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Hydrocodone Withdrawal

Some people with moderate-to-severe pain are prescribed hydrocodone as part of a pain management program. The potent opioid medication is more widely known by its trade names Vicodin, Lorcet, Lortab, Norco. It is a blend of the drug hydrocodone and acetaminophen, an over-the-counter pain reliever. Pure hydrocodone is sold as an extended-release capsule under the name Zohydro ER.

Hydrocodone’s strength is similar to that of morphine. Both medications are opioids. Like most other drugs in this class, hydrocodone binds to pain receptors in the central nervous system, blocking the pain signals that the nerves send to the brain. As a result, people who use hydrocodone perceive pain differently though the source of the pain has not been changed or eliminated.

According to the U.S. Drug Enforcement Administration (DEA), medicines that contain hydrocodone are prescribed more frequently in the U.S. than any other opioid medication. Users who take hydrocodone may experience nausea, vomiting, constipation, drowsiness, dizziness, anxiety, and slowed or irregular breathing.

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Hydrocodone’s potency makes it easy for many users to become dependent on it and ultimately addicted to it. It is among the prescription medications that are cited as responsible for the current opioid addiction and overdose crisis in the U.S.

People who take the medicine on prescription likely will build up a tolerance to it over time. This commonly happens with many drugs, but when it does, it means that a person may take more of the drug than prescribed or use it in a manner that it’s not designed for, which counts as abuse. Some use the drug to relax and experience euphoria. Crushing and snorting the pills in powder form is often done to get high. This practice often leads to stronger drug tolerance, dependence, and addiction. 

Ending an opioid addiction is a tough battle that’s hard to fight without proper medical support and guidance. If you  or someone you know wants to stop hydrocodone use properly, help is available to get back to full-time sobriety. However, hydrocodone withdrawal is just the beginning of the journey.

What Are Hydrocodone Withdrawal Symptoms?

Once someone decides to stop chronic or frequent use of a substance, the body will react as it adjusts to functioning without the drug that it has come to rely on. Stopping use usually results in withdrawal symptoms that can be uncomfortable. Common symptoms of hydrocodone withdrawal include:

  • Headaches
  • Muscle aches
  • Teary eyes
  • Sweating
  • Runny nose
  • Fatigue
  • Excessive yawning
  • Insomnia
  • Trouble concentrating
  • Agitation
  • Restlessness
  • Drug cravings
  • Depression
  • Stomach cramping
  • Irregular heartbeat
  • Nausea
  • Vomiting
  • Diarrhea
  • Chills

Stages of the Hydrocodone Withdrawal Timeline

Most people who are going through drug withdrawal want to know when it will end. The answer depends on the person and factors unique to them and their situation. The intensity and duration of the hydrocodone withdrawal timeline depend on various factors, such as:

  • The hydrocodone dose taken
  • How often the drug is taken
  • How long hydrocodone use has occurred
  • Age, genetics, medical history
  • Substance use history
  • Whether other drugs were abused along with hydrocodone

It’s best to consult with a physician who can help you determine which timeline you can expect your withdrawal to take. Generally, a hydrocodone withdrawal can look something like this:

woman-experiencing-detox-symptoms-sitting-on-bed

Days 1-2 – You may begin to feel mild withdrawal symptoms within the first six to 12 hours after the last dose. Body aches usually happen early in this phase. Users report feeling muscle, joint, and bone pain. Nausea, stomach cramps, and increased sweating are common during this time.

Days 3-5 – Withdrawal symptoms may peak during this time, which means they will be very uncomfortable.  Diarrhea, shaking, vomiting, and other flu-like symptoms may occur along with increased aches throughout the body. 

Days 6-7 – Users may feel some relief by the time they reach Day 6 as physical symptoms begin to ease up. However, mood swings are common during this period. Other psychological symptoms, such as drug cravings, can linger.

Day 8 and after – Many users find that their physical symptoms have subsided by this point. However, people with  severe cases of addiction may experience symptoms for a longer time. Anxiety can arise, along with mood swings, for a few days, weeks, or months. Continued treatment after the detox process takes place is strongly recommended.

