Hydrocodone is a semi-synthetic opioid synthesized from codeine, a substance derived from opium. The term opioid used to mean any synthetic drug that provided the same effects as naturally-derived opiates like codeine or morphine, but now opioid has become the blanket term for any drugs within the opiate family, natural or synthetic.
Like other drugs in the opioid class, hydrocodone is a narcotic and analgesic, which is another way to say that it is a painkiller, and as such is typically prescribed to treat the symptoms of moderate to severe pain, although it also commonly used as a cough suppressant.
First synthesized in Germany in 1920, hydrocodone was approved for sale in the United States by the FDA in 1943, becoming one of the most prescribed medications in the country, especially in the form of Vicodin, the name brand for a combination of hydrocodone and acetaminophen.
According to the International Narcotics Control Board, the United States currently consumes roughly 99 percent of the worldwide supply of hydrocodone.
Despite its addictive qualities and high potential for abuse and overdose, hydrocodone was only placed on the tightly controlled Schedule II DEA substance classification as of 2013.
Currently, the United States prescribes three times as many opioids as the rest of the world, and according to the National Institute on Drug Abuse, more than 115 people in the United States die of an opioid overdose every day, a statistic that includes prescription opioids like hydrocodone.
If you or someone you care about has become dependent on hydrocodone, don’t wait until it’s too late and risk becoming a statistic. It is vital that you seek out professional treatment and detoxification as soon as possible.
What are the Symptoms of Hydrocodone Withdrawal?
Hydrocodone works in the same way that many opioids do, rapidly entering the brain and producing the effects of sedation and pain relief in as little as 10 to 20 minutes. It does this by binding to neurotransmitters throughout the brain and central nervous system known as opioid receptors.
Opioid receptors are brain chemicals that regulate stress levels and are also responsible for transmitting pain signals throughout the brain and nervous system. Hydrocodone binds to these receptors by mimicking their chemical composition and activating them to increase opioid production and activity.
This process blocks off parts of the brain from receiving pain signals as well as stopping the spinal cord from sending them. Finally, it also boosts the levels of a different neurotransmitter called dopamine in the limbic system, also known as the brain’s pleasure center. This causes an increase in feelings of pleasure and euphoria, specifically the “high” that comes with the pain relief.
When someone becomes dependent on hydrocodone, their brain stops making its own dopamine and opioids, instead relying on those provided by regular hydrocodone abuse in order to continue functioning as normal. It also builds up a tolerance to hydrocodone’s effects, requiring more and more of it as time goes on.
When someone tries to stop using hydrocodone, their body, now deprived of both dopamine and the pain-masking effects of the opioids, will crash as it struggles to cope with this shortage, which is what causes hydrocodone withdrawal symptoms.
Like most opioid withdrawal symptoms, the symptoms of hydrocodone withdrawal are rarely ever fatal, but they can be very difficult to manage and sometimes quite painful. Hydrocodone withdrawal covers a range of physical and psychological symptoms, including, most commonly:
- Muscle aches
- Irregular heart rate
- Abdominal cramps
- Impaired focus and concentration
- Mood swings
- High blood pressure
- Drug cravings
- Suicidal thoughts or behavior
- Night sweats
Can Hydrocodone Withdrawal Kill You?
As we mentioned before, hydrocodone withdrawal itself, while definitely unpleasant, is almost never deadly. However, there is still some danger associated with hydrocodone withdrawal, especially if someone is attempting to detox on their own instead of at a professional medical detox facility.
The first danger someone attempting a home hydrocodone detox is likely to encounter is the possibility of a relapse mid-detox due to the some of the more overpoweringly uncomfortable withdrawal symptoms.
There’s also the increased risk of suicidal behavior and self-harm due to intense mood-related symptoms such as depression. Luckily, under the round the clock monitoring and supervision of a medical professional at a detox center, these dangers can all be easily avoided.
And since one of these symptoms is craving for hydrocodone, someone relapsing and trying to find relief from these cravings is at an extremely high risk of accidentally overdosing, with potentially fatal consequences. There’s also the increased risk of suicidal behavior and self-harm due to intense mood-related symptoms such as depression.
Luckily, under the round the clock monitoring and supervision of a medical professional at a detox center, these dangers can all be easily avoided.
So while hydrocodone withdrawal most likely will not kill you, it is nearly always a better idea to go through the withdrawal process at a medical facility to ensure both your own safety and also a successful detox.
