it was introduced as a hydrocodone 5mg / acetaminophen 500mg C-III medication which indicated it was addicting and had a high potential for abuse. In the late 1990’s a stronger version of hydrocodone was introduced, sold under the brand Norco, as a hydrocodone 10mg / acetaminophen 325 mg tablet. Coinciding with the increased strength, emergency room visits for overdoses caused by hydrocodone began to increase. By 2009, the number of hydrocodone-related visits reached over 105,000 annually and overdose deaths from opioids increased by four-fold. Newer medications including Zohydro ER and Hysinga ER are manufactured with abuse-deterrent mechanisms that prevent the drug from being snorted or injected.
In 2014, all hydrocodone products were changed to the higher C-II controlled substance classification, putting it into the same category as morphine, oxycodone, and hydromorphone. This move was intended to notify prescribers that the drug was more addicting and more dangerous than previously considered and served to make hydrocodone more difficult to obtain. Prescriptions of hydrocodone products are limited in quantity and frequency, cannot be refilled and must be issued under a specialized prescribing system, depending on the state.
Despite this increase in prescribing requirements, hydrocodone continues to be widely abused and many people are addicted to the medication.
Side Effects of Hydrocodone
Like other drugs, hydrocodone has a number of side effects. Most of these effects involve its activity in the central nervous system and brain but other areas are affected as well. Common side effects include
- Nausea / Vomiting
- Blurred vision
- Dry mouth
- Constricted pupils
Signs of Hydrocodone Abuse
When taken as prescribed, hydrocodone does not commonly cause severe side effects but when taken for non-medical reasons it may result in serious and potentially life-threatening effects such as:
- Extreme Dizziness
- Excessive Vomiting
- Loss of consciousness
- Slowed breathing
Like all opioids, hydrocodone may also cause tolerance when taken for a long period of time. People who become dependent upon hydrocodone will require increasingly larger doses to achieve the same effects. Because hydrocodone is commonly prescribed as one of the acetaminophen combination drugs, high doses of acetaminophen may also cause liver disease.
In addition to the physical effects, long-term use of hydrocodone can also result in psychological effects. Some of these may include:
- Excessive anger
- Chronic Anxiety
- Visual disturbance of difficulties
- Relationship troubles
- Difficulty with employment
People who take hydrocodone for non-medical reasons over a long period of time may become “used” to feeling “numb”. The brain also begins to crave the euphoric effects of hydrocodone, creating a pattern of repeated abuse.
Over time, certain processes involving opiate receptors within the brain undergo physical changes. When the drug is absent, symptoms of withdrawal will occur.
Hydrocodone Withdrawal Symptoms
In many cases, the symptoms of withdrawal are “opposite” to the effects of taking the medication. Because hydrocodone relieves pain, causes euphoria and has effects like constipation, the withdrawal will result in the opposite reactions.
Common symptoms of hydrocodone withdrawal include:
- Flu-like symptoms of body aches, headache and backache
- Skin sensitivity
- Severe anxiety or panic
- Restlessness and insomnia
- Heart palpitations
- Cold sweats
- Auditory and olfactory disturbance
Hydrocodone Addiction Treatment
Withdrawal from hydrocodone can be extremely painful, making it very difficult to do, particularly without assistance. Medical treatments can sometimes be used to reduce symptom severity but close supervision is required.
In other cases, a physician may be able to slowly wean a patient off of the medication by using medications such as buprenorphine or methadone. In addition, behavioral treatments such as group or individual therapy, 12 step programs or rehabilitation treatment increase the chance of recovery.
In all cases, the first step towards recovery is recognition of the disease. Some patients will seek assistance while others must be forced or coerced into treatment. Rehabilitation centers are often successful at designing and implementing a plan that can effectively manage withdrawal and help to recognize and change behavior patterns so that recovery is possible.
Notwithstanding claims relating to this product, the drug/medical device remains approved by the U.S. FDA.