Hydrocodone Abuse, Withdrawal, Effects, & Treatment
Hydrocodone – known by various brand names, including Norco, and Lortab – is the most widely prescribed painkiller in the United States.
Hydrocodone is an opioid medication, and its principal use is to treat moderate to severe pain. All opioids, prescription or illegal, have a high potential for abuse and dependence and are DEA-controlled substances.1 You can only legally use hydrocodone with a prescription, though this drug is sometimes produced and sold illegally.2,3
Abusing hydrocodone may quickly lead not only to physical dependence (which causes withdrawal when one tries to cut back or stop using) and opioid addiction (opioid use disorder).4
Signs of Hydrocodone Abuse
You may worry a loved one is abusing hydrocodone. It’s sometimes difficult to tell if a problem exists, especially if your loved one does have a prescription for the drug and a legitimate medical need for pain relief. However, there are some red flags you can look out for. These include:5,6
- Repeatedly reporting “lost” or “stolen” hydrocodone prescriptions.
- Trying to obtain hydrocodone from places other than primary prescriber.
- Displaying signs of withdrawal (flu-like symptoms) at appointments to get painkillers.
- Requesting increasing amounts/doses of opioids from doctors
- Unwilling to entertain alternatives to painkillers for treatment.
- Often appears oversedated or extremely sleepy.
- Changes in personal hygiene, exercise habits, weight, and sleeping.
- Increasing isolation and suspicious behavior.
- Decreased libido.
- New problems with money/finances.
The main thing you may notice is a preoccupation with opioids. If your loved one is spending a great deal of time in thinking about opioids and planning how to get or use them, they may be abusing them. They may also become so preoccupied with hydrocodone that it takes priority over other activities, obligations, and relationships.7
Long-Term Effects of Hydrocodone Abuse
There are numerous health issues that can occur with many years of hydrocodone abuse. They include:
- Cardiovascular damage: Some studies have associated hydrocodone use with increased risk cardiovascular death.8
- Gastrointestinal problems: Prescription opioids may cause many GI issues, including constipation (which may be very severe), nausea, vomiting, and reflux, as well as abdominal pain and cramping.9,10
- Malnutrition: Those who abuse hydrocodone are likely to experience reduced appetite/anorexia and may become malnourished.10
- Chronic constipation: Chronic constipation may damage the intestinal tract and may cause bowel obstruction.10
- Oxygen deprivation: Chronic opioid use is linked to an increased risk of sleep apnea and hypoxemia (a low level of oxygen in the blood).11 Having too little oxygen in the blood may lead to symptoms including shortness of breath, confusion, and headache.
- Hormonal changes: Opioid use can impact the endocrine system in both males and females and may increase the risk of problems such as infertility, decreased sexual functioning, and depression.12
- Hyperalgesia: Abusing opioid drugs like hydrocodone can paradoxically increase a person’s sensitivity to painful stimuli.13
- Tolerance, dependence, and addiction: Long-term opioid use can result in tolerance, or needing ever-increasing doses to achieve the effects. It can also result in the body becoming physically dependent on the drug to function as expected and avoid withdrawal. Repeated misuse of opioids like hydrocodone can also result in an opioid addiction.4
Hydrocodone Overdose Risk
Chronic hydrocodone abuse is associated with the risk of opioid overdose. This occurs when you take more of an opioid drug than your body can tolerate. Someone who misuses or is addicted to hydrocodone may risk overdose by:14
- Taking higher and higher doses to get the effects they want.
- Take hydrocodone with other substances like alcohol.
- Taking hydrocodone that was produced and sold illegally (as it may contain other substances such as fentanyl).
The 3 most common signs of a hydrocodone overdose (known as the opioid overdose triad) are:14
- Extremely small pupil size.
- Loss of consciousness.
- Slowed and/or difficult breathing.
Hydrocodone Withdrawal & Detox
Hydrocodone withdrawal can be very physically uncomfortable and may also create some psychological distress. While not typically dangerous, the opioid withdrawal syndrome can be really challenging and may cause relapse for those trying to get sober. The symptoms of hydrocodone withdrawal mimic those of a bad flu and often last for about 3-5 days.15
Medical detox for hydrocodone withdrawal can take place in an inpatient facility or outpatient program. With medications and the support of professionals, withdrawal from hydrocodone can be made much more manageable. At Desert Hope, we provide inpatient medical detox utilizing medications and the 24/7 supervision and support of doctors and nurses.
Finding Hydrocodone Addiction Treatment
Each person’s hydrocodone addiction is different, thus each person’s treatment plan should be individualized.
Talking to a Loved One About Hydrocodone Abuse
If you are a friend or family member who has noticed the signs of opioid abuse or addiction in a loved one and wish to help them seek help for hydrocodone addiction, it is important to remember that you can’t fix the situation. You can guide your loved one toward treatment but you cannot be responsible for their addiction or their sobriety.
If your loved one is willing to accept help, they should be referred to an appropriate treatment facility. If your loved one is not open to receiving treatment, different approaches may be warranted.
Some people may refuse to seek treatment for fear that it may become public knowledge that they are in a rehabilitation facility. In such cases, it is important to reassure the individual that no provider can release any of the person’s medical information without written consent. Privacy laws are in effect that prevent such information from being shared as well.
The person may also fear being “forced” to stop taking hydrocodone. Family members and friends should take this fear into consideration and not dismiss it as invalid. Reassure your loved one that programs that incorporate medical detox will help ease the transition to sobriety and keep them comfortable during acute withdrawal.
If your loved one’s fear is related to an inability to pay for treatment, rest assured that financial issues don’t have to be an obstacle on the road to recovery. The Mental Health Parity and Addiction Equity Act requires insurance providers to cover mental health and addiction services in the same way that other essential services are covered. If the person does not have health insurance, some facilities offer a sliding fee scale. These facilities offer services at a low cost to clients in need, and rates are normally based on clients’ income levels. Individuals who need treatment, or their loved ones, may contact facilities before committing to treatment to ask about which payment options they offer.
Those who have previously been to rehab should be reminded that they are not a failure. The person has learned the skills necessary to recover and should not be afraid to try treatment again. Relapse is often part of the recovery process, and the individual’s return to treatment may indicate that care needs to be adjusted or changed in some way.