What are the Stages of the Hydrocodone Withdrawal Timeline?
So, as illustrated, while hydrocodone withdrawal is not life-threatening, its symptoms are nonetheless difficult to endure and manage, which is why the question usually first on someone’s mind as they begin their hydrocodone detox is, “How long does hydrocodone withdrawal last?”
Unfortunately, while hydrocodone does follow the established general timeline for opioid withdrawal, everyone’s withdrawal experience is going to be different. This is due to a wide range of factors that can’t be generalized and are unique to a given individual. Some of the factors that will have a significant impact on the length of someone’s hydrocodone withdrawal timeline include:
- How much hydrocodone someone was abusing
- How high a dosage of hydrocodone they were taking and how often
- How they were taking hydrocodone (orally as a tablet or liquid, crushed into a powder and snorted, etc.)
- If the were abusing hydrocodone at the same time as alcohol or other drugs
- If they have a history of previous addictions
- If they have a mental illness or other co-occurring disorders
- If they are detoxing on a tapered schedule
- If they are detoxing with the aid of medical maintenance opioid treatment
It also matters what form of hydrocodone someone has been abusing. While most hydrocodone products such Vicodin, Lorcet, and Norco are immediate-release, meaning that they work very rapidly and therefore have a short half-life, extended-release forms of hydrocodone like Hysingla and Zohydro are meant to last up to 12 hours per dose and therefore take much longer to leave the body.
Keeping in mind how these factors will influence the exact timeline of an individual’s hydrocodone withdrawal, the typical stages of the hydrocodone withdrawal timeline will go at least somewhat as follows:
- 6 to 12 Hours: Hydrocodone and common medications containing hydrocodone have a very short half-life, and so early withdrawal symptoms can begin appearing as soon as six hours after the last dose and usually within 12 hours. However, in extended-release form, it can take anywhere from 24 to 48 hours begin experiencing symptoms of hydrocodone withdrawal.
- One to Three Days: During this period, both the physical and psychological withdrawal symptoms will have manifested and will be reaching their peak intensity. This is when someone undergoing hydrocodone detox will be most vulnerable to having a relapse.
- 7 to 10 Days: Over the course of the next week to 10 days, the symptoms of hydrocodone withdrawal should begin to diminish, with some becoming much weaker and others disappearing completely.
- Two Weeks and Beyond: Once past the two-week mark after someone’s last dose of hydrocodone, they will have reached the end of the withdrawal period and no longer experiencing withdrawal symptoms. However, anxiety, insomnia, and depression are likely to persist for several weeks or even a month after completing a hydrocodone detox.
What Can Help With Hydrocodone Withdrawal?
At a medical detox facility, a doctor can set up a tapering schedule to slowly wean those dependent on hydrocodone down to smaller and smaller dosages through the means of medical maintenance therapy, which also helps to lessen cravings and the amount of general discomfort caused by the symptoms of hydrocodone withdrawal.
These medications provide effects similar to more potent opioids like hydrocodone, but at a significantly weaker level, giving them a much lower potential for abuse and addiction. Some common medication involved in opioid tapering include:
Most frequently used in treating those with heroin dependency, methadone is a tried and true opioid therapy medication, easing cravings while also blocking the high that typically accompanies hydrocodone use. It is important to remember though that methadone use requires very careful monitoring, as it still carries a risk of addiction
Buprenorphine has a lower addiction risk than methadone, because it is only what’s known as a partial opioid. It takes up space in the opioid receptors to decrease cravings while simultaneously blocking hydrocodone out.
This is the name brand medication that is a combination of buprenorphine and an opioid antagonist called naloxone. Naloxone completely blocks the effects of hydrocodone and is typically only used on its own to reverse overdoses. Without buprenorphine, naloxone is too strong for maintenance therapy.
What is the Next Treatment Step?
Once the process of hydrocodone withdrawal is complete and the drug has successfully been flushed from the body, the next treatment step is, ideally, checking into an addiction recovery treatment program.
Choosing to go without at least some form of aftercare or addiction rehabilitation, whether it is on an inpatient or outpatient basis is a certain path to relapsing. In order for someone to properly address and then change the addictive behaviors that led to their dependence on hydrocodone, aftercare treatment is a must.
There are many kinds of recovery treatment programs available including counseling, therapy, support groups, and even sober living communities. What is most important is deciding what treatment will be most effective for maintaining long-term sobriety and then moving on to this next phase of recovery.