Vicodin (generic name hydrocodone-acetaminophen) is a prescription medication containing a powerful opioid (hydrocodone) and an over-the-counter antipyretic (acetaminophen). Vicodin is a pill and is meant to be swallowed. However, like many pills, people may misuse Vicodin by crushing and either snorting or dissolving it in water and then injecting it. People do this to get the hydrocodone opioid into their bloodstream faster, which delivers a sensation of being high.
Manipulating medications this way is incredibly dangerous. Risks include infections, tissue damage, overdose, and death.
[Health Warning: Snorting Vicodin can be dangerous to your health and even life-threatening. It can lead to severe respiratory depression, coma and overdose as well as a myriad of other health problems like nasal damage.]
Key Facts About Snorting and Injecting Vicodin
Key Facts About Snorting and Injecting Vicodin
- Medications with hydrocodone are among America’s most frequently misused drugs.[1]
- Misusing drugs like Vicodin, which also contain acetaminophen, can also cause liver damage.[2]
- Almost 100% of all the hydrocodone in the world is used within the United States.[14]
- In one study of people in an opioid use disorder treatment program, 80% tampered with their pills in order to sniff or inject the substances to make them work faster.[4]
- Nearly 5 million people aged 12 or older misused hydrocodone medications in 2020.[9]
What is Vicodin?
The prescription painkiller Vicodin contains two ingredients:
- Hydrocodone, an opioid that’s chemically similar to powerful drugs like heroin
- Acetaminophen, an over-the-counter painkiller/anti-pyretic
In 2014, officials classified Vicodin as a Schedule II drug, due to concerns about misuse and addiction.[5]
What is Vicodin Used For?
Vicodin is used short term to help people with mild to moderate pain that can’t be controlled with safer therapies like aspirin or ibuprofen. Vicodin along with other opioids painkillers are intended to be used on a short term basis only, such as after a surgery or a dental procedure. [1]
Vicodin and other opioids should not be used long-term as evidence shows that they have significant harms and side effects with long-term use, including:[13]
- Paradoxical increases in pain (called “hyperalgesia”)
- Constipation
- GI upset
- Itching
- Mental status changes
- Fractures
- Osteoporosis
- Sleep-related breathing problems
- Weakened immune system
- Chronic constipation
- Bowel obstruction
- Sedation
- Overdose
- Respiratory depression
- Heart attack
- Infertiilty
- Erectile dysfunction
- Depression
- Coma
- Death
How Do People Misuse Vicodin?
People using Vicodin in order to get high may do so in a few ways. They may take more or higher doses of Vicodin at a time than prescribed by their doctor. They may also ingest the medication in a way other than by mouth, such as crushing the pill and then either sniffing/snorting it or injecting it. [4]
Why Do People Snort or Inject Vicodin?
Tampering with tablets by snorting or injecting them allows Vicodin to enter the bloodstream and ultimately the brain more quickly.
Users experience a more intense, rapid high via this method.
Injecting or Snorting Vicodin: Which is Worse?
Tampering with Vicodin is dangerous, no matter whether you snort the substance or inject it. Neither is safe.
What Are the Dangers of Snorting Vicodin?
Vicodin tablets should be swallowed orally. The ingredients aren’t made to interact directly with the sensitive tissue inside your nose and throat.
Potential complications include the following:[3],[10]
- Nosebleeds
- Runny nose
- Whistling sounds when you breathe
- Voice changes
- Sore throat
- Damage to the nasal septum, which could impact your ability to breathe
- Loss of sense of smell
- Infections caused by sharing snorting tools (like straws)
- Damage to your throat and mouth
What Are the Dangers of Injecting Vicodin?
Injecting Vicodin, or any medication for that matter, can lead to the following consequences:[10]
- Bloodstream or skin Infections where the needle enters your body
- Scars caused by your infections and injections
- HIV infections caused by sharing needles
- Hepatitis C infections caused by sharing needles
- Organ damage caused by particles moving into your bloodstream via needle
- Sepsis and death
- Respiratory depression leading to overdose and even death
Vicodin Misuse and Liver Damage
One significant danger of misusing Vicodin is severe liver toxicity and damage. This is because Vicodin contains acetaminophen, which is safe at therapeutic doses (up to 1000mg every 4-6 hours) but harmful at higher doses. Research indicates that acetaminophen can be toxic at 7.5 grams per day. [12]
And people who misuse Vicodin tend to use larger amounts than recommended and misuse it by snorting or injecting it, which puts them at risk for severe liver damage.
