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Hydrocodone Addiction: Signs, Symptoms & Medications

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Aug 10, 2023 • 8 cited sources

Signs of hydrocodone addiction include a fixation on getting and using hydrocodone, isolation from family and friends, a decline in performance at work or school, and financial issues. Those with an opioid use disorder (OUD) related to hydrocodone use often experience sedation, constipation, mood swings, and withdrawal symptoms when they don’t take the drug.

The recommended treatment for hydrocodone addiction is Medication for Addiction Treatment (MAT). MAT combines the use of a medication like Suboxone to manage withdrawal and cravings with therapy to address OUD.

Hydrocodone is an opioid used to relieve pain and ease coughing. For decades, the drug was relatively easy to get. When it was combined with other ingredients (like acetaminophen), its use was loosely regulated. Doctors prescribed it routinely.

Since hydrocodone’s dangers have become clear, regulations have shifted and the drug is harder to get. Even so, many people are introduced to hydrocodone by their doctors, and they develop difficult substance misuse issues as a result. 

Keep reading to find out what hydrocodone is and how it works. 

What Is Hydrocodone?

Hydrocodone is an opioid medication that is chemically similar to heroin. It latches to receptors within the brain and triggers chemical reactions, leading to intense relaxation and euphoria. 

Hydrocodone is included in many familiar brand-name medications, including the following:

  • Vicodin
  • Lorcet
  • Lortab
  • Norco
  • Tussionex

All told, the drug is included in several hundred brand-name and generic medications, some used for pain and others for cough.[1] It’s commonly included with other pain relievers, including acetaminophen, in one pill. 

Key Facts About Hydrocodone

Understand Hydrocodone Overdose

Hydrocodone is a central nervous system (CNS) depressant, slowing electrical signals between the brain and the body. Within minutes of taking the drug, people feel sedated and slow. CNS depression is to blame. 

When the CNS is depressed too much, breathing rates and heartbeats slow to dangerous levels. Cells starved of oxygen and nutrients begin to die, and blood clots within the veins. Without quick action, people can die due to a hydrocodone overdose. 

Common hydrocodone overdose symptoms include the following:[5]

  • Cold or clammy skin 
  • Pinpoint pupils 
  • Slow breathing 
  • Loss of consciousness

The opioid antagonist naloxone can inactivate hydrocodone and restore consciousness within minutes. A nasal spray delivers this potent medication, and it’s designed for novices to administer. Anyone who uses hydrocodone should keep this medication on hand. 

Some people overdose the very first time they try hydrocodone. But often, long-time users experience this complication.

As hydrocodone misuse deepens, people need larger doses. In time, the doses they need to experience euphoria or avoid sickness are so large that they suppress the CNS. An overdose quickly follows.

It’s not uncommon for people who have been taking hydrocodone for years to overdose. Even if they have been continually raising their dosage, they simply reach a point where they take too much.

What Is Hydrocodone Tolerance & Dependence?

People need larger doses of hydrocodone due to drug tolerance, which can build within just two to three doses.[6] 

Hydrocodone tricks brain cells into releasing large amounts of neurotransmitters, which are responsible for the drug’s euphoria. Brain cells adjust by dampening their reaction to the drug, forcing the person to take more. 

While people might take hydrocodone for euphoria, in time, they take the drug to avoid sickness. Dependence means brain cells function improperly when the drug is not in the person’s system. They’ve adjusted and regulated to account for the constant presence of hydrocodone. When the drug isn’t available, sickness begins.

Between doses, people with hydrocodone dependence can experience flu-like symptoms accompanied by muscle aches and anxiety. The doses they take don’t make them high, but they can make sickness stop.

If people attempt a cold-turkey halt to hydrocodone, these symptoms worsen. People may experience deep nausea, diarrhea and dehydration. Withdrawal like this can be life-threatening. 

Side Effects of Hydrocodone Misuse

Dependence can keep people taking hydrocodone even when they want to quit. Both physical and mental health issues can develop. 

Side effects of hydrocodone misuse include the following:[3]

  • Confusion
  • Constipation
  • Depression
  • Dizziness
  • Dry mouth 
  • Increased pain sensitivity
  • Itching
  • Nausea
  • Sedation

Some people crush hydrocodone pills, mix them with water and inject the solution. Coatings on hydrocodone pills don’t dissolve in the bloodstream and can clump together to block blood vessels. Many people who inject drugs develop deep sores and painful tissues due to these foreign bodies.