Why Should I Detox from Hydrocodone Use?

Some people will attempt to quit longtime hydrocodone on their own in “cold turkey” fashion. However,  quitting the drug on the spot is not recommended. It’s not safe, and there are no guarantees that relapse won’t happen. Stopping suddenly can be hard on the body because it has become used to functioning on the drug.

It is recommended that you enter a facility that offers medical detox to ensure you safely come off the drug. This process is carried out under the supervision of medical professionals and addiction care specialists who understand the unique challenges of drug withdrawal. You will  be monitored for up to 10 days (or more if needed) for any complications that may arise. You will most likely be guided through a tapering schedule that will gradually reduce the dose you’re used to having to help minimize withdrawal symptoms. If you are given medications during this period, they may include:

  • Buprenorphine
  • Methadone
  • Naltrexone
  • Clonidine

What Is the Next Treatment Step?

A detox under medical supervision is the start of the recovery journey. This is an important first step because users gain the stability that’s needed to continue the work that must be done. After detox wraps up, you will receive recommendations on where to continue the rest of your treatment. A continuum of care offers various placements at any point in the recovery process that should be able to address your situation.

You can enroll in a residential or partial hospitalization program or an intensive outpatient or outpatient program. Any of these placements can provide you with behavioral therapies, counseling, and other services that you need for your recovery and growth in sobriety. You will learn the reasons behind your hydrocodone dependence or addiction and gain the tools and strategies to guard against relapse, which is common in recovery. 

The National Institute on Drug Abuse writes that relapse rates in the recovery community are between 40 to 60 percent. These are similar to relapse rates for other commonly known chronic illnesses such as hypertension (high blood pressure) and asthma, among others. 

Psychological disorders that might be present are also addressed in treatment through dual diagnosis programs.  Many users need treatment for anxiety, depression,  or post-traumatic stress disorder, among other disorders, while in treatment for substance use disorders. They often occur hand in hand, so both need to be addressed at the same time together to improve the chance of managing both effectively.

Residential Treatment

Residential treatment is for people who have severe addictions and need more time to address and work through it. People who enroll in this kind of program live on-site at a monitored facility that offers 24-hour care from medical professionals and a setting that promotes a full-time focus on recovering from substance abuse. Treatment can last between 30 to 90 days, but longer stays are possible, as each person’s individual needs help determine their stay.

Partial Hospitalization

A partial hospitalization program (PHP) is a step down from residential treatment program. It is moderately structured but still offers the flexibility that addresses a person’s needs and the medical care they need as well. This placement is ideal for those who have finished medical detox and completed their time in residential treatment. Individuals can move from detox to a PHP after their needs have been reviewed. People who have attained stability to the point where they do not require traditional residential services, such as medical services, may find a partial hospitalization program is a good fit for their recovery.

Intensive Outpatient Programs and Outpatient Programs

An intensive outpatient program (IOP) is ideal for users in recovery who live at the treatment center as they attend therapy and counseling. This kind of program is attractive to people who need more flexibility in their schedule so that they can handle other responsibilities, such as going to work or school or caring for a child.

The key difference between intensive outpatient programs and outpatient programs is the number of hours participants are required to complete each week. IOPs require nine or more hours a week, while OPs require fewer than nine hours a week. These programs are ideal for people who are in the early stages of substance recovery and for those whose addiction isn’t severe but serious enough that it requires working with an addiction treatment professional or counselor.

It’s best to be as honest as you can when deciding which setting is best for treating your hydrocodone dependence or addiction. Professionals can advise you or your loved one on the level of care that you need so you can leave substance abuse far behind for a life free from drug use.

Sources

“Drug Fact Sheet: Hydrocodone.” Drug Enforcement Administration. from https://www.dea.gov/druginfo/drug_data_sheets/Hydrocodone.pdf

“Understanding Hydrocodone Addiction.” Healthline. 26 June 2014. from http://www.healthline.com/health/understanding-hydrocodone-addiction#Overview1

National Institute on Drug Abuse. (2018, July). Treatment and Recovery. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

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