Acetaminophen toxicity is the leading cause of liver transplants in the U.S. and is responsible for about 56,000 emergency department visits per year.[12]
Can Snorting or Injecting Vicodin Cause an Overdose?
Yes. Since 1999, more than 760,000 people have died from opioid overdoses. [6] Vicodin, particularly if snorted or injected, is an opioid that can cause overdose. [7] People can overdose accidentally even if they are taking their medications orally as prescribed. However, you are even more likely to experience an overdose if you misuse your medication by snorting or injecting.
Symptoms of Vicodin overdose include the following:[8]
- Pale, clammy skin
- Limp body
- Blue or purple fingernails or lips
- Vomiting
- Unconsciousness
- Slowed breathing or heartbeat
Anyone with these symptoms is experiencing a medical emergency. Call 911 and follow the operator’s instructions carefully. If Narcan is available, administer it immediately.
Legal Consequences of Misusing Vicodin
Vicodin is a Schedule II Controlled Substance, which means that it has a legitimate medical use but also has a high risk of misuse, dependence, and addiction. It also means that it is highly regulated.
Every state has different laws pertaining to illegal Vicodin possession and misuse. However, it is illegal no matter where you live in the United States.
In some states, like California, it is considered a misdemeanor punishable by up to one year in jail and/or $1,000 in fines.
However, other states, such as Georgia, have harsher laws and consider opioid possession a felony, carrying up to 30 years in jail, depending on the quantity.[11]
Unlawful Vicodin possession includes having and using it without a prescription, buying it on the street, and possessing it with intent to sell.
Learn About Bicycle Health for OUD Treatment
People who misuse Vicodin may struggle to quit without help. Their withdrawal symptoms can push them back to using, even when they want to quit.
Bicycle Health offers Suboxone treatment. This medication can reduce withdrawal symptoms and limit drug cravings. With the help of this medication, you could stop using illicit drugs and start living a different life.
The Bicycle Health team uses telemedicine to connect with patients. You’ll have safe, secure appointments from home, and you’ll pick up your medications at a pharmacy near you.
Contact us to find out if this model is right for you.
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
- Why Do We Prescribe Vicodin? JADA. https://jada.ada.org/article/S0002-8177(16)30415-9/fulltext. July 2016. Accessed November 2022.
- Hydrocodone. Drug Enforcement Administration. https://www.deadiversion.usdoj.gov/drug_chem_info/hydrocodone.pdf. October 2019. Accessed November 2022.
- Hydrocodone Snorting Leading to Hypersensitivity Pneumonitis. Baylor University Medical Center Proceedings. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900771/. July 2016. Accessed November 2022.
- Strategies to Reduce the Tampering and Subsequent Abuse of Long-Acting Opioids: Potential Risks and Benefits of Formulations with Physical or Pharmacologic Deterrents to Tampering. Mayo Clinic Proceedings. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498428/. July 2012. Accessed November 2022.
- DEA to Publish Final Rule Rescheduling Hydrocodone Combination Products. Drug Enforcement Administration. https://www.dea.gov/press-releases/2014/08/21/dea-publish-final-rule-rescheduling-hydrocodone-combination-products. August 2014. Accessed November 2022.
- Opioid Crisis Statistics. U.S. Department of Health and Human Services. https://www.hhs.gov/opioids/statistics. December 2022. Accessed January 2024.
- Opioid Abuse. American Society of Anesthesiologists. https://www.asahq.org/madeforthismoment/pain-management/opioid-treatment/opioid-abuse/. Accessed November 2022.
- Opioid Overdose. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/opioid-overdose. September 2022. Accessed November 2022.
- Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PDFW102121.pdf. Substance Abuse and Mental Health Services Administration. 2021. Accessed December 2023.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
- Penalties for Violation of Georgia Controlled Substance and Dangerous Drug Laws. Emory University. https://clery.emory.edu/policies/penalties.html. Accessed December 2023.
- Acetaminophen Toxicity. Agrawal, S. and Khazaeni, B. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; January 2023. Agrawal S, Khazaeni B. Acetaminophen Toxicity. [Updated 2023 Jun 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441917/. Accessed December 2023.
- Von Korff M, Kolodny A, Deyo RA, Chou R. Long-term opioid therapy reconsidered. Ann Intern Med. 2011;155(5):325-328. doi:10.7326/0003-4819-155-5-201109060-00011
- Hot topic: global trends in the use of opioid analgesics. Current Addiction Reports. https://link.springer.com/article/10.1007/s40429-019-0234-2. March 2019. Accessed January 2024.
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