Injecting drugs can also lead to hepatitis and HIV infections. Sharing needles with people who are infected can mean pushing the viruses directly into veins. But opioids can also lower inhibitions and reduce decision-making abilities. These traits can mean engaging in risky sexual practices, leading to infections.

Misusing hydrocodone products that contain acetaminophen comes with original dangers. The liver processes acetaminophen, and this critical organ can be damaged if too much is taken. People can die due to toxic amounts of acetaminophen. 

Signs & Symptoms of Hydrocodone Misuse

Anyone can misuse hydrocodone. Substance use issues don’t discriminate and can impact people from all walks of life. 

Common physical symptoms include the following:

  • Unexplained sedation
  • Episodes of head nodding or unconsciousness
  • Track marks due to injecting drugs
  • Frequent complaints of pain and requests for drugs 
  • Unexplained constipation
  • Sweating or anxiety between doses
  • Mood swings

Common behavioral symptoms include the following:

  • Demands for privacy
  • Unexplained absences from work or school
  • Disinterest in things the person once enjoyed
  • Withdrawal from friends and family

When Is It Time for Treatment?

Some people read through physical and behavioral symptoms, recognize themselves and ask for help. But it’s hard for others to accept that their drug use has become a problem. 

If you’re using hydrocodone, ask yourself the following questions:

  • Are you using the drug without a prescription?
  • If you have a prescription, are you straying from your doctor’s instructions?
  • Do you feel sick or anxious between doses?
  • Have you tried to quit and failed?

Hydrocodone addiction treatment works. But if you have the symptoms listed above, it’s critical to talk to your doctor about your drug use and find out about your options. 

How Does MAT Work?


Medication for Addiction Treatment programs use prescription medications to correct chemical imbalances involved in hydrocodone dependence. Those therapies can also mitigate the cravings caused by opioid use disorders.

The U.S. Food and Drug Administration approved three MAT drugs for hydrocodone misuse: buprenorphine, methadone and naltrexone.[7] Your doctor can help you decide what medication is right for you.

Some MAT programs also use therapy (such as cognitive behavioral therapy) to help people develop healthy thought patterns and behaviors. But MAT is also effective when the program only uses medications. 

When an MAT program plan is followed correctly, people can take their medications for years.[8] Prescriptions don’t get people high, but they can keep them focused on recovery without relapse. Many people continue to take their medication indefinitely, as it provides continued support.

Getting Started With Bicycle Health

Bicycle Health uses telemedicine to administer MAT programs. Meet with a qualified provider via phone or computer to discuss your hydrocodone misuse, treatment history and future goals. If you’re a good candidate, your doctor will write a prescription you can fill at your local pharmacy.

Bicycle Health providers use Suboxone, a combination of two powerful MAT therapies. Buprenorphine in Suboxone corrects chemical imbalances and eases cravings, while naloxone works as a misuse deterrent. If you slip and try to inject your Suboxone, the medication won’t work.

Suboxone is approved for at-home use, so you can take your medication without visiting an in-person clinic. And since all of your appointments are conducted via telemedicine, no one will know about your private medical concerns. 

Bicycle Health is accepting new patients now, and the enrollment team can help you understand how the model works and whether it’s right for you. Contact us to find out more and get started on a whole new life.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

Sources
  1. Hydrocodone. Drug Enforcement Administration. https://www.deadiversion.usdoj.gov/drug_chem_info/hydrocodone.pdf. October 2019. Accessed April 2023.
  2. New Restrictions on Hydrocodone to Take Effect. Arkansas Medical Society. https://www.arkmed.org/news/2014/08/new-restrictions-on-hydrocodone-to-take-effect/. August 2014. Accessed April 2023.
  3. Prescription Opioids. Centers for Disease Control and Prevention. https://www.cdc.gov/opioids/basics/prescribed.html. August 2017. Accessed April 2023.
  4. Prescription Opioids Drug Facts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/prescription-opioids. June 2021. Accessed April 2023.
  5. Hydrocodone. Drug Enforcement Administration. https://www.mcieast.marines.mil/Portals/33/Documents/Safety/Abuse/Hydrocodone.pdf. Accessed April 2023.
  6. Opioids and the Physiology of Tolerance. University of Utah. https://learn.genetics.utah.edu/content/addiction/tolerance. Accessed April 2023.
  7. Information About Medication-Assisted Treatment (MAT). U.S. Food and Drug Administration. https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat. February 2019. Accessed April 2023.
  8. Opioid Addiction Treatment. American Society of Addiction Medicine. https://www.asam.org/docs/default-source/publications/asam-opioid-patient-piece_-5bopt2-5d_3d.pdf. 2016. Accessed April 2023